EVALUATION OF WHILE MATTER INTEGRITY BY DIFFUSION TENSOR MRI AND NEUROCOGNITIVE FUNCTIONS IN NON-STROKE CHILDREN WITH SICKLE CELL DISEASE
(Abstract release date: 05/19/16)
EHA Library. Ragab I. 06/09/16; 133044; E1495
Assoc. Prof. Iman Ragab
Contributions
Contributions
Abstract
Abstract: E1495
Type: Eposter Presentation
Background
Cerebral vasoocclusion may result in overt or silent infarctions, whether in absence of infarction, it may induce subtle ischemic changes need to be determined. Conventional brain MRI cannot precisely delineate microstructural changes and the white matter tracts of the brain. Diffusion-tensor imaging (DTI ) can detect and quantify microstructural brain changes.
Aims
We aimed to evaluate the ability of multiple diffusion measures to detect subtle changes in the white matter integrity in patients with SCD compared with age and sex matched healthy control subjects; and to correlate the MRI findings with neurocognitive functions.
Methods
We performed a cross-sectional case control study including twenty one patients with SS and Sβ0 with age between 5-15 years. All patients were free from any neurological symptoms with no history of stroke. They were subjected to history taking and revision of hospital records for details of diagnosis including age, hemoglobin electrophoresis, transfusion, hydroxyurea, hospital admission and SCD complications. Diffusion tensor MRI (DTI) were done for all patients and ten age matched healthy control subject. Fractional anisotropy (FA) and apparent diffusion coefficients (ADCs) were calculated in regions of interest selected in various brain areas (superior and inferior frontal, parietal, occipital, and temporal white matter areas), centrum semiovale, basal ganglia (lentiform nucleus), pons, cerebellar white matter areas. Transcranial doppler was done for the patients with assessment of flow velocities in different brain regions. Cognitive assessment was done using the following tests, Wechsler intelligence scale for children for measuring IQ, the Benton visual retention test for visual memory and Wisconsin card sorting test is used as a measure of ‘executive’ or higher-order cognitive functions.
Results
Patients group included 7females (33.3%) and 14 males (66.7%), with mean age of 11.2 ± 3.2 years, weight for age SDS was (-0.029 ± 1.6), height for age SDS (-0.243 ± 1.4) and median age at diagnosis was 18 months. As regards admission etiologies over the last year, 19 patients had vaso-occlusive crises (90.5%), 3 patients had acute chest syndrome(14.3%). Twelve patients were receiving frequent transfusions (57.1%). Patients with SCD had mean full scale IQ, verbal and performance IQ below 90 and there is no significant difference between patients and control group in full scale IQ (P= 0.892), verbal IQ (P= 0.759) and performance IQ (P =1). Concerning executive functions tested by WCST there was no significant difference in all parameters of the tests between patients and control group except for (non preservative errors) (P= 0.045). Regarding MRI DTI there was no significant difference between patients and control group in both FA and ADC in superior and inferior frontal, temporal, parietal, occipital, basal ganglia and cerebellum .No significant difference in FA and ADC results in patients with CBF velocity less and above 70cm/sec.There was positive correlation between difference in errors in BVRT and ADC of right frontal lobe (r = 0.458) and parietal lobe (r = 0.455). While there was negative correlation between ADC of right temporal lobe and FSIQ (r = -0.452), VIQ (r = - 0.518) and positive correlation between FSIQ and FA of left temporal lobe (r = 0.475).
Conclusion
In absence of clinical evidence of cerebral infarction, white matter integrity by MRI DTI and neurocognitive functions in children and adolescents with SCD were preserved compared with healthy control group.
Session topic: E-poster
Keyword(s): MRI, Sickle cell disease
Type: Eposter Presentation
Background
Cerebral vasoocclusion may result in overt or silent infarctions, whether in absence of infarction, it may induce subtle ischemic changes need to be determined. Conventional brain MRI cannot precisely delineate microstructural changes and the white matter tracts of the brain. Diffusion-tensor imaging (DTI ) can detect and quantify microstructural brain changes.
Aims
We aimed to evaluate the ability of multiple diffusion measures to detect subtle changes in the white matter integrity in patients with SCD compared with age and sex matched healthy control subjects; and to correlate the MRI findings with neurocognitive functions.
Methods
We performed a cross-sectional case control study including twenty one patients with SS and Sβ0 with age between 5-15 years. All patients were free from any neurological symptoms with no history of stroke. They were subjected to history taking and revision of hospital records for details of diagnosis including age, hemoglobin electrophoresis, transfusion, hydroxyurea, hospital admission and SCD complications. Diffusion tensor MRI (DTI) were done for all patients and ten age matched healthy control subject. Fractional anisotropy (FA) and apparent diffusion coefficients (ADCs) were calculated in regions of interest selected in various brain areas (superior and inferior frontal, parietal, occipital, and temporal white matter areas), centrum semiovale, basal ganglia (lentiform nucleus), pons, cerebellar white matter areas. Transcranial doppler was done for the patients with assessment of flow velocities in different brain regions. Cognitive assessment was done using the following tests, Wechsler intelligence scale for children for measuring IQ, the Benton visual retention test for visual memory and Wisconsin card sorting test is used as a measure of ‘executive’ or higher-order cognitive functions.
Results
Patients group included 7females (33.3%) and 14 males (66.7%), with mean age of 11.2 ± 3.2 years, weight for age SDS was (-0.029 ± 1.6), height for age SDS (-0.243 ± 1.4) and median age at diagnosis was 18 months. As regards admission etiologies over the last year, 19 patients had vaso-occlusive crises (90.5%), 3 patients had acute chest syndrome(14.3%). Twelve patients were receiving frequent transfusions (57.1%). Patients with SCD had mean full scale IQ, verbal and performance IQ below 90 and there is no significant difference between patients and control group in full scale IQ (P= 0.892), verbal IQ (P= 0.759) and performance IQ (P =1). Concerning executive functions tested by WCST there was no significant difference in all parameters of the tests between patients and control group except for (non preservative errors) (P= 0.045). Regarding MRI DTI there was no significant difference between patients and control group in both FA and ADC in superior and inferior frontal, temporal, parietal, occipital, basal ganglia and cerebellum .No significant difference in FA and ADC results in patients with CBF velocity less and above 70cm/sec.There was positive correlation between difference in errors in BVRT and ADC of right frontal lobe (r = 0.458) and parietal lobe (r = 0.455). While there was negative correlation between ADC of right temporal lobe and FSIQ (r = -0.452), VIQ (r = - 0.518) and positive correlation between FSIQ and FA of left temporal lobe (r = 0.475).
Conclusion
In absence of clinical evidence of cerebral infarction, white matter integrity by MRI DTI and neurocognitive functions in children and adolescents with SCD were preserved compared with healthy control group.
Session topic: E-poster
Keyword(s): MRI, Sickle cell disease
Abstract: E1495
Type: Eposter Presentation
Background
Cerebral vasoocclusion may result in overt or silent infarctions, whether in absence of infarction, it may induce subtle ischemic changes need to be determined. Conventional brain MRI cannot precisely delineate microstructural changes and the white matter tracts of the brain. Diffusion-tensor imaging (DTI ) can detect and quantify microstructural brain changes.
Aims
We aimed to evaluate the ability of multiple diffusion measures to detect subtle changes in the white matter integrity in patients with SCD compared with age and sex matched healthy control subjects; and to correlate the MRI findings with neurocognitive functions.
Methods
We performed a cross-sectional case control study including twenty one patients with SS and Sβ0 with age between 5-15 years. All patients were free from any neurological symptoms with no history of stroke. They were subjected to history taking and revision of hospital records for details of diagnosis including age, hemoglobin electrophoresis, transfusion, hydroxyurea, hospital admission and SCD complications. Diffusion tensor MRI (DTI) were done for all patients and ten age matched healthy control subject. Fractional anisotropy (FA) and apparent diffusion coefficients (ADCs) were calculated in regions of interest selected in various brain areas (superior and inferior frontal, parietal, occipital, and temporal white matter areas), centrum semiovale, basal ganglia (lentiform nucleus), pons, cerebellar white matter areas. Transcranial doppler was done for the patients with assessment of flow velocities in different brain regions. Cognitive assessment was done using the following tests, Wechsler intelligence scale for children for measuring IQ, the Benton visual retention test for visual memory and Wisconsin card sorting test is used as a measure of ‘executive’ or higher-order cognitive functions.
Results
Patients group included 7females (33.3%) and 14 males (66.7%), with mean age of 11.2 ± 3.2 years, weight for age SDS was (-0.029 ± 1.6), height for age SDS (-0.243 ± 1.4) and median age at diagnosis was 18 months. As regards admission etiologies over the last year, 19 patients had vaso-occlusive crises (90.5%), 3 patients had acute chest syndrome(14.3%). Twelve patients were receiving frequent transfusions (57.1%). Patients with SCD had mean full scale IQ, verbal and performance IQ below 90 and there is no significant difference between patients and control group in full scale IQ (P= 0.892), verbal IQ (P= 0.759) and performance IQ (P =1). Concerning executive functions tested by WCST there was no significant difference in all parameters of the tests between patients and control group except for (non preservative errors) (P= 0.045). Regarding MRI DTI there was no significant difference between patients and control group in both FA and ADC in superior and inferior frontal, temporal, parietal, occipital, basal ganglia and cerebellum .No significant difference in FA and ADC results in patients with CBF velocity less and above 70cm/sec.There was positive correlation between difference in errors in BVRT and ADC of right frontal lobe (r = 0.458) and parietal lobe (r = 0.455). While there was negative correlation between ADC of right temporal lobe and FSIQ (r = -0.452), VIQ (r = - 0.518) and positive correlation between FSIQ and FA of left temporal lobe (r = 0.475).
Conclusion
In absence of clinical evidence of cerebral infarction, white matter integrity by MRI DTI and neurocognitive functions in children and adolescents with SCD were preserved compared with healthy control group.
Session topic: E-poster
Keyword(s): MRI, Sickle cell disease
Type: Eposter Presentation
Background
Cerebral vasoocclusion may result in overt or silent infarctions, whether in absence of infarction, it may induce subtle ischemic changes need to be determined. Conventional brain MRI cannot precisely delineate microstructural changes and the white matter tracts of the brain. Diffusion-tensor imaging (DTI ) can detect and quantify microstructural brain changes.
Aims
We aimed to evaluate the ability of multiple diffusion measures to detect subtle changes in the white matter integrity in patients with SCD compared with age and sex matched healthy control subjects; and to correlate the MRI findings with neurocognitive functions.
Methods
We performed a cross-sectional case control study including twenty one patients with SS and Sβ0 with age between 5-15 years. All patients were free from any neurological symptoms with no history of stroke. They were subjected to history taking and revision of hospital records for details of diagnosis including age, hemoglobin electrophoresis, transfusion, hydroxyurea, hospital admission and SCD complications. Diffusion tensor MRI (DTI) were done for all patients and ten age matched healthy control subject. Fractional anisotropy (FA) and apparent diffusion coefficients (ADCs) were calculated in regions of interest selected in various brain areas (superior and inferior frontal, parietal, occipital, and temporal white matter areas), centrum semiovale, basal ganglia (lentiform nucleus), pons, cerebellar white matter areas. Transcranial doppler was done for the patients with assessment of flow velocities in different brain regions. Cognitive assessment was done using the following tests, Wechsler intelligence scale for children for measuring IQ, the Benton visual retention test for visual memory and Wisconsin card sorting test is used as a measure of ‘executive’ or higher-order cognitive functions.
Results
Patients group included 7females (33.3%) and 14 males (66.7%), with mean age of 11.2 ± 3.2 years, weight for age SDS was (-0.029 ± 1.6), height for age SDS (-0.243 ± 1.4) and median age at diagnosis was 18 months. As regards admission etiologies over the last year, 19 patients had vaso-occlusive crises (90.5%), 3 patients had acute chest syndrome(14.3%). Twelve patients were receiving frequent transfusions (57.1%). Patients with SCD had mean full scale IQ, verbal and performance IQ below 90 and there is no significant difference between patients and control group in full scale IQ (P= 0.892), verbal IQ (P= 0.759) and performance IQ (P =1). Concerning executive functions tested by WCST there was no significant difference in all parameters of the tests between patients and control group except for (non preservative errors) (P= 0.045). Regarding MRI DTI there was no significant difference between patients and control group in both FA and ADC in superior and inferior frontal, temporal, parietal, occipital, basal ganglia and cerebellum .No significant difference in FA and ADC results in patients with CBF velocity less and above 70cm/sec.There was positive correlation between difference in errors in BVRT and ADC of right frontal lobe (r = 0.458) and parietal lobe (r = 0.455). While there was negative correlation between ADC of right temporal lobe and FSIQ (r = -0.452), VIQ (r = - 0.518) and positive correlation between FSIQ and FA of left temporal lobe (r = 0.475).
Conclusion
In absence of clinical evidence of cerebral infarction, white matter integrity by MRI DTI and neurocognitive functions in children and adolescents with SCD were preserved compared with healthy control group.
Session topic: E-poster
Keyword(s): MRI, Sickle cell disease
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