An Investigation of Episodic Memory Performance in Relation to Inflammation in Children with Sickle Cell Disease

Abstract

It is now well established that children with sickle cell disease (SCD) demonstrate cognitive deficits even in the absence of clinical stroke, but studies in children who have not experienced a stroke or other neurological event are lacking. Systemic processes that occur in SCD, like chronic inflammation and hypoxia, have been associated with hippocampal damage and episodic memory deficits in a range of clinical populations and animal models. However, studies examining episodic memory performance in children with SCD and in relation to systemic processes are largely absent. The present study addressed these gaps in young children with SCD (Mage = 7.37 years, SD = 1.51) who had not experienced a clinical stroke. Participants (N = 31) completed various memory measures as part of a larger neuropsychological protocol and participated in routine clinical blood draws. Latent class analysis (LCA) was used to empirically define SCD groups based on measures of specific visual memory processes, and results revealed two distinct visual memory groups, characterized by (1) visual memory deficits, specifically in delayed recognition abilities, and (2) intact visual memory. Follow-up analyses revealed that the two classes did not significantly differ on verbal memory performance. The relation between memory processes and both biomarkers of inflammation and adaptive functioning also were examined with variable-centered analyses. Results showed only one significant relation between C-reactive protein (CRP) and a measure of verbal delayed recognition. In sum, young children with SCD demonstrate variable episodic memory performance, with most notable deficits in visual delayed recognition. Higher levels of CRP, a biomarker of inflammation, were associated with poorer verbal delayed recognition. The results indicate that young children with SCD experience deficits in memory, even in the absence of a neurological event, and specific memory processes should be assessed in these children to guide targeted interventions.