Patterns of Verbal Long-Term and Working Memory Performance Reveal Deficits in Strategic Processing in Children With Frontal Infarcts Related to Sickle Cell Disease

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Abstract
Frontal brain regions are thought to mediate strategic processes that facilitate memory. We hypothesized that children with frontal cerebral infarcts related to sickle cell disease (SCD) would exhibit impairments in long-term and working memory as a result of disruptions in strategic processing. Word-list learning and digit span tasks were used to assess verbal memory and strategic processing in 21 children with SCD without infarcts (controls) and in 10 children with SCD with frontal infarcts. On the word-list learning task, children with frontal infarcts performed more poorly in terms of learning and free recall, although recognition and cued recall were adequate; this pattern suggested intact encoding and storage with impaired retrieval. Children with frontal infarcts performed more poorly on backward digit span, although forward digit span was adequate; this pattern suggested intact maintenance with impaired manipulation of information in working memory. Overall, these findings support the notion that disruptions in strategic processing contribute to memory impairments in children with frontal infarcts.