The Development of Neuroimaging Biomarkers for Cognitive Decline in Sickle Cell Disease

Neuroimaging and Cognitive Function in Sickle Cell Disease: A Systematic Review

“…As with other reviews of retrospectively published findings, the results may be biased as significant correlations are more likely to be reported than non-significant relationships [ 81 ]. Another limitation of this review is the exclusion of other MRI measures, including cerebral blood flow and oxygen extraction fraction (OEF), and their relationship with cognitive function, recently reviewed by Ramos et al [ 27 ]. Lastly, although articles used standardised neuropsychological assessments, they differed significantly, making direct comparisons challenging.…”

“…Similarly, a previous meta-analysis concluded that children with SCD without MRI abnormalities were at risk of cognitive difficulties [ 24 ]. Prussien et al found participants with SCD, including those without SCI or overt strokes, showed significant impairments in attention, FSIQ, executive function, and verbal reasoning [ 26 ], positing that anaemia and altered cerebral haemodynamics [ 27 ] impact neurological functioning [ 28 ].…”

Role of Traditional Stroke Risk Factors Aiding in Prediction of Infarcts in Adult Patients With Sickle Cell Disease

“…The neuroanatomical changes arising under those conditions in the brain may give rise to cognitive deficits that are likely attributed to chronic cerebral hypoxemia and neuroinflammation. 10 , 11 , 12 The major contributors to SCD‐related neurological complications include the polymerization of hemoglobin S, which leads to RBC distortion and subsequent vaso‐occlusion. This phenomenon results in ischemia, infarctions, and chronic hemolytic anemia.…”

“…Assessing oxygen stress and oxygen extraction fraction 17 using the proteomics and molecular approaches targeting urinary exosomes 18 to identify potential biomarker(s) of cerebral metabolic stress in SCD has been recently explored. In addition to developing neuroimaging biomarkers for the cognitive decline in patients with SCD, 12 other studies have considered using blood biomarkers such as the NfL (neurofilament light chain), a central nervous system neuron‐specific protein, to detect the cerebrovascular disorder in children with SCD in populations with limited access to the advanced imaging tools such as magnetic resonance imaging. Elevated NfL has been reported to strongly associate with infarcts confirmed with magnetic resonance imaging.…”