Cognitive deficits associated with frontal-lobe infarction in children with sickle cell disease |
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| Authors: | KE Watkins MSc D E M Hewes MRCP A Connelly PhD BE Kendall FRCR D P E Kingsley FRCR J E P Evans FRCP DG Gadian DPhil F Vargha-Khadem PhD FJ Kirkham FRCP |
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| Institution: | Cognitive Neuroscience Unit;Institute of Child Health, University College London Medical School;London, UK;Neurosciences Unit;Institute of Child Health, University College London Medical School;London, UK;Radiology and Physics Unit;Institute of Child Health, University College London Medical School;London, UK;Department of Radiology;Institute of Child Health, University College London Medical School;London, UK;Department of Radiology;Great Ormond Street Hospital for Children NHS Trust;London, UK;Department of Haematology, Queen Elizabeth Hospital for Children, Hackney;London, UK;Radiology and Physics Unit;Institute of Child Health, University College London Medical School;London, UK;Cognitive Neuroscience Unit;Institute of Child Health, University College London Medical School;London, UK;Neurosciences Unit;Institute of Child Health, University College London Medical School;London, UK |
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| Abstract: | This study examined the cognitive manifestations of frontal-lobe infarction in a population of children with sickle cell disease (SCD). Forty-one patients with SCD underwent MRI. Five patients with stroke symptoms had large infarcts encroaching on the tissue of the frontal lobes. Four patients without symptoms had smaller frontal-lobe infarcts. The patients with stroke were significantly impaired on measures of intelligence, memory, and frontal-lobe function (Wisconsin Card Sorting Test, WCST) compared with both the patients with normal MRI scans ( N = 30) and a group of sibling controls ( N = 15), who did not differ from each other. Patients with covert infarction obtained scores on the intelligence tests and the WCST that fell in between those of the stroke patients and the other two groups. This trend toward impairment suggests that patients with covert infarction are at similar risk for cognitive deficits to those with stroke. |
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