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Cerebral Cortex Advance Access originally published online on November 7, 2008
Cerebral Cortex 2009 19(7):1549-1556; doi:10.1093/cercor/bhn193
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© The Author 2008. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Regionally Specific Cortical Thinning in Children with Sickle Cell Disease

Gregory R. Kirk1, M. Ryan Haynes1,2, Susan Palasis1, Clark Brown3, Thomas G. Burns4, Megan McCormick4 and Richard A. Jones1,5

1 Department of Radiology, Children's Healthcare of Atlanta, Atlanta, GA 30342, USA, 2 Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA, 3 Department of Hematology, 4 Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, GA 30342, USA, 5 Department of Radiology, Emory University, Atlanta, GA 30332, USA

Address correspondence to Richard A. Jones, Department of Radiology, Children's Healthcare of Atlanta, 1001 Johnson Ferry Road, Atlanta, GA 30342, USA. Email: Richard.Jones{at}choa.org.

Sickle cell disease (SCD) is a chronic disease with a significant rate of neurological complications in the first decade of life. In this retrospective study, cortical thickness was examined in children with SCD who had no detectable abnormalities on conventional magnetic resonance imaging/magnetic resonance angiography. Regional differences in cortical thickness from SCD were explored using age-matched healthy controls as comparison. A comparison analysis was done for SCD (n = 28) and controls (n = 29) based on age (5–11; 12–21 years), due to the age-dependent variation in cortex maturation. Distinct regions of thinning were found in SCD patients in both age groups. The number, spatial extent, and significance (P < 0.001) of these areas of thinning were increased in the older SCD group. Regions of interest (ROIs) were defined on the areas of highly significant thinning in the older group and then mapped onto the younger cohort; a multiparametric linear regression analysis of the ROI data demonstrated significant (P < 0.001) cortical thinning in SCD subjects, with the largest regions of thinning in the precuneus and the posterior cingulate. The regionally specific differences suggest that cortical thickness may serve as a marker for silent insults in SCD and hence may be a useful tool for identifying SCD patients at risk for neurological sequelae.

Key Words: cortical thickness • magnetic resonance imaging • sickle cell disease


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