TY - JOUR
T1 - Cognitive screening examinations for silent cerebral infarcts in sickle cell disease
AU - DeBaun, Michael R.
AU - Schatz, J.
AU - Siegel, M. J.
AU - Koby, M.
AU - Craft, S.
AU - Resar, L.
AU - Chu, J. Y.
AU - Launius, G.
AU - Dadash-Zadeh, M.
AU - Lee, R. B.
AU - Noetzel, M.
PY - 1998/6
Y1 - 1998/6
N2 - Objective: In children with sickle cell disease (SCD), silent cerebral infarcts are the most frequent cause of neurologic injury. We determined the sensitivity and specificity of selective neurocognitive measures when separating children with silent cerebral infarcts and SCD from sibling controls. Additionally, we tested the validity of the same cognitive measures to identify patients with overt strokes. Methods: We examined performance on a neuropscychologic battery containing measures of attention/executive, spatial, language, memory, and motor functioning for seven children with SCD and silent cerebral infarct, 21 children with SCD and overt stroke, and 17 normal siblings. Diagnosis of cerebral infarct was based on results of MRI. Results: Measures from the attention and executive domains were the most useful for identifying children with silent cerebral infarct. The Test of Variables of Attention was the most robust measure and yielded a sensitivity rate of 86% and a specificity rate of 81%. This measure also showed a sensitivity rate of 95% in identifying overt stroke. Conclusions: Brief cognitive screening measures, if properly constructed, may be an effective means of identifying children with silent cerebral infarct. Future prospective studies should be pursued to assess the utility of cognitive screening for silent cerebral infarcts in SCD.
AB - Objective: In children with sickle cell disease (SCD), silent cerebral infarcts are the most frequent cause of neurologic injury. We determined the sensitivity and specificity of selective neurocognitive measures when separating children with silent cerebral infarcts and SCD from sibling controls. Additionally, we tested the validity of the same cognitive measures to identify patients with overt strokes. Methods: We examined performance on a neuropscychologic battery containing measures of attention/executive, spatial, language, memory, and motor functioning for seven children with SCD and silent cerebral infarct, 21 children with SCD and overt stroke, and 17 normal siblings. Diagnosis of cerebral infarct was based on results of MRI. Results: Measures from the attention and executive domains were the most useful for identifying children with silent cerebral infarct. The Test of Variables of Attention was the most robust measure and yielded a sensitivity rate of 86% and a specificity rate of 81%. This measure also showed a sensitivity rate of 95% in identifying overt stroke. Conclusions: Brief cognitive screening measures, if properly constructed, may be an effective means of identifying children with silent cerebral infarct. Future prospective studies should be pursued to assess the utility of cognitive screening for silent cerebral infarcts in SCD.
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U2 - 10.1212/WNL.50.6.1678
DO - 10.1212/WNL.50.6.1678
M3 - Article
C2 - 9633710
AN - SCOPUS:0031775847
SN - 0028-3878
VL - 50
SP - 1678
EP - 1682
JO - Neurology
JF - Neurology
IS - 6
ER -