PDF(Pubmed)
Abstract：
Children with sickle cell disease (SCD) may experience cognitive difficulties, including slowed processing speed. Thus, we investigated if processing speed changes over time. From 1992-2001, 103 participants with SCD aged 3-16 years (n ≤ 8.99 = 45; n ≥ 9.00 = 58) completed cognitive assessments. MRI was available for 54 participants. Between 1992-2002, 58 participants consented to one or two further assessments. A repeated measures regression using linear mixed-effects modelling determined longitudinal changes in processing speed index (PSI), examining the interaction between age (continuous variable) and timepoint (i.e., assessment 1 or 3) and controlling for MRI infarct status (i.e., no infarct, silent infarct, or stroke). Those aged ≤8.99 and ≥9.00 at first assessment experienced PSI decline. Declines were most prominent for the processing speed coding subtest, with a significant interaction between timepoint and age, t(31) = 2.64, p = 0.01. This decline may reflect a developmental delay, likely due to disease progression, with slower improvements in processing speed. Although there have been significant improvements in SCD treatments, mostly in high-income countries, processing speed still remains a target; thus, incorporating clinical monitoring of processing speed may help identify delay and allow for early intervention.
摘要：
患有镰状细胞病（SCD）的儿童可能会遇到认知困难，包括处理速度减慢。因此，我们调查了处理速度是否随时间变化。从1992年至2001年，103名3-16岁的SCD参与者（n≤8.99=45；n≥9.00=58）完成了认知评估。MRI可用于54名参与者。在1992年至2002年期间，58名与会者同意进行一到两次进一步评估。使用线性混合效应建模的重复测量回归确定了处理速度指数（PSI）的纵向变化，检查年龄(连续变量)和时间点(即，评估1或3)和控制MRI梗塞状态(即，没有梗塞,无声梗塞,或中风)。首次评估时年龄≤8.99和≥9.00的患者出现PSI下降。处理速度编码子测试的下降最为突出，时间点和年龄之间有显著的相互作用，t(31)=2.64,p=0.01。这种下降可能反映了发育迟缓，可能是由于疾病进展，处理速度提高较慢。虽然SCD治疗有了显著的改善，主要在高收入国家，处理速度仍然是目标；因此，结合处理速度的临床监测可能有助于识别延迟并允许早期干预。
