Cognition and the Default Mode Network in Children with Sickle Cell Disease: A Resting State Functional MRI Study.
Cognition and the Default Mode Network in Children with Sickle Cell Disease: A Resting State Functional MRI Study.
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DOI：
10.1371/journal.pone.0157090
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Sainati L
中科院分区：
文献类型：
--
作者：
Colombatti R;Lucchetta M;Montanaro M;Rampazzo P;Ermani M;Talenti G;Baracchini C;Favero A;Basso G;Manara R;Sainati L
脑血管并发症是镰状细胞病儿童的常见事件，但常规使用的技术，如经颅多普勒（TCD），磁共振（MRI）和血管造影（MRA），不足以解释认知能力差的原因。对40例SS-S β°患儿（平均年龄8岁）进行了神经认知功能评价，并进行了TCD、MRI、MRA、静息状态（RS）功能MRI和默认模式网络（DMN）的综合脑成像评估。16名年龄匹配的健康对照者接受了MRI、MRA和RS功能性MRI。即使在标准成像技术没有改变的情况下，SCD儿童的DMN也显示出大脑连接性增加。与无认知障碍或对照组的儿童相比，神经认知评分低的患者表现出更高的大脑连通性，这表明最初的代偿机制可以维持表现。在我们的队列中，稳态血红蛋白水平与大脑连接性增加无关，但血氧饱和度<97%与此相关。我们的研究结果提供了新的证据表明，SCD的特点是选择性破坏大脑相关区域之间的连接，可能导致认知能力降低和功能性脑动力学改变。RS功能磁共振成像可以作为一个有用的工具，以评估认知和脑损害的SCD在纵向试验。
Cerebrovascular complications are frequent events in children with sickle cell disease, yet routinely used techniques such as Transcranial Doppler (TCD), Magnetic Resonance (MRI) and Angiography (MRA), insufficiently explain the cause of poor cognitive performances. Forty children with SS-Sβ° (mean age 8 years) underwent neurocognitive evaluation and comprehensive brain imaging assessment with TCD, MRI, MRA, Resting State (RS) Functional MRI with evaluation of the Default Mode Network (DMN). Sixteen healthy age-matched controls underwent MRI, MRA and RS functional MRI.Children with SCD display increased brain connectivity in the DMN even in the absence of alterations in standard imaging techniques. Patients with low neurocognitive scores presented higher brain connectivity compared to children without cognitive impairment or controls, suggesting an initial compensatory mechanism to maintain performances. In our cohort steady state haemoglobin level was not related to increased brain connectivity, but SatO2<97% was. Our findings provide novel evidence that SCD is characterized by a selective disruption of connectivity among relevant regions of the brain, potentially leading to reduced cognition and altered functional brain dynamics. RS functional MRI could be used as a useful tool to evaluate cognition and cerebral damage in SCD in longitudinal trials.