In Patients with Minor Beta-Thalassemia, Cognitive Performance Is Related to Length of Education, But not to Minor Beta-Thalassemia or Hemoglobin Levels

  • Mohammad Ahmadpanah Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran.
  • Yasaman Asadi Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran
  • Mohammad Haghighi Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran.
  • Hamidreza Ghasemibasir Department of Pathology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
  • Elham Khanlarzadeh Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
  • Serge Brand University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland. . University of Basel, Department of Sport, Exercise and Health, Division of Sport Sciences and Psychosocial Health, Basel, Switzerland. Kermanshah University of Medical Sciences, Sleep Disorders Research Center and Substance Abuse Prevention Research Center, Kermanshah, Iran.
Keywords: Beta-Thalassemia Minor; Cognitive Performance; Long-Term Memory; Length of Education; Working Memory

Abstract

Objective: Thalassemia is one of the most frequent monogenic disorders, leading to impairment in the maturation and survival of red blood cells. The question examined here is whether, and if so, to what extent, people with beta-thalassemia might also be impaired in their cognitive functioning. Previous results in adults with beta-thalassemia showed cognitive impairment when compared to healthy controls. However, length of education was never taken into consideration as a possible confounder. Accordingly, the aim of the present study was to assess people with minor beta-thalassemia and compare them to healthy controls, while controlling for length of education. Method: A total of 25 adults (mean age: 29.36 years; 56% females) with beta-thalassemia and 25 healthy controls (mean age: 27.84 years; 72% females) took part in this cross-sectional study. They underwent cognitive testing (executive functions, attention, working memory), and their haemoglobin levels were assessed. Results: Cognitive performance did not significantly differ between patients with minor beta-thalassemia and healthy controls. Irrespective of group, higher cognitive performance was strongly associated with time spent in education. No gender differences were observed. Conclusion: Compared to healthy controls, cognitive performance was not impaired among patients with minor beta-thalassemia when length of education was introduced as a further co-variate. In both patients with minor beta-thalassemia and healthy controls, higher cognitive performance was associated with time spent for education. Health professionals should inform patients with minor beta-thalassemia that cognitive performance is related to the length of education and not to the health status of minor beta-thalassemia per se.

References

Taher AT, Weatherall DJ and Cappellini MD. Thalassaemia. Lancet (London, England) 2017 2017/08/05. DOI: 10.1016/s0140-6736(17)31822-6.

Li CK. New trend in the epidemiology of thalassaemia. Best Pract Res Clin Obstet Gynaecol 2017; 39: 16-26. 2016/11/17. DOI: 10.1016/j.bpobgyn.2016.10.013.

Fauci AS. Harrison's principles of internal medicine. McGraw-Hill, Medical Publishing Division New York, 2008.

Zarei T, Dehbozorgian J, Imanifard J, et al. A Number of Cases in Iran Presenting with Coinheritance of Hemoglobin-H Disease and Beta-Thalassemia Minor. Hemoglobin 2016; 40: 316-318.

Cetin T, Oktenli C, Ozgurtas T, et al. Renal tubular dysfunction in β-thalassemia minor. American journal of kidney diseases 2003; 42: 1164-1168.

Oktenli C and Bulucu F. Renal tubular dysfunction in a patient with beta-thalassemia minor. Nephron 2002; 92: 222-223.

Dong AC and Rivella S. Gene Addition Strategies for beta-Thalassemia and Sickle Cell Anemia. Advances in experimental medicine and biology 2017; 1013: 155-176. 2017/11/12. DOI: 10.1007/978-1-4939-7299-9_6.

Shehata GA, Elsayh KI, Rafet NH, et al. Study of beta-thalassemia biomarkers and their relationship to cognition among children. J Child Neurol 2010; 25: 1473-1479. 2010/06/04. DOI: 10.1177/0883073810368996.

Duman O, Arayici S, Fettahoglu C, et al. Neurocognitive function in patients with β‐thalassemia major. Pediatrics International 2011; 53: 519-523.

Karimi M, Yarmohammadi H and Cappellini D. Analysis of intelligence quotient in patients with homozygous beta-thalassemia. Saudi medical journal 2006; 27: 982-985.

Nevruz O, Ulas U, Cetin T, et al. Cognitive dysfunction in β‐thalassemia minor. American journal of hematology 2007; 82: 203-207.

Zangiabadi N, Yarahmadi F, Darekordi A, et al. Comparison between beta-thalassemia minor and normal individuals using the Wechsler Adult Intelligence Scale. Hemoglobin 2013; 37: 467-476. 2013/06/29. DOI: 10.3109/03630269.2013.806330.

Monastero R, Monastero G, Ciaccio C, et al. Cognitive deficits in beta‐thalassemia major. Acta Neurologica Scandinavica 2000; 102: 162-168.

Kessels RP, Eikelboom WS, Schaapsmeerders P, et al. Effect of Formal Education on Vascular Cognitive Impairment after Stroke: A Meta-analysis and Study in Young-Stroke Patients. J Int Neuropsychol Soc 2017; 23: 223-238. 2017/01/10. DOI: 10.1017/s1355617716001016.

Jones RN, Manly J, Glymour MM, et al. Conceptual and measurement challenges in research on cognitive reserve. J Int Neuropsychol Soc 2011; 17: 593-601. 2011/03/18. DOI: 10.1017/s1355617710001748.

Shayganfard M, Jahangard L, Nazaribadie M, et al. Repetitive Transcranial Magnetic Stimulation Improved Symptoms of Obsessive-Compulsive Disorders but Not Executive Functions: Results from a Randomized Clinical Trial with Crossover Design and Sham Condition. Neuropsychobiology 2016; 74: 115-124. 2017/03/24. DOI: 10.1159/000457128.

Berg EA. A simple objective technique for measuring flexibility in thinking. J Gen Psychol 1948; 39: 15-22. DOI: 10.1080/00221309.1948.9918159.

Monchi O, Petrides M, Petre V, et al. Wisconsin Card Sorting revisited: distinct neural circuits participating in different stages of the task identified by event-related functional magnetic resonance imaging. J Neurosci 2001; 21: 7733-7741.

Jahangard L, Haghighi, M., Shyayganfard, M., Ahmadpanah, M., Sadeghi Bahmani, D., Bajoghli, H., Holsboer-Trachsler, E., Brand, S. . Repetitive Transcranial Magnetic Stimulation (rTMS) improved symptoms of obsessive compulsive disorders (OCD), but also cognitive performance? - Results from randomized clinical trial with cross-over design and sham-condition. Neuropsychobiology 2016.

Gronwall DM. Paced auditory serial-addition task: a measure of recovery from concussion. Percept Mot Skills 1977; 44: 367-373. DOI: 10.2466/pms.1977.44.2.367.

Diehr MC, Cherner M, Wolfson TJ, et al. The 50 and 100-item short forms of the Paced Auditory Serial Addition Task (PASAT): demographically corrected norms and comparisons with the full PASAT in normal and clinical samples. J Clin Exp Neuropsychol 2003; 25: 571-585. DOI: 10.1076/jcen.25.4.571.13876.

Published
2018-12-16
How to Cite
1.
Ahmadpanah M, Asadi Y, Haghighi M, Ghasemibasir H, Khanlarzadeh E, Brand S. In Patients with Minor Beta-Thalassemia, Cognitive Performance Is Related to Length of Education, But not to Minor Beta-Thalassemia or Hemoglobin Levels. ijps. 14(1):47-3.
Section
Original Article(s)