Related Experiment Video
Updated: Aug 9, 2026
Scanning Dos and Don'ts: Using Magnetic Resonance Imaging in Awake Children Aged 3 to 5 Years to Assess Brain Structure and Function
Published on: March 10, 2026
Radiographic predictors of neurocognitive functioning in pediatric Sickle Cell disease
Mary C Kral1, Ronald T Brown, Mark Connelly
1Department of Pediatrics, Medical University of South Carolina, Charleston, 29425, USA. kralm@musc.edu
Insights
Transcranial Doppler ultrasonography can predict verbal memory deficits in children with sickle cell anemia, even when accounting for age and hematocrit. Abnormalities may indicate subtle neurocognitive impairment.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Neurocognition
Background:
- Sickle cell disease (SCD) is associated with neurocognitive deficits.
- Identifying reliable predictors of neurocognitive impairment in children with SCD is crucial for early intervention.
Purpose of the Study:
- To compare magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), and transcranial Doppler ultrasonography (TCD) as predictors of neurocognitive functions in children with SCD.
- To investigate the association between neuroimaging findings, TCD velocities, and neurocognitive performance.
Main Methods:
- 27 children with sickle cell anemia (hemoglobin SS) without a history of stroke were assessed.
- Neuroimaging included MRI (normal vs. silent infarct) and MRA (normal vs. abnormal).
- TCD measured time-averaged mean flow velocity in cerebral arteries. Neurocognitive tests assessed intellectual functioning, academic achievement, attention, memory, visual-motor integration, and executive functions. Age and hematocrit were also analyzed.
Main Results:
- Age and hematocrit were significant predictors of global and specific neurocognitive functions.
- After controlling for age and hematocrit, TCD was a unique predictor of verbal memory.
- Abnormalities on TCD were associated with subtle neurocognitive deficits.
- Low hemoglobin levels correlated with neurocognitive impairment.
Conclusions:
- TCD can identify children with sickle cell anemia at risk for verbal memory deficits.
- Neuroimaging and TCD findings, particularly TCD abnormalities, may indicate underlying neurocognitive impairment.
- Age and hematocrit are important factors influencing neurocognitive outcomes in pediatric SCD.
Abstract:
We compared magnetic resonance imaging (MRI), magnetic resonance angiography, and transcranial Doppler ultrasonography as predictors of specific neurocognitive functions in children with sickle cell disease. Participants were 27 children with sickle cell anemia (hemoglobin SS) who were participants in the Stroke Prevention Trial in Sickle Cell Anemia (STOP) and had no documented history of stroke. Children's MRIs were classified as normal or silent infarct, and their magnetic resonance angiograms were classified as normal or abnormal. The highest time-averaged mean flow velocity on transcranial Doppler ultrasonographic examination of the major cerebral arteries was analyzed. Age and hematocrit also were analyzed as predictor variables. The battery of neurocognitive tests included measures of intellectual functioning, academic achievement, attention, memory, visual-motor integration, and executive functions. MRI, magnetic resonance angiography, transcranial Doppler ultrasonography, age, and hematocrit were analyzed as predictors of participants' performance on the various measures of neurocognitive functioning. Age and hematocrit were robust predictors of a number of global and specific neurocognitive functions. When age and hematocrit were controlled, transcranial Doppler ultrasonography was a significantly unique predictor of verbal memory. We found an association between low hemoglobin and neurocognitive impairment. We also found that abnormalities on transcranial Doppler ultrasonography can herald subtle neurocognitive deficits. (J Child Neurol 2006;21:37-44).