ArticleBlood2023
Silent cerebral infarction during immune TTP remission: prevalence, predictors, and impact on cognition.
Article in Blood, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 20 citations in OpenAlex.
- Increased VWF-to-ADAMTS13 ratio is associated with large cerebral white matter hyperintensities.Blood vessels, thrombosis & hemostasis · 2026Article
- The quiet brain injury in thrombotic thrombocytopenic purpura: Are we missing the warning signs?British journal of haematology · 2026Article
- Case Series and Literature Narrative Review of Immune-Mediated Thrombotic Thrombocytopenic Purpura in Children.Children (Basel, Switzerland) · 2026Article
- Risk factors for silent cerebral infarction in immune-mediated thrombotic thrombocytopenic survivors.British journal of haematology · 2026Article
- Health-related quality of life and mental health in autoimmune thrombotic thrombocytopenic purpura patients in the caplacizumab era.Research and practice in thrombosis and haemostasis · 2026Article
- Update in treatment options for congenital and immune thrombotic thrombocytopenic purpura.Frontiers in pharmacology · 2026Review
- Progressive silent cerebral infarction is associated with stroke and persistent cognitive impairment in survivors of iTTP.Blood advances · 2025Article
- Challenges and opportunities in the long-term management of immune-mediated TTP.Hematology. American Society of Hematology. Education Program · 2025Review
- Tailored treatment of acute immune-mediated thrombotic thrombocytopenic purpura.Hematology. American Society of Hematology. Education Program · 2025Review
- The Patient-Reported Outcomes Measurement Information System perspective of adults with long-standing atypical hemolytic uremic syndrome.Research and practice in thrombosis and haemostasis · 2025Article
- Ischemic Stroke in Immune-Mediated Thrombotic Thrombocytopenia Purpura: Diagnostic and Management Challenges.Stroke · 2025Article
- Multicenter Prospective Pilot Study Identifying Thrombomodulin as a Potential Biomarker for Neurocognitive Outcomes in Immune Thrombotic Thrombocytopenic Purpura.Journal of clinical medicine · 2025Article
- The TMA team and TTP pathway improved outcomes in a cohort with Thrombotic thrombocytopenic purpura.PloS one · 2025Article
- Initial US tertiary health care system experience using caplacizumab in patients with immune thrombotic thrombocytopenic purpura.Annals of hematology · 2024Article
- Real-World Data on Effectiveness and Safety of First-Line Use of Caplacizumab in Italian Centers for the Treatment of Thrombotic Thrombocytopenic Purpura: The Roscapli Study.Journal of clinical medicine · 2024Article
- Tailoring caplacizumab administration using ADAMTS13 activity for immune-mediated thrombotic thrombocytopenic purpura.Blood vessels, thrombosis & hemostasis · 2024Article
- Thrombotic Microangiopathy in Pregnancy: Current Understanding and Management Strategies.Kidney international reports · 2024Review
- Progression of enlarged perivascular spaces contributes to occurrence of silent lacunar infarction in the elderly.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Article
- Hereditary Thrombotic Thrombocytopenic Purpura.Genes · 2023Review
- Cardiovascular Disease and Stroke in Immune TTP-Challenges and Opportunities.Journal of clinical medicine · 2023Review
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Authors and funding
18 authors at 5 institutions in 1 country.
Funding
Abstract
Immune thrombotic thrombocytopenic purpura (iTTP) survivors have increased risk of cardiovascular disease, including strokes, and report persistent cognitive difficulties during remission. We conducted this prospective study involving iTTP survivors during clinical remission to determine the prevalence of silent cerebral infarction (SCI), defined as magnetic resonance imaging (MRI) evidence of brain infarction without corresponding overt neurodeficits. We also tested the hypothesis that SCI is associated with cognitive impairment, assessed using the National Institutes of Health ToolBox Cognition Battery. For cognitive assessments, we used fully corrected T scores adjusted for age, sex, race, and education. Based on the diagnostic and statistical manual 5 criteria, we defined mild and major cognitive impairment as T scores with a 1 or 2 standard deviation (SD) and >2 SD below the mean on at least 1 test, respectively. Forty-two patients were enrolled, with 36 completing MRIs. SCI was present in 50% of the patients (18), of which 8 (44.4%) had prior overt stroke including during acute iTTP. Patients with SCI had higher rates of cognitive impairment (66.7% vs 27.7%; P = .026), including major cognitive impairment (50% vs 5.6%; P = .010). In separate logistic regression models, SCI was associated with any (mild or major) cognitive impairment (odds ratio [OR] 10.5 [95% confidence interval (95% CI), 1.45-76.63]; P = .020) and major cognitive impairment (OR 7.98 [95% CI, 1.11-57.27]; P = .039) after adjusting for history of stroke and Beck depression inventory scores. MRI evidence of brain infarction is common in iTTP survivors; the strong association of SCI with impaired cognition suggests that these silent infarcts are neither silent nor innocuous.
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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.