Venous cerebral blood flow quantification and cognition in patients with sickle cell anemia
Venous cerebral blood flow quantification and cognition in patients with sickle cell anemia
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
2), 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
2 in patients, irrespective of sequence. Across high-signal sagittal sinus regions, CBF was also increased in association with reduced CaO
2 using both sequences. However, BAT was increased rather than reduced in patients across these regions, with no association with CaO
2. 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.
Cerebrovascular disease, MRI, cognition, hematology, hemodynamics
1061-1077
Stotesbury, Hanne
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Hales, Patrick W.
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Koelbel, Melanie
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Hood, Anna M.
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Kawadler, Jamie M.
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Saunders, Dawn E.
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Sahota, Sati
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Rees, David C.
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Wilkey, Olu
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Layton, Mark
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Pelidis, Maria
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Inusa, Baba P. D.
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Howard, Jo
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Chakravorty, Subarna
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Clark, Chris A.
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Kirkham, Fenella J.
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6 June 2022
Stotesbury, Hanne
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Hales, Patrick W.
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Koelbel, Melanie
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Hood, Anna M.
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Kawadler, Jamie M.
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Saunders, Dawn E.
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Sahota, Sati
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Rees, David C.
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Wilkey, Olu
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Layton, Mark
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Pelidis, Maria
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Inusa, Baba P. D.
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Howard, Jo
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Chakravorty, Subarna
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Clark, Chris A.
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Kirkham, Fenella J.
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Stotesbury, Hanne, Hales, Patrick W., Koelbel, Melanie, Hood, Anna M., Kawadler, Jamie M., Saunders, Dawn E., Sahota, Sati, Rees, David C., Wilkey, Olu, Layton, Mark, Pelidis, Maria, Inusa, Baba P. D., Howard, Jo, Chakravorty, Subarna, Clark, Chris A. and Kirkham, Fenella J.
(2022)
Venous cerebral blood flow quantification and cognition in patients with sickle cell anemia.
Journal of Cerebral Blood Flow & Metabolism, 42 (6), .
(doi:10.1177/0271678X211072391).
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
2), 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
2 in patients, irrespective of sequence. Across high-signal sagittal sinus regions, CBF was also increased in association with reduced CaO
2 using both sequences. However, BAT was increased rather than reduced in patients across these regions, with no association with CaO
2. 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.
Text
0271678x211072391
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Accepted/In Press date: 9 December 2021
Published date: 6 June 2022
Additional Information:
Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Hanne Stotesbury was funded by Action Medical Research (GN2509) and Jamie Kawadler by Great Ormond Street Children’s Charity (V4615). Anna Hood was supported by an NIH grant (1F32HL143915). Patrick Hales was funded by Children with Cancer UK (CwCUK-15-203). The National Institute for Health Research (PB-PG-1112-29099) and NIH (R01HL079937) provided funding for patient recruitment. The work was supported by the National Institute for Health Research Biomedical Research Centre (IS-BRC-1215-20012) at Great Ormond Street Hospital for Children NHS Foundation Trust and University College London. Acknowledgements
Funding Information:
The authors thank the patients and controls who participated in this research and their families and the research radiographers The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Hanne Stotesbury was funded by Action Medical Research (GN2509) and Jamie Kawadler by Great Ormond Street Children’s Charity (V4615). Anna Hood was supported by an NIH grant (1F32HL143915). Patrick Hales was funded by Children with Cancer UK (CwCUK-15-203). The National Institute for Health Research (PB-PG-1112-29099) and NIH (R01HL079937) provided funding for patient recruitment. The work was supported by the National Institute for Health Research Biomedical Research Centre (IS-BRC-1215-20012) at Great Ormond Street Hospital for Children NHS Foundation Trust and University College London.
Publisher Copyright:
© The Author(s) 2022.
Keywords:
Cerebrovascular disease, MRI, cognition, hematology, hemodynamics
Identifiers
Local EPrints ID: 470219
URI: http://eprints.soton.ac.uk/id/eprint/470219
ISSN: 0271-678X
PURE UUID: f084f601-cd63-44a0-a2d8-cf260d3d1a4f
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Date deposited: 04 Oct 2022 16:50
Last modified: 17 Mar 2024 02:53
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Contributors
Author:
Hanne Stotesbury
Author:
Patrick W. Hales
Author:
Melanie Koelbel
Author:
Anna M. Hood
Author:
Jamie M. Kawadler
Author:
Dawn E. Saunders
Author:
Sati Sahota
Author:
David C. Rees
Author:
Olu Wilkey
Author:
Mark Layton
Author:
Maria Pelidis
Author:
Baba P. D. Inusa
Author:
Jo Howard
Author:
Subarna Chakravorty
Author:
Chris A. Clark
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