在患有状细胞疾病的儿童中,认知缺陷和功能连接与输血的可逆性
Landon C Power1, Amy E Mirro1, Micahel M Binkley1
1From the Department of Pediatrics (L.C.P., A.E.M., M.M.B., K.P.G., M.E.F.), Center for Biostatistics and Data Science (J.W.), Department of Neurology (K.P.G., J.B.L., A.L.F., J.-M.L., M.E.F.), Mallinckrodt Institute of Radiology (K.P.G., A.L.F., J.S.S., H.A., J.-M.L.), and Department of Biomedical Engineering (J.-M.L.), Washington University School of Medicine, St. Louis, MO.
Neurology
|May 6, 2024
概括
在状细胞疾病 (SCD) 中,红血细胞 (RBC) 输血急剧改善了前双双体网络连接和执行功能. 这表明功能连接MRI可能作为SCD中可逆神经认知损伤的生物标志物.
科学领域:
- 神经科学是一个神经科学.
- 血液学 血液学 血液学
- 放射学 放射学是一门学科.
背景情况:
- 状细胞疾病 (SCD) 构成认知功能障碍的风险,独立于中风.
- SCD的神经后果包括功能连接和白质完整性的减少.
- 已知慢性输血治疗在SCD中具有神经保护作用,可以预防中风并增强执行功能.
研究的目的:
- 测试假设红细胞 (RBC) 输血急性逆转SCD儿童功能连接中障碍的假设.
- 为了确定白质完整性是否受到急性红细胞输血的影响.
- 在SCD中探索功能连接,执行功能和红细胞输血之间的关系.
主要方法:
- 大脑MRI (扩散张力成像和静止状态功能连接) 在RBC输血前后3天内对SCD的儿童进行.
- 使用NIH工具箱进行认知评估后输血和在下一个输血周期之前进行.
- 分析的重点是大规模大脑网络和白质完整度指标中的功能连接的变化.
主要成果:
- 输血后,前侧双叶网络中的功能连接显著加强 (p < 0.001),与改善的执行功能相关 (p = 0.021).
- 没有观察到全球连接或其他测试的大脑网络中的任何显著变化.
- 白质完整性,通过分数异构和平均扩散度来评估,在输血后保持不变.
- 较强的输血前前两侧连接预测了更大的执行功能改善.
结论:
- 红细胞输血导致前额对象网络连接的急性加强,并增强SCD儿童的执行功能.
- 功能连接性MRI显示,它有可能成为SCD中急性可逆神经认知损伤的生物标志物.
- 这些发现支持输血的神经保护作用,并为SCD的新疗法开发提供信息.
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