Your institution is subscribed to Read Institutional Edition. Log in or Sign Up to read full text articles.


Reduced global cerebral oxygen metabolic rate in sickle cell disease and chronic anemias

Chau Vu, Adam Bush, Soyoung Choi, Matthew Borzage, Xin Miao, Aart J Nederveen, Thomas D Coates, John C Wood
American Journal of Hematology 2021 April 23
Anemia is the most common blood disorder in the world. In patients with chronic anemia, such as sickle cell disease or major thalassemia, cerebral blood flow increases to compensate for decreased oxygen content. However, the effects of chronic anemia on oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2 ) are less well understood. In this study, we examined 47 sickle-cell anemia subjects (age 21.7±7.1, female 45%), 27 non-sickle anemic subjects (age 25.0±10.4, female 52%) and 44 healthy controls (age 26.4±10.6, female 71%) using MRI metrics of brain oxygenation and flow. Phase contrast MRI was used to measure resting cerebral blood flow, while T2 -relaxation-under-spin-tagging (TRUST) MRI with disease appropriate calibrations were used to measure OEF and CMRO2 . We observed that patients with sickle cell disease and other chronic anemias have decreased OEF and CMRO2 (respectively 27.4±4.1% and 3.39±0.71 mL O2 /100g/min in sickle cell disease, 30.8±5.2% and 3.53±0.64 mL O2 /100g/min in other anemias) compared to controls (36.7±6.0% and 4.00±0.65 mL O2 /100g/min). Impaired CMRO2 was proportional to the degree of anemia severity. We further demonstrate striking concordance of the present work with pooled historical data from patients having broad etiologies for their anemia. The reduced cerebral oxygen extraction and metabolism are consistent with emerging data demonstrating increased non-nutritive flow, or physiological shunting, in sickle cell disease patients. This article is protected by copyright. All rights reserved.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.