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

Publication ,  Journal Article
Choudhury, NA; DeBaun, MR; Rodeghier, M; King, AA; Strouse, JJ; McKinstry, RC
Published in: Neurology
January 16, 2018

OBJECTIVE: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

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Published In

Neurology

DOI

EISSN

1526-632X

Publication Date

January 16, 2018

Volume

90

Issue

3

Start / End Page

e239 / e246

Location

United States

Related Subject Headings

  • Single-Blind Method
  • Neurology & Neurosurgery
  • Magnetic Resonance Imaging
  • Intelligence Tests
  • Intelligence
  • Intellectual Disability
  • Humans
  • Cross-Sectional Studies
  • Child, Preschool
  • Child
 

Citation

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ICMJE
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Choudhury, N. A., DeBaun, M. R., Rodeghier, M., King, A. A., Strouse, J. J., & McKinstry, R. C. (2018). Silent cerebral infarct definitions and full-scale IQ loss in children with sickle cell anemia. Neurology, 90(3), e239–e246. https://doi.org/10.1212/WNL.0000000000004832
Choudhury, Natasha A., Michael R. DeBaun, Mark Rodeghier, Allison A. King, John J. Strouse, and Robert C. McKinstry. “Silent cerebral infarct definitions and full-scale IQ loss in children with sickle cell anemia.Neurology 90, no. 3 (January 16, 2018): e239–46. https://doi.org/10.1212/WNL.0000000000004832.
Choudhury NA, DeBaun MR, Rodeghier M, King AA, Strouse JJ, McKinstry RC. Silent cerebral infarct definitions and full-scale IQ loss in children with sickle cell anemia. Neurology. 2018 Jan 16;90(3):e239–46.
Choudhury, Natasha A., et al. “Silent cerebral infarct definitions and full-scale IQ loss in children with sickle cell anemia.Neurology, vol. 90, no. 3, Jan. 2018, pp. e239–46. Pubmed, doi:10.1212/WNL.0000000000004832.
Choudhury NA, DeBaun MR, Rodeghier M, King AA, Strouse JJ, McKinstry RC. Silent cerebral infarct definitions and full-scale IQ loss in children with sickle cell anemia. Neurology. 2018 Jan 16;90(3):e239–e246.

Published In

Neurology

DOI

EISSN

1526-632X

Publication Date

January 16, 2018

Volume

90

Issue

3

Start / End Page

e239 / e246

Location

United States

Related Subject Headings

  • Single-Blind Method
  • Neurology & Neurosurgery
  • Magnetic Resonance Imaging
  • Intelligence Tests
  • Intelligence
  • Intellectual Disability
  • Humans
  • Cross-Sectional Studies
  • Child, Preschool
  • Child