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Regionally specific cortical thinning in children with sickle cell disease
Gregory R Kirk1, M Ryan Haynes, Susan Palasis
1Department of Radiology, Children's Healthcare of Atlanta, 1001 Johnson Ferry Road, Atlanta, GA 30342, USA.
Insights
Sickle cell disease (SCD) can cause subtle brain changes. This study found reduced cortical thickness in children with SCD, indicating potential silent neurological damage.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Sickle cell disease (SCD) is a chronic condition associated with neurological complications.
- Children with SCD often experience neurological issues early in life.
- Conventional MRI/MRA may not detect these subtle brain changes.
Purpose of the Study:
- To investigate cortical thickness differences in children with SCD.
- To identify if cortical thinning is present even without detectable MRI/MRA abnormalities.
- To explore age-dependent variations in cortical thinning in pediatric SCD.
Main Methods:
- Retrospective analysis of cortical thickness in children with SCD and age-matched healthy controls.
- Comparison of cortical thickness between SCD patients (n=28) and controls (n=29) across two age groups (5-11 and 12-21 years).
- Utilized multiparametric linear regression analysis on defined regions of interest (ROIs) in areas of significant thinning.
Main Results:
- Children with SCD showed distinct regions of cortical thinning compared to controls.
- Cortical thinning was more pronounced in older children with SCD (12-21 years) in terms of number, extent, and significance (P < 0.001).
- Significant thinning (P < 0.001) was observed in the precuneus and posterior cingulate regions in SCD subjects.
Conclusions:
- Regional cortical thinning may serve as a biomarker for subclinical brain injury in pediatric SCD.
- Cortical thickness measurements could help identify children with SCD at risk for neurological sequelae.
- This approach may reveal silent neurological insults not detected by standard imaging techniques.
Abstract:
Sickle cell disease (SCD) is a chronic disease with a significant rate of neurological complications in the first decade of life. In this retrospective study, cortical thickness was examined in children with SCD who had no detectable abnormalities on conventional magnetic resonance imaging/magnetic resonance angiography. Regional differences in cortical thickness from SCD were explored using age-matched healthy controls as comparison. A comparison analysis was done for SCD (n = 28) and controls (n = 29) based on age (5-11; 12-21 years), due to the age-dependent variation in cortex maturation. Distinct regions of thinning were found in SCD patients in both age groups. The number, spatial extent, and significance (P < 0.001) of these areas of thinning were increased in the older SCD group. Regions of interest (ROIs) were defined on the areas of highly significant thinning in the older group and then mapped onto the younger cohort; a multiparametric linear regression analysis of the ROI data demonstrated significant (P < 0.001) cortical thinning in SCD subjects, with the largest regions of thinning in the precuneus and the posterior cingulate. The regionally specific differences suggest that cortical thickness may serve as a marker for silent insults in SCD and hence may be a useful tool for identifying SCD patients at risk for neurological sequelae.
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