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Assessment of Cerebral Lateralization in Children using Functional Transcranial Doppler Ultrasound fTCD
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Cerebral Vasoreactivity in Children with Sickle Cell Disease: A Transcranial Doppler Study

Rejane de Souza Macedo-Campos1, Samuel Ademola Adegoke2, Maria Stella Figueiredo3

  • 1Disciplina de Neurologia Clínica, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|July 28, 2018
PubMed

Insights

Children with sickle cell disease (SCD) show impaired cerebral vasoreactivity. This study found lower breath-holding index (BHI) values in pediatric SCD patients, indicating reduced cerebrovascular autoregulation capacity.

Area of Science:

  • Pediatric Neurology
  • Vascular Biology
  • Hematology

Background:

  • Reduced vasodilatory capacity and cerebrovascular reserve are observed in adults with sickle cell disease (SCD), potentially contributing to stroke.
  • This study investigates whether children with SCD also exhibit impaired cerebral vasoreactivity compared to healthy controls.

Purpose of the Study:

  • To determine the frequency of impaired cerebral vasoreactivity in children with SCD.
  • To compare cerebral vasoreactivity between children with SCD and healthy controls.

Main Methods:

  • Transcranial Doppler (TCD) ultrasonography with a breath-holding maneuver was used in 42 SCD patients (ages 10-18) and 20 healthy controls.
  • The Breath-holding Index (BHI) was calculated by correlating the percentage increase in mean flow velocity during breath-holding with the breath-hold duration.
  • An abnormal BHI was defined as a value less than 0.69.

Main Results:

  • Patients with SCD exhibited significantly higher blood flow velocities in all evaluated arteries compared to controls (P < .001).
  • SCD patients had significantly lower BHI values on both the left (1.27 ± 0.65 vs. 1.74 ± 0.15) and right (1.16 ± 0.45 vs. 1.61 ± 0.11) sides (P = .013 and P = .002, respectively).
  • Abnormal BHI values were found in 19% of SCD patients, compared to none of the controls (P = .036).

Conclusions:

  • Children with SCD demonstrate impaired cerebral vasoreactivity.
  • Lower BHI values in pediatric SCD patients suggest a compromised cerebral autoregulation capacity.
  • These findings highlight a potential risk factor for cerebrovascular events in children with SCD.
Abstract

Keywords:
Breath-holding indexcerebral vasoreactivitychildrensickle cell diseasetranscranial Doppler

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