title: Cognitive screening examinations for silent cerebral infarcts in sickle cell disease.
abstract: 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 neuropsychologic 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.
authors.affiliation: Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: DeBaun
authors.forename: J
authors.initials: J
authors.lastname: Schatz
authors.forename: M J
authors.initials: MJ
authors.lastname: Siegel
authors.forename: M
authors.initials: M
authors.lastname: Koby
authors.forename: S
authors.initials: S
authors.lastname: Craft
authors.forename: L
authors.initials: L
authors.lastname: Resar
authors.forename: J Y
authors.initials: JY
authors.lastname: Chu
authors.forename: G
authors.initials: G
authors.lastname: Launius
authors.forename: M
authors.initials: M
authors.lastname: Dadash-Zadeh
authors.forename: R B
authors.initials: RB
authors.lastname: Lee
authors.forename: M
authors.initials: M
authors.lastname: Noetzel
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D001288:Attention / Q000502:physiology; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D002648:Child; D003071:Cognition / Q000502:physiology*; D006801:Humans; D009483:Neuropsychological Tests; D012680:Sensitivity and Specificity