White matter has impaired resting oxygen delivery in sickle cell patients

Abstract : Although modern medical management has lowered overt stroke occurrence in patients with sickle cell disease (SCD), progressive white matter (WM) damage remains common. It is known that cerebral blood flow (CBF) increases to compensate for anemia, but sufficiency of cerebral oxygen delivery, especially in the WM, has not been systematically investigated. Cerebral perfusion was measured by arterial spin labeling in 32 SCD patients (age range: 10-42 years old, 14 males, 7 with HbSC, 25 HbSS) and 25 age and race-matched healthy controls (age range: 15-45 years old, 10 males, 12 with HbAS, 13 HbAA); 8/24 SCD patients were receiving regular blood transfusions and 14/24 non-transfused SCD patients were taking hydroxyurea. Imaging data from control subjects were used to calculate maps for CBF and oxygen delivery in SCD patients and their T-score maps. Whole brain CBF was increased in SCD patients with a mean T-score of 0.5 and correlated with lactate dehydrogenase (r2  = 0.58, P < 0.0001). When corrected for oxygen content and arterial saturation, whole brain and gray matter (GM) oxygen delivery were normal in SCD, but WM oxygen delivery was 35% lower than in controls. Age and hematocrit were the strongest predictors for WM CBF and oxygen delivery in patients with SCD. There was spatial co-localization between regions of low oxygen delivery and WM hyperintensities on T2 FLAIR imaging. To conclude, oxygen delivery is preserved in the GM of SCD patients, but is decreased throughout the WM, particularly in areas prone to WM silent strokes.
Complete list of metadatas

Cited literature [58 references]  Display  Hide  Download

https://www.hal.inserm.fr/inserm-02174474
Contributor : Julie Coloigner <>
Submitted on : Friday, July 5, 2019 - 10:11:21 AM
Last modification on : Friday, September 13, 2019 - 9:50:02 AM

File

 Restricted access
To satisfy the distribution rights of the publisher, the document is embargoed until : jamais

Please log in to resquest access to the document

Identifiers

Citation

Yaqiong Chai, Adam Bush, Julie Coloigner, Aart Nederveen, Benita Tamrazi, et al.. White matter has impaired resting oxygen delivery in sickle cell patients. American Journal of Hematology, Wiley, 2019, 94 (4), pp.467-474. ⟨10.1002/ajh.25423⟩. ⟨inserm-02174474⟩

Share

Metrics

Record views

72