ArticleFrontiers in neuroscience2026
Elevated cerebral blood flow in distal and intermediate arterial territories in pediatric sickle cell anemia.
Article in Frontiers in neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Children with sickle cell anemia (SCA) are at increased risk of cerebrovascular complications due to chronic anemia and progressive vascular injury, yet how their cerebral hemodynamics are altered remains poorly understood. Previous research has shown that overall cerebral blood flow (CBF) is often higher in SCA, likely as an adaptive response to their chronic anemia, while this CBF increase is also linked to a greater risk of stroke, silent infarcts, and cognitive deficits. Distinguishing when this elevation reflects effective compensation versus early pathophysiology is critical. Methods: This study examined spatial patterns of cerebral blood flow (CBF) and their relationship with transcranial Doppler (TCD) velocity to better characterize hemodynamic adaptation in pediatric SCA. CBF was quantified using arterial spin labeling MRI in 32 children with HbSS or HbS/β Results: Across all three territories, distal and intermediate sub-territories exhibited significantly higher CBF than proximal regions ( Conclusions: These findings suggest that compensatory increases in CBF in response to chronic anemia occur primarily at the microvascular level within distal and intermediate sub-territories, highlighting the vulnerability of the distal microcirculation especially in MCA. Territorial perfusion mapping may therefore reveal early hemodynamic adaptations not captured by global CBF measures or detectable by conventional TCD screening. This approach may improve early detection and support better treatment strategies in patients.
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