New study shows how sickle cell affects brain function
New research from the Wood Neuro Research Group suggests sickle cell disease changes how the brain鈥檚 networks work together, with the brain calling on extra support from attention systems to keep thinking and decision-making on track.
By Sara Pecchia Email Sara Pecchia
Sickle cell disease is often thought of solely as a blood disorder, but new research from the Wood Neuro Research Group provides measurable evidence that it can reshape how brain networks function. Previous neuroimaging studies have relied on functional connectivity to show that adults with sickle cell disease may experience changes in how brain networks communicate among one another, potentially compensating for reduced oxygen delivery. However, this method is limited in determining the directionality or influence between networks.
鈥淩ed blood cells that carry oxygen to the brain are altered by the disease, resulting in reduced oxygen delivery to all regions of the brain and long term changes in how it functions,鈥� outlined Nahom Mossazghi, biomedical engineering Ph.D. student and the . 鈥淭he brain actively recruits other regions to help process information, which we do not see in people without the disease.鈥�
The study used MRI and advanced analytical tools originally developed in economics to examine how different brain networks influence one another. Instead of functional connectivity, effective connectivity was used to address a gap in the field and interpret how specific networks support one another in response to the disease-related changes. Results showed that the executive control network, responsible for higher cognitive functions like decision-making, recruits support from attention networks. Patients with milder complications of sickle cell disease rely on the dorsal attention network, which focuses attention, while patients more severely impacted by the condition rely on the ventral attention network, which responds to unexpected events.
鈥淭his shows the brain is compensating for oxygen shortages by reorganizing its network to maintain function,鈥� Mossazghi said.
The findings also highlight why cognitive challenges in adults with sickle cell disease have been overlooked.
鈥淓ven if patients seem to function normally, their brain is networked and rewired differently,鈥� emphasized Sossena Wood, assistant professor of biomedical engineering. 鈥淭heir task accuracy may match healthy controls, but their behavioral and neural response speed is slower, showing unseen compensation. We hope that this evidence paired with novel therapeutics helps alleviate some of the rewiring caused by the disease.鈥�
We hope that this evidence paired with novel therapeutics helps alleviate some of the rewiring caused by (sickle cell) disease.
Sossena Wood
Assistant Professor, Biomedical Engineering
Traditionally, sickle cell disease care focuses on children and hematology, and in many regions, adult care clinics are not available or commutable from patients鈥� homes. Pittsburgh has one of the few adult sickle cell disease clinics in the United States. This new research underscores the need for more involved neurology in adult care and raises awareness of cognitive impacts that affect daily life, school, and work. It also emphasizes healthcare equity, since sickle cell disease primarily affects underserved communities.
Looking forward, the Wood Neuro Research Group is studying how these networks respond during specific cognitive tasks. Combining MRI with simultaneous EEG, researchers hope to identify neural circuits that could be targeted with noninvasive interventions to improve cognitive function.
鈥淭his could transform how adults with sickle cell disease are cared for and help us understand how the brain compensates for chronic conditions more broadly,鈥� Mossazghi added.
The study, supported by NIH and internal funding, is the first to apply this economic-style analytical approach to sickle cell disease brain networks. It provides a new framework for understanding compensation in adult patients and sets the stage for future research to improve quality of life.
For media inquiries, please contact Sara Pecchia at pecchia@cmu.edu.