Tract specific analysis in patients with sickle cell disease

Area of Science:

• Neurology
• Hematology
• Medical Imaging

Background:

• Sickle cell disease (SCD) is an inherited blood disorder affecting hemoglobin, leading to reduced lifespan, pain, anemia, infections, and neurocognitive decline.
• White matter (WM) alterations in the brain are increasingly recognized as a complication of SCD.
• Understanding these WM changes is crucial for managing SCD-related neurocognitive impairments.

Purpose of the Study:

• To investigate, for the first time, white matter (WM) tract alterations in sickle cell disease (SCD) patients using Tract-Specific Analysis (TSA).
• To compare WM integrity across 11 major brain tracts between SCD patients and healthy controls.
• To explore the potential relationship between observed WM alterations and neurocognitive deficits in SCD.

Main Methods:

• Diffusion tensor magnetic resonance imaging (dMRI) was utilized to acquire brain imaging data.
• Tract-Specific Analysis (TSA), a statistical method, was employed to evaluate white matter integrity.
• A cohort of SCD patients was compared with age-matched healthy subjects.

Main Results:

• Significant alterations in white matter integrity were identified in multiple major brain tracts.
• Affected tracts include the corpus callosum (CC), cortico-spinal tract (CST), inferior fronto-occipital fasciculus (IFO), inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus (SLF), and uncinated fasciculus (UNC).
• These findings represent the first application of TSA to assess WM changes in SCD.

Conclusions:

• Tract-Specific Analysis successfully identified significant white matter alterations in SCD patients.
• The observed changes in specific brain tracts may underlie the neurocognitive impairments and depression commonly seen in individuals with SCD.
• This study highlights the utility of TSA in characterizing the neurological impact of sickle cell disease.