Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Ppublish 10 citations
PubMed: 34986673 DOI: 10.1177/0271678X211072391
Venous cerebral blood flow quantification and cognition in patients with sickle cell anemia.
J Cereb Blood Flow Metab 42(6):1061-1077
Authors: Hanne Stotesbury, Patrick W Hales, Melanie Koelbel, Anna M Hood, Jamie M Kawadler, Dawn E Saunders, Sati Sahota, David C Rees, Olu Wilkey, Mark Layton, Maria Pelidis, Baba Pd Inusa, Jo Howard, Subarna Chakravorty, Chris A Clark, Fenella J Kirkham
Affiliations
- Developmental Neurosciences, UCL Great Ormond St. Institute of Child Health, London, UK.
- Division of Psychology and Mental Health, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK.
- Radiology, Great Ormond Hospital for Children NHS Trust, London, UK.
- King's College London, London, UK.
- North Middlesex University Hospital NHS Foundation Trust, London, UK.
- Haematology, Imperial College Healthcare NHS Foundation Trust, London, UK.
Abstract
Prior studies have described high venous signal qualitatively using arterial spin labelling (ASL) in patients with sickle cell anemia (SCA), consistent with arteriovenous shunting. We aimed to quantify the effect and explored cross-sectional associations with arterial oxygen content (CaO), disease-modifying treatments, silent cerebral infarction (SCI), and cognitive performance. 94 patients with SCA and 42 controls underwent cognitive assessment and MRI with single- and multi- inflow time (TI) ASL sequences. Cerebral blood flow (CBF) and bolus arrival time (BAT) were examined across gray and white matter and high-signal regions of the sagittal sinus. Across gray and white matter, increases in CBF and reductions in BAT were observed in association with reduced CaO in patients, irrespective of sequence. Across high-signal sagittal sinus regions, CBF was also increased in association with reduced CaO using both sequences. However, BAT was increased rather than reduced in patients across these regions, with no association with CaO. Using the multiTI sequence in patients, increases in CBF across white matter and high-signal sagittal sinus regions were associated with poorer cognitive performance. These novel findings highlight the utility of multiTI ASL in illuminating, and identifying objectively quantifiable and functionally significant markers of, regional hemodynamic stress in patients with SCA.
MeSH
Hematology, Hemodynamics, Anemia, Sickle Cell, Blood Circulation, Cerebrovascular Circulation, Cells, Cognition
Cited by
- Detectability of white matter cerebral blood flow using arterial spin labeling MRI in patients with sickle cell disease: Relevance of flow territory, bolus arrival time and hematocrit. J Cereb Blood Flow Metab, 2025
- Quantification of Silent Cerebral Infarction on High-Resolution FLAIR and Cognition in Sickle Cell Anemia. Front Neurol, 2022
- Neurocognitive functioning in children with sickle cell anemia and history of abnormal transcranial doppler ultrasonography. Pediatr Blood Cancer, 2022
- Cerebral vascular shunting and oxygen metabolism in sickle cell disease. Blood Adv, 2025
- Quantitative susceptibility mapping (QSM) and R2 of silent cerebral infarcts in sickle cell anemia. Front Neurol, 2022
- Assessment of functional shunting in patients with sickle cell disease. Haematologica, 2022
- Individual Watershed Areas in Sickle Cell Anemia: An Arterial Spin Labeling Study. Front Physiol, 2022