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Neuropsychological and behavioral profile of children with sickle cell disease.

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Katiusha de Cerqueira Abreu
Total Authors: 1
Document type: Master's Dissertation
Press: Ribeirão Preto.
Institution: Universidade de São Paulo (USP). Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto (PCARP/BC)
Defense date:
Examining board members:
Sonia Regina Pasian; Alessandra Gotuzo Seabra Capovilla; Nayara Silva Argollo Vieira
Advisor: Sonia Regina Pasian

The Sickle Cell Disease (SCD) is a haematological pathology that leads to several systemic complications, especially neurological sequelae and cognitive deficits. Some studies have correlated exams of Magnetic Resonance Imaging (MRI) and Transcranial Doppler (TCD) ultrasonography with neuropsychological assessment in children with SCD, indicating specific cognitive impairments and general intellectual deficit that tend to predispose to poor academic performance and higher rates of school retention. In Brazil there is a high prevalence of this disease, making it important to conduct studies in children, since early diagnosis of neuropsychological difficulties enables preventive interventions and formulation of rehabilitation programs in frames of brain dysfunction. Objective: To characterize the behavioral and neuropsychological performance of children with SCD, in the range 7-12 years. Aims to assess and describe the main cognitive functions (attention / executive function, learning and memory, language, visuospatial processing, sensorimotor function) and possible behavioral difficulties and to correlate these results with clinical and sociodemographic variables. Method: In this study, participated 60 children, also composing two groups of 30 volunteers (clinical and control) matched for sex, age and school origin. Were used as instruments of psychological assessment: IQ Estimate the WISC III and Raven\'s Coloured Progressive Matrices, NEPSY II - Neuropsychological Development and Child Behavior Checklist (CBCL). The Clinical Group conducted clinical neurological examination, MRI, TCD and blood count. Results: Children with SCD in neuropsychological profile showed impairments in general intellectual functioning and deficits in several specific neuropsychological domains, especially executive function, language, visuospatial memory and visuospatial skills compared to the Control Group. In medical examinationof Clinical Group, all TCD were considered within the normal range and prevalence of MRI was 24% of the sample with silent cerebral infarction (ICS). The impairment in general intellectual ability, narrative and visuospatial memory and phonological processing were more significant in the Group with ICS. These diverse neuropsychological deficits in Clinical Group tend to predispose to difficulties in academic performance and increased school failure. Furthermore, there was evidence of significant levels of behavioral and emotional problems in children with SCD. Observed cognitive decline in various neuropsychological functions with increasing chronologic age, but it has not shown the influence of variables such as gender,iables such as gender, genetic type, type of medication and the blood count indices in neuropsychological and behavioral outcomes in these children. These results provide relevant implications for the treatment of patients with SCD, because it emphasizes the importance of multidisciplinary monitoring and the need to conduct neuropsychological assessment and adequate intervention in rehabilitation centers with the aim of promoting a better quality of life and favorable conditions for the development of these children. (CAPES e FAPESP). (AU)

FAPESP's process: 11/16260-6 - Neuropsychological profile of children with sickle cell disease
Grantee:Katiusha de Cerqueira Abreu
Support Opportunities: Scholarships in Brazil - Master