Association between biological markers of sickle cell disease and cognitive functioning amongst Cameroonian children
Association between biological markers of sickle cell disease and cognitive functioning amongst Cameroonian children
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DOI：
10.1080/09297049.2011.640932
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发表时间：
2013-03-01
影响因子：
2.2
通讯作者：
Sztajzel, R.
中科院分区：
文献类型：
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作者：
Ruffieux, N.;Njamnshi, A. K.;Sztajzel, R.
背景资料：镰状细胞病（SCD）的一些主要并发症发生在大脑中，除了明显的中风外，患者还存在认知障碍。我们试图评估喀麦隆年轻SCD患者认知缺陷的患病率及其生物学预测因素。研究方法：使用神经心理学成套测试评估了雅温得健康受试者的认知功能（执行功能、注意力、记忆力和感觉运动技能）的四个领域，对雅温得SCD年轻患者的认知表现进行了评估。结果：在96例6 ~ 24岁的SCD患者中，高达37.5%（M=13.5，SD=4.9）有轻度至重度认知障碍。认知缺陷往往随着年龄的增长而增加。SCD对执行功能和注意力有显著影响，而SCD患者在记忆和感觉运动技能测试中表现良好。结构方程模型显示：（a）严重贫血与执行功能低下，（B）胎儿血红蛋白水平低与执行功能和注意力低下，（c）脑血管意外史与执行功能、感觉运动技能和记忆力低下，（d）病理性脑电图与注意力低下，（e）经颅多普勒异常与记忆力低下之间存在显著相关性。结论：喀麦隆的SCD患者呈现出非常高的认知缺陷患病率，并伴有执行功能和注意力的特定损害。在资源有限的情况下，如在撒哈拉以南非洲地区，对SCD患者的认知缺陷进行早期检测的常规神经心理学评估可能是一种具有成本效益的工具。
Background: Some of the major complications of sickle cell disease (SCD) occur in the brain and apart from overt stroke, patients also present with cognitive impairments. We sought to evaluate the prevalence of cognitive deficits as well as their biological predicting factors in young SCD patients in Cameroon. Methods: The cognitive performances of Cameroonian SCD young patients were evaluated using a neuropsychological test battery assessing four domains of cognitive functioning (executive functions, attention, memory, and sensory-motor skills) previously adapted and normalized on healthy subjects in Yaounde. Findings: Up to 37.5% of the 96 SCD patients aged 6 to 24 years (M=13.5, SD=4.9) had mild-to-severe cognitive deficits. The cognitive deficits tend to increase with age. There was a significant effect of SCD on executive functions and attention, whereas SCD patients performed as well as controls on memory and sensory-motor skills tests. Structural equation models showed a significant association between (a) severe anemia and lower executive functioning, (b) low fetal hemoglobin levels and lower executive functioning and attention, (c) history of cerebrovascular accidents and lower performances in executive functioning, sensory-motor skills, and memory, (d) pathological electroencephalogram and lower attention, and (e) abnormal Transcranial Doppler and lower memory. Conclusion: SCD patients in Cameroon presented a very high prevalence of cognitive deficits, with a specific impairment of executive functions and attention. Routine neuropsychological evaluation for early detection of cognitive deficits in SCD patients could represent a cost-effective tool to implement in resource-limited contexts such as in sub-Saharan Africa.