White Matter Damage Relates to Oxygen Saturation in Children With Sickle Cell Anemia Without Silent Cerebral Infarcts
White Matter Damage Relates to Oxygen Saturation in Children With Sickle Cell Anemia Without Silent Cerebral Infarcts
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DOI：
10.1161/strokeaha.115.008721
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发表时间：
2015-07-01
期刊：
影响因子：
8.3
通讯作者：
Clark, Chris A.
中科院分区：
文献类型：
--
作者：
Kawadler, Jamie M.;Kirkham, Fenella J.;Clark, Chris A.
背景和目的镰状细胞性贫血与血红蛋白携氧能力受损以及显性和隐性卒中的高发有关。然而，在没有脑梗死证据的儿童中，相对于健康对照组，脑形态测量学发生了变化，这可能与慢性贫血和氧去饱和有关。方法对25例t2加权磁共振成像未发现异常的镰状细胞性贫血患儿（男性13例，年龄8 ~ 18岁）和14例年龄和种族匹配对照（男性7例，年龄10 ~ 19岁）进行全脑道空间统计分析，确定白质损伤程度。白质损伤与白天外周氧饱和度和稳态血红蛋白有关的假设进行了检验。结果皮质下白质（皮质脊髓束和小脑）的部分各向异性明显较低，而广泛性区域的平均弥散度和径向弥散度较高。径向扩散系数与氧饱和度呈显著负相关
Background and Purpose Sickle cell anemia is associated with compromised oxygen-carrying capability of hemoglobin and a high incidence of overt and silent stroke. However, in children with no evidence of cerebral infarction, there are changes in brain morphometry relative to healthy controls, which may be related to chronic anemia and oxygen desaturation.Methods A whole-brain tract-based spatial statistics analysis was carried out in 25 children with sickle cell anemia with no evidence of abnormality on T2-weighted magnetic resonance imaging (13 male, age range: 8-18 years) and 14 age- and race-matched controls (7 male, age range: 10-19 years) to determine the extent of white matter injury. The hypotheses that white matter damage is related to daytime peripheral oxygen saturation and steady-state hemoglobin were tested.Results Fractional anisotropy was found to be significantly lower in patients in the subcortical white matter (corticospinal tract and cerebellum), whereas mean diffusivity and radial diffusivity were higher in patients in widespread areas. There was a significant negative relationship between radial diffusivity and oxygen saturation (P