Diffusion tensor imaging (DTI) studies have reported widespread reductions in fractional anisotropy (FA) and increases in radial diffusivity (RD). MRI studies have revealed hemodynamic 6, – 11 and structural abnormalities 12, – 14 that may underlie cognitive impairment. 3 Reduced processing speed is the most prominent impairment 4 and may mediate difficulties across other domains, 5 but the etiology is not well understood, and there are no models of risk factors. Even in the absence of silent cerebral infarction (SCI), patients with sickle cell anemia (SCA) are at risk of cognitive impairment that may worsen with age 1, 2 and affect quality of life.
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