+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Silent cerebral infarct definitions and full-scale IQ loss in children with sickle cell anemia



Silent cerebral infarct definitions and full-scale IQ loss in children with sickle cell anemia



Neurology 90(3): E239-E246



To evaluate whether application of the adult definition of silent cerebral infarct (SCI) (T2-weighted hyperintensity ≥5 mm with corresponding T1-weighted hypointensity on MRI) is associated with full-scale IQ (FSIQ) loss in children with sickle cell anemia (SCA), and if so, whether this loss is greater than that of the reference pediatric definition of SCI (T2-weighted hyperintensity ≥3 mm in children on MRI; change in FSIQ -5.2 points; p = 0.017; 95% confidence interval [CI] -9.48 to -0.93). Among children with SCA screened for SCI in the Silent Cerebral Infarct Transfusion trial, ages 5-14 years, a total of 150 participants (107 with SCIs and 43 without SCIs) were administered the Wechsler Abbreviated Scale of Intelligence. A multivariable linear regression was used to model FSIQ in this population, with varying definitions of SCI independently substituted for the SCI covariate. The adult definition of SCI applied to 27% of the pediatric participants with SCIs and was not associated with a statistically significant change in FSIQ (unstandardized coefficient -3.9 points; p = 0.114; 95% CI -8.75 to 0.95), with predicted mean FSIQ of 92.1 and 96.0, respectively, for those with and without the adult definition of SCI. The adult definition of SCI may be too restrictive and was not associated with significant FSIQ decline in children with SCA. Based on these findings, we find no utility in applying the adult definition of SCI to children with SCA and recommend maintaining the current pediatric definition of SCI in this population.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 065513482

Download citation: RISBibTeXText

PMID: 29263226

DOI: 10.1212/wnl.0000000000004832


Related references

Factors associated with growth and blood pressure patterns in children with sickle cell anemia: Silent Cerebral Infarct Multi-Center Clinical Trial cohort. American Journal of Hematology 90(1): 2-7, 2015

Silent cerebral infarct in patients with sickle cell anemia. Revista de Neurologia 35(8): 716-719, 2002

Natural history of silent infarct in children with sickle cell anemia. Blood 94(10 Suppl. 1 Part 1): 419a, 1999

Thrombospondin-1 and L-selectin are associated with silent cerebral infarct in children with sickle cell anaemia. British Journal of Haematology 162(3): 421-424, 2013

Silent Cerebral Infarcts in Children With Sickle Cell Anemia. Aap Grand Rounds 27(3): 28-28, 2012

Acute silent cerebral infarction in children with sickle cell anemia. Pediatric Blood and Cancer 54(3): 461-464, 2010

Silent infarct is a risk factor for infarct recurrence in adults with sickle cell anemia. Neurology 91(8): E781-E784, 2018

Acute silent cerebral ischemic events in children with sickle cell anemia. JAMA Neurology 70(1): 58-65, 2013

Silent infarcts in children with sickle cell anemia and abnormal cerebral artery velocity. Archives of Neurology 58(12): 2017-2021, 2001

Proteomic analysis of plasma from children with sickle cell anemia and silent cerebral infarction. Haematologica 103(7): 1136-1142, 2018

Sickle cell anemia: intracranial stenosis and silent cerebral infarcts in children with low risk of stroke. Advances in Medical Sciences 59(1): 108-113, 2014

Low socioeconomic status, not silent cerebral infarcts, is associated with grade failure in children with sickle cell anemia. 2007

Prevalence of intracranial stenosis and silent cerebral infarcts in children with sickle cell anemia and low risk of stroke. International Journal of Stroke 8(7): E50-E51, 2013

Intracranial vasculopathy and infarct recurrence in children with sickle cell anaemia, silent cerebral infarcts and normal transcranial Doppler velocities. British Journal of Haematology 183(2): 324-326, 2018

White Matter Damage Relates to Oxygen Saturation in Children With Sickle Cell Anemia Without Silent Cerebral Infarcts. Stroke 46(7): 1793-1799, 2015