Description
Title: Children with Sickle Cell Disease: Laboratory Biomarkers, Cerebral Blood Flow Velocity, and Intellectual Function
Abstract: A young sample of neurologically healthy children with SCD was used in this preliminary study to describe putative markers of cerebral vasculopathy and explore the relationships between these markers, demographic factors, and cognitive function. Study Plan. There were 138 children with homozygous HbS, ranging in age from 4 to 11 years. Transcranial Doppler velocities, hydroxyurea use, estimated IQ, markers of coagulation and endothelial activation, hemolysis, and inflammation, as well as demographic data, were gathered. Results. Few significant independent associations between biomarkers or blood flow velocity and estimated IQ were found using multiple regression analyses. Although blood flow velocity did not act as a mediator in this relationship, lactic dehydrogenase (LDH) independently predicted cognitive function. Age of the patient, maternal education, and hydroxyurea status all independently predicted cognition. In order to further identify potential IQ predictors given the small sample size, a LASSO statistical model was used. This model identified LDH, absolute neutrophil count (ANC), platelet count, thrombin-antithrombin (TAT), tissue factor (TF), maternal education, age, and hydroxyurea as potential predictors of cognition. Conclusions. Some vasculopathic markers are related to cognitive function in young children with SCD, and these relationships do not seem to be mediated by blood flow velocity, in addition to the effects of age and maternal education. The results support further investigation into the impact of vasculopathic markers on cognitive function in children with SCD without stroke, particularly intravascular hemolysis and coagulation/endothelial activation, and a potential role for HU treatment in preventing or reversing cognitive decline, even though the lack of association among some variables was not as predicted.
Paper Quality: SCOPUS / Web of Science Level Research Paper
Subject: Medicine
Sub Category: Hematology
Writer Experience: 20+ Years
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