COGNITION IN CHILDREN WITH SICKLE CELL ANEMIA

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 这项建议的目的是确定除了脑梗死和贫血之外，还有哪些因素会导致镰状细胞性贫血（SCA）儿童的认知缺陷。 研究表明，至少30%的无脑梗死的SCA儿童有明显的认知缺陷。 我们提出了两个相互关联的项目，在前瞻性队列的儿童与SCA探讨贫困，母亲抑郁症和母亲的应对机制与认知功能的关系。 我们计划从无症状脑梗死试验（SIT;一项多中心试验，以确定输血治疗是否降低无症状脑梗死SCA儿童的神经系统发病率）中招募100名儿童，并招募80名MRI显示无梗死的儿童。 所有儿童将在三年内完成两次认知测试。 在第一个项目中，家长将自我报告年度SES措施，我们将记录参与者的学术状况和临床信息。 在第二个项目中，母亲也将被要求完成流行病学研究中心抑郁量表（CES-D）的工具，以确定母亲的情绪状态对儿童的认知的任何影响。 我们将在患有SCA且无脑梗死的儿童中检验两个假设： 主要假设：SES是显著认知缺陷的独立危险因素。 次要假设：母亲抑郁症与儿童认知障碍有关。 本研究完成后，我们希望能够确定无脑梗死的SCA儿童认知能力低下的风险因素，并为提高这一弱势群体认知能力的潜在干预措施提供基础。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The goal of this proposal is to determine what factors other than cerebral infarcts and anemia contribute to cognitive deficits in children with sickle cell anemia (SCA). Research has shown that at least 30% of SCA children without cerebral infarcts have significant cognitive deficits. We propose two interrelated projects in prospective cohorts of children with SCA to explore the relationships of poverty, maternal depression and maternal coping mechanisms with cognitive function. We plan to enroll 100 children from the Silent Cerebral Infarct Trial (SIT; a multi-center trial to determine whether blood transfusion therapy decreases neurologic morbidity in SCA children with silent cerebral infarcts) and 80 children who have no infarct on MRI. All children will complete cognitive testing twice over three years. In the first project, parents will self-report annual SES measures, and we will document academic status and clinical information of the participants. In the second project, mothers will also be asked to complete the Center for Epidemiologic Studies Depression Scale (CES-D) instrument to determine any influence of maternal emotional status on the children's cognition. We will test two hypotheses in children with SCA and no cerebral infarct: Primary Hypothesis: SES is an independent risk factor for significant cognitive deficits. Secondary Hypothesis: Maternal depression is associated with child cognitive impairments. After completion of this study, we hope to be able to determine risk factors for poor cognition in children with SCA without cerebral infarcts and provide the basis for potential interventions to increase cognition in this vulnerable population.