Neuropsychological Studies of Children With Sickle Cell

This study has been completed.
Sponsor:
Information provided by:
National Heart, Lung, and Blood Institute (NHLBI)
ClinicalTrials.gov Identifier:
NCT00005438
First received: May 25, 2000
Last updated: June 23, 2005
Last verified: November 2001
  Purpose

To identify those factors that contributed to cognitive deficiencies in children with sickle cell disease (SCD) who had not demonstrated any overt or clinically apparent neurological abnormalities.


Condition
Blood Disease
Anemia, Sickle Cell
Neurologic Manifestations

Study Type: Observational
Study Design: Observational Model: Natural History
Time Perspective: Longitudinal

Resource links provided by NLM:


Further study details as provided by National Heart, Lung, and Blood Institute (NHLBI):

Study Start Date: February 1993
Estimated Study Completion Date: January 1998
Detailed Description:

BACKGROUND:

Although there has been evidence for a relationship between sickle cell disease and pathology of the central nervous system since 1923, there has been a tendency in the psychosocial literature to attribute any decreased cognitive performance in children with sickle cell disease to illness-related or demographic factors (e.g., school absenteeism, socioeconomic status) rather than to the disease process of SCD (e.g., chronic microvascular insults to the central nervous system). Cerebral infarction is the most common neurological complication that occurs in children with SCD, but clinically it presents itself in only five to ten percent of children with this chronic illness. The majority of children with SCD are also at high risk of demonstrating learning deficits and poor school performance. Studies suggest that a significant number of children with SCD who do not display any overt symptomatology of neurologic disease often exhibit decreased academic performance in comparison to healthy matched peers. Given the pathophysiology of SCD, it is reasonable to hypothesize that the insidious onset of impaired cognitive functioning is the result of multiple microinfarcts, small hemorrhages, and progressive vascular disease. Therefore, the disease process of SCD could be a primary contributing factor to long-term decreased cognitive performance often demonstrated by the adult SCD population. It is thus critical to examine young children with SCD who do not exhibit gross manifestations of neurological insult in order to determine the cause of these cognitive deficits.

DESIGN NARRATIVE:

A total of 60 infants and toddlers with SCD and 60 matched normally-developing peers between the ages of birth and three years served as subjects in a five-year longitudinal design in order to permit between-group comparisons. Subjects were assessed at regularly scheduled intervals with a variety of developmental (e.g., Bayley), cognitive (e.g., Stanford-Binet), neuropsychological (e.g., Purdue Pegboard), family functioning, and physiological indices in order to delineate those factors in the SCD group that were associated with decreased cognitive and academic performance. A unique and important feature of this research was the inclusion of magnetic resonance imaging technology. These techniques made it possible to study in a comprehensive and componential manner the neuroanatomical effects of SCD instead of relying on any single instrument or assessment to document this phenomenon. Goals of this study included the identification of: (a) specific areas of learning deficiencies in children with SCD; (b) the period in which these deficiencies began to occur; and (c) the relationship between types of learning deficits and various outcome measures. In sum, this study helped to determine how these factors interacted and changed over time as the child with SCD matured, the disease fluctuated, and the family and/or the environmental context changed in relation to cognitive development.

  Eligibility

Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

No eligibility criteria

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

No Contacts or Locations Provided
  More Information

No publications provided

ClinicalTrials.gov Identifier: NCT00005438     History of Changes
Other Study ID Numbers: 4366
Study First Received: May 25, 2000
Last Updated: June 23, 2005
Health Authority: United States: Federal Government

Additional relevant MeSH terms:
Anemia, Sickle Cell
Hematologic Diseases
Neurologic Manifestations
Anemia, Hemolytic, Congenital
Anemia, Hemolytic
Anemia
Hemoglobinopathies
Genetic Diseases, Inborn
Nervous System Diseases
Signs and Symptoms

ClinicalTrials.gov processed this record on October 16, 2014