ArticleFrontiers in neurology2019
Vascular Instability and Neurological Morbidity in Sickle Cell Disease: An Integrative Framework.
Article in Frontiers in neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 60 citations in OpenAlex.
- The influence of voxelotor on cerebral blood flow and oxygen extraction in pediatric sickle cell disease.Blood · 2024Trial
- Computational Fluid Dynamics Analysis of Cerebrovascular Hemodynamic Differences in Adults with Sickle Cell Disease: Comparing Stroke and Non-Stroke Cohorts.Annals of biomedical engineering · 2026Article
- Sickle cell pain: call for whole person health approaches to mechanisms-informed integrative management.Blood advances · 2026Article
- Article
- Electrophysiological and Psychological Correlates of Cognition in Adult Homozygous Sickle Cell Disease Patients.Annals of neurosciences · 2026Article
- Polysomnographic Characteristics and Sleep Disorders in Pediatric Moyamoya Arteriopathy.Nature and science of sleep · 2026Article
- Elevated cerebral blood flow in distal and intermediate arterial territories in pediatric sickle cell anemia.Frontiers in neuroscience · 2026Article
- The Breakdown of Neurovascular Barriers: Molecular Mechanisms of Tight Junction Dysfunction.Molecular neurobiology · 2025Review
- Neurocognitive functioning of patients with sickle cell disease in low- and middle-income countries.Blood global hematology · 2025Article
- Timely surgical intervention in sickle cell-related hemorrhagic stroke: a pediatric success story and literature review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Review
- A clinical evaluation program to monitor neurocognitive risk in children and adolescents with sickle cell disease.The Clinical neuropsychologist · 2025Article
- Assessment of Inter-Reader Reliability of Fazekas Scoring on Magnetic Resonance Imaging of the Brain in Adult Patients with Sickle Cell Disease.Diagnostics (Basel, Switzerland) · 2025Article
- Posterior cerebral circulation in children with sickle cell anemia: an uncharted territory.Haematologica · 2025Article
- Cognitive considerations for adults with sickle cell disease completing the brief pain inventory.Pain reports · 2025Article
- Cerebral Hemodynamic Responses to Disease-Modifying and Curative Sickle Cell Disease Therapies.Neurology · 2025Article
- Operative considerations for resection of pituitary adenoma in patients with sickle cell disease: A retrospective analysis of 19,653 patients.Surgical neurology international · 2025Article
- Altered cerebral blood flow and functional connectivity in sickle cell disease.Journal of sickle cell disease · 2025Article
- Blood-brain barrier breakdown in brain ischemia: Insights from MRI perfusion imaging.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Review
- Stroke without cerebral arteriopathy in sickle cell disease children: causes and treatment.Haematologica · 2024Article
- Empirically derived profiles of neurocognitive functioning in youth and young adults with sickle cell disease.Journal of pediatric psychology · 2024Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
It is well-established that patients with sickle cell disease (SCD) are at substantial risk of neurological complications, including overt and silent stroke, microstructural injury, and cognitive difficulties. Yet the underlying mechanisms remain poorly understood, partly because findings have largely been considered in isolation. Here, we review mechanistic pathways for which there is accumulating evidence and propose an integrative systems-biology framework for understanding neurological risk. Drawing upon work from other vascular beds in SCD, as well as the wider stroke literature, we propose that macro-circulatory hyper-perfusion, regions of relative micro-circulatory hypo-perfusion, and an exhaustion of cerebral reserve mechanisms, together lead to a state of cerebral vascular instability. We suggest that in this state, tissue oxygen supply is fragile and easily perturbed by changes in clinical condition, with the potential for stroke and/or microstructural injury if metabolic demand exceeds tissue oxygenation. This framework brings together recent developments in the field, highlights outstanding questions, and offers a first step toward a linking pathophysiological explanation of neurological risk that may help inform future screening and treatment strategies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.