Abstract
We have shown that cerebellar injury in the premature infant is followed by significant growth impairment of the contralateral cerebral hemisphere evident as early as term adjusted age. In this study, we hypothesize that this remote growth restriction is region specific in the cerebrum. In a prospectively enrolled cohort of 38 expreterm infants with isolated cerebellar injury by neonatal MRI, we performed follow-up volumetric MRI studies at a mean postnatal age of 35.5 ± 13.8 mo. We measured volumes of cortical and subcortical gray matter, and cerebral white matter within eight parcellated regions for each cerebral hemisphere. Unilateral cerebellar injury (n = 24) was associated with significantly smaller volumes of cortical gray and cerebral white matter in the following regions of the contralateral (versus ipsilateral) cerebral hemisphere: dorsolateral prefrontal, premotor (PM), sensorimotor, and midtemporal regions (p < 0.001 for all except midtemporal cortical gray, p = 0.01), as well as subcortical gray matter in the PM region (p < 0.001). Conversely, in cases of bilateral cerebellar injury (n = 14), there was no significant interhemispheric difference in tissue volumes for any of the cerebral regions studied. These findings suggest that regional cerebral growth impairment results from interruption of cerebellocerebral connectivity and loss of neuronal activation critical for development.
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Abbreviations
- DLPF:
-
dorsolateral prefrontal
- IO:
-
inferior occipital
- OF:
-
orbitofrontal
- PM:
-
premotor
- SG:
-
subgenual
- SM:
-
sensorimotor
- MT:
-
midtemporal
- PO:
-
parietooccipital
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Acknowledgements
We thank Shaye Moore for assistance with manuscript preparation and the children and families for their participation in this study.
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Supported by the Hearst Foundation, the LifeBridge Fund, the Caroline Levine Foundation, the Trust Family Foundation, the National Institutes of Health (NINDS K24NS057568, A.J.P.), and the Canada Research Chairs Program, Canada Research Chair in Brain and Development Tier 2 (C.L.).
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Limperopoulos, C., Chilingaryan, G., Guizard, N. et al. Cerebellar Injury in the Premature Infant Is Associated With Impaired Growth of Specific Cerebral Regions. Pediatr Res 68, 145–150 (2010). https://doi.org/10.1203/PDR.0b013e3181e1d032
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DOI: https://doi.org/10.1203/PDR.0b013e3181e1d032
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