Patient description: The patient is a 34-year-old African American man with the known history of Sickle cell disease comes to the clinic with severe bone pain. The patient had severe pain in his lower back that radiated to both thighs scored 9 out of 10. The patient has had positive history of sickle cell crises since childhood. He also had the same symptoms in past two weeks treated with oxycodone which was not beneficial to his pain. His PCP sent him to the emergency department to receive intra venous pain modulators. The patient is afebrile within the normal blood pressure. No splenomegaly was detected in the physical exam. He has no positive history of drug allergy. He won't smoke or uses any illicit drugs. The lab study is as bellow: Hgb: 8 g/dl WBC: 10000 /mm3 Plt: 300000 /ml MCV: 106 fL Hemoglobine electrophoresis: 91% HbS 6%HbF 3%HbA2 AST: 22 U/L ALT: 43 U/L Alk P: 53 U/L Ferritin: 1200 ng/ml

Clinical trial eligibility criteria: eligible ages (years): 21.0-55.0,  Anemia, Sickle Cell Individuals who meet all of the following are eligible for enrollment as cases into the study: 1. Adult between the ages of 21 and 55 2. African descent 3. Proficient/fluent in English 4. Hemoglobin electrophoresis confirming hemoglobin SS or SB0 (%A <= 15) 5. Hemoglobin <= 10 g/dL 6. Capable of giving informed consent for the protocol Individuals who meet all of the following are eligible for enrollment as community controls into the study: 1. Adult between the ages of 21 and 55 2. African descent 3. Proficient/fluent in English 4. Capable of giving informed consent for the protocol  Individuals who meet any of the following are disqualified from enrollment in the case group of the study: 1. Overt stroke 2. Previous evidence of an abnormal MRI or CT other than small peri-ventricular or watershed lesions 3. History of head injury that resulted in neurological symptoms or medical visit 4. Abnormal neurologic exam with focal findings 5. Mini-Mental Status Examination (MMSE) score of < 20 6. Profile of Mood States (POMS) score on the Depression-Dejection Subscale suggestive of a clinical depression (score > 40) 7. Alcohol consumption exceeding 14 drinks/week if female, 21 drinks/week if male 8. Drug abuse, defined as using non-prescribed medication 9. History of claustrophobia and/or presence of metallic implants such as pacemakers, surgical aneurysm clips, or known metal fragments embedded in the body 10. Pregnancy 11. Baseline blood pressure > 140/90 on two repeated measurements. A second measurement is needed only if the first is > 140/90 12. History of uncontrolled hypertension 13. Any chronic disorder that may result in neurocognitive or brain dysfunction that is not secondary to SCD including: 1. Inflammatory arterial disorders (lupus, polyarteritis) 2. History of cancer requiring chemotherapy and/or radiation 3. Untreated hyperlipidemia 4. Diabetes 5. Ongoing active infection such as HIV, tuberculosis, sarcoidosis 6. History of chronic transfusion 7. Chronic renal failure/Dialysis 8. Chronic lung disease characterized by need for oxygen 9. Morbid obesity (weight >115 kg) 10. Heart disease: history of congestive heart failure, history of severe coronary artery disease characterized by angioplasty or surgery, or history of angina 11. Active hepatitis or liver failure 12. Acquired or congenital immune deficiency 13. History of psychoses (delusions, hallucinations) and/or schizophrenia 14. Neurodegenerative disorders 15. Genetic disorder associated with neurocognitive dysfunction such as Down Syndrome 16. Other chronic illness or disorder other than SCD that will adversely affect the subject's performance in the study 14. Currently on Procrit or related drug that stimulates red blood cell production Individuals who meet any of the following are disqualified from enrollment as community controls in to the study: 1. Hb electrophoresis other than AA 2. Abnormal Hb (females: < 12 g/dL; males: < 13.5 g/dL) 3. Overt stroke 4. Previous abnormal MRI or CT 5. History of head injury that resulted in neurological symptoms or medical visit 6. Abnormal neurologic exam with focal findings 7. Mini-Mental Status Examination (MMSE) score of < 20 8. Profile of Mood States (POMS) score on the Depression-Dejection Subscale suggestive of a clinical depression (score > 40) 9. Alcohol consumption exceeding 14 drinks/week if female, 21 drinks/week if male 10. Drug abuse, defined as using non-prescribed medication 11. History of claustrophobia and/or presence of metallic implants such as pacemakers, surgical aneurysm clips, or known metal fragments embedded in the body 12. Pregnancy 13. Baseline blood pressure > 140/90 on two repeated measurements. A second measurement is needed only if the first is > 140/90 14. History of uncontrolled hypertension 15. Any chronic disorder that may result in neurocognitive or brain dysfunction including: 1. Inflammatory arterial disorders (lupus, polyarteritis) 2. History of cancer requiring chemotherapy and/or radiation 3. Untreated hyperlipidemia 4. Diabetes 5. Ongoing active infection such as HIV, tuberculosis, sarcoidosis 6. History of chronic transfusion 7. Chronic renal failure/Dialysis 8. Chronic lung disease characterized by need for oxygen 9. Morbid obesity (weight > 115 kg) 10. Heart disease: history of congestive heart failure, history of severe coronary artery disease characterized by angioplasty or surgery, or history of angina 11. Active hepatitis or liver failure 12. Acquired or congenital immune deficiency 13. History of psychoses (delusions, hallucinations) and/or schizophrenia 14. Neurodegenerative disorders 15. Genetic disorder associated with neurocognitive dysfunction such as Down Syndrome 16. Other chronic illness or disorder that will adversely affect the subject's performance in the study 16. Currently on Procrit or related drug that stimulates red blood cell production