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Cerebral Hemodynamics and Executive Function in Sickle Cell Anemia.

Kemar V Prussien1,2,3,4, Bruce E Compas1,2,3,4, Rachel E Siciliano1,2,3,4

  • 1Department of Psychology and Human Development, Vanderbilt University, Nashville, TN (K.V.P., B.E.C., R.E.S., A.E.C.).

Stroke
|April 12, 2021
PubMed
Summary

Sickle cell anemia is linked to cognitive issues. Higher cerebral blood flow and oxygen extraction fraction correlate with poorer executive function in patients.

Keywords:
anemiabloodexecutive functionhemodynamicsoxygensickle cell

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Area of Science:

  • Neurology
  • Hematology
  • Cognitive Neuroscience

Background:

  • Sickle cell anemia (SCA) patients often exhibit cognitive deficits, independent of overt cerebrovascular events.
  • Understanding the underlying mechanisms of these deficits is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the association between hemodynamic markers and executive function in individuals with SCA.
  • To test the hypothesis that elevated cerebral blood flow (CBF) and oxygen extraction fraction (OEF) are linked to reduced executive function.

Main Methods:

  • Utilized 3-Tesla brain MRI to assess anatomic structure, gray matter CBF, and global OEF.
  • Executive function was evaluated using the working memory index (Wechsler battery) and NIH Toolbox Cognition Battery tasks.
  • Statistical analyses included bivariate and multivariate models, controlling for covariates.

Main Results:

  • In 54 SCA participants (ages 6-31), higher CBF correlated with lower working memory and inhibitory control.
  • Elevated OEF was associated with slower processing speed.
  • Hematocrit showed a positive relationship with fluid cognition.

Conclusions:

  • Hemodynamic impairments, indicated by elevated CBF and OEF, are associated with executive function deficits in sickle cell anemia.
  • These findings highlight potential neurovascular mechanisms contributing to cognitive impairment in SCA.