COGNITION IN CHILDREN WITH SICKLE CELL ANEMIA

这个子项目是众多研究子项目之一

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.