Abstract

Neuropsychological impairments have been observed in both individuals with sleep-disordered breathing and in individuals with sickle cell disease (SCD), but there has been little research on the potential effect of sleep-disordered breathing on neuropsychological function in individuals with SCD. This study aims to examine the effect nocturnal oxygen desaturations have on neuropsychological functioning in individuals with sickle cell disease when compared to those with non-sickle anemia and healthy controls. Thirty-four participants with SCD, 18 non-sickle anemia controls (ACTL), and 29 healthy controls (CTL), ages 9 to 63 years, participating in an IRB-approved Children’s Hospital Los Angeles study of cerebral blood flow underwent neuropsychological evaluation examining general intelligence (WASI-II FSIQ), processing speed (WISC-IV/WAIS-IV Coding), inhibition (D-KEFS Color-Word Interference Inhibition), and cognitive flexibility (D-KEFS Color-Word Interference Inhibition/Switching). Oxygen saturation via finger plethysmography was recorded for 24 hours. When comparing the SCD group with the ACTL group, the ACTL group performed better on measures of processing speed, inhibition, and cognitive flexibility. With regard to an interaction between oxygen desaturations and disease status impacting processing speed, significant differences were found when comparing the SCD group with the CTL group. Significant differences were also found when comparing the SCD group with the ACTL group. Simple slope analysis revealed that in both cases, higher values of nocturnal oxygen desaturations predicted lower processing speed scores for the SCD group when compared to both the ACTL and CTL groups, suggesting a moderating effect of oxygen desaturations on processing speed. Participants with SCD in this study performed more poorly on measures of processing speed, inhibition, and cognitive flexibility when compared to those with non-sickle anemia. Further, individuals with SCD with higher nocturnal oxygen desaturations had a slower speed of processing when compared to healthy controls and those with non-sickle anemia. Neuropsychological assessment may identify those at risk and early rehabilitation efforts restoring oxygen may lead to a greater recovery of function and a higher quality of life for this vulnerable population.

Library of Congress Subject Headings

Sleep apnea syndromes; Anoxemia -- Psychological aspects; Sickle cell anemia; Neuropsychology -- Research

Date of Award

2021

School Affiliation

Graduate School of Education and Psychology

Department/Program

Psychology

Degree Type

Dissertation

Degree Name

Doctorate

Faculty Advisor

Louis Cozolino

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