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Cognitive functions in adults with β-thalassemia major: before and after blood transfusion and comparison with
Sivan Raz1,2, Ariel Koren3,4, Orrie Dan1
1Department of Behavioral Sciences, The Center for Psychobiological Research, The Max Stern Yezreel Valley College, Israel.
Insights
Adults with beta-thalassemia major (β-TM) experience cognitive deficits, particularly in performance intelligence (IQ) and attention. Blood transfusions significantly improve attention, highlighting the need for neurocognitive monitoring in β-TM care.
Area of Science:
- Neuroscience
- Hematology
- Psychology
Background:
- Physiological complications of beta-thalassemia major (β-TM) are known.
- Neuropsychological and cognitive implications in adult β-TM patients are understudied.
- Existing research primarily focuses on pediatric populations.
Purpose of the Study:
- To evaluate cognitive function in adult β-TM patients compared to controls.
- To assess the impact of blood transfusions on cognitive function in β-TM patients.
Main Methods:
- Performance intelligence quotient (IQ) assessed using Wechsler Adult Intelligence Scale (WAIS-III) subtests.
- Attention functions evaluated via online continuous performance test (OCPT).
- Two studies conducted: β-TM patients vs. controls, and β-TM patients pre/post-transfusion.
Main Results:
- β-TM patients showed poorer performance on three WAIS-III subtests and lower total performance IQ.
- Abnormal performance IQ (<85) was five times higher in β-TM patients (58%) versus controls (12%).
- OCPT revealed improved attention post-transfusion, with fewer errors and faster, more consistent response times.
Conclusions:
- Adult β-TM patients exhibit significant neurocognitive deficits.
- Blood transfusions positively impact attention in β-TM patients.
- Neurocognitive assessment and management are crucial for improving quality of life in the growing β-TM population.
Abstract:
While β-thalassemia major (β-TM)-related physiological complications have been well established, less is known about implications for neuropsychological and cognitive function. The few existing studies have focused almost exclusively on children. We evaluated cognitive function in adult β-TM patients compared to healthy controls (study 1) and in β-TM patients before and after blood transfusion (study 2). Performance intelligence quotient (IQ) was evaluated with four subtests from the Wechsler Adult Intelligence Scale (WAIS-III). Attention functions were evaluated using the online continuous performance test (OCPT). The results of study 1 revealed poorer performance of β-TM patients on three of the four intelligence subtests, with significantly lower total performance IQ scores compared with controls. The percentage of participants with abnormal performance IQ (<85) was almost five times higher in the β-TM group (58%) than in the control group (12%). In study 2, significant differences were found in OCPT performance as a function of blood transfusion. Before transfusion, patients had higher rates of omission and commission errors, slower response times (RTs), and lower RT consistency than after transfusion. As β-TM patients' life expectancy is increasing, assessment and treatment of neurocognitive functions should become an integral part of appropriate follow-up to improve patients' quality of life.
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