Changes of the corpus callosum in children who suffered perinatal injury of the periventricular crossroads of pathways

Department of Neonatology and Pediatric Intensive Care, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia.
Collegium antropologicum (Impact Factor: 0.61). 02/2008; 32 Suppl 1:25-9.
Source: PubMed


There is a high incidence of periventricular leukomalacia, caused by hypoxia-ischemia, in preterm infants. These lesions damage the periventricular crossroads of commissural, projection and associative pathways, which are in a close topographical relationship with the lateral ventricles. We explored to what extent abnormalities of echogenicity of the periventricular crossroads correlate with changes in size of the corpus callosum. Our study included nine infants (gestation from 26-41 weeks; birth weight between 938-4450 grams) with perinatal brain injury. Periventricular areas, which topographically correspond to the frontal, main and occipital crossroad, were readily visualized by cranial ultrasound scans, performed during the first two weeks after birth. Corpus callosum mediosagittal area measurements were performed using magnetic resonance images, acquired between the first and sixth postnatal month (postmenstrual age 40-49 weeks). We found a statistically significant correlation between the increased echogenicity in the crossroad areas and the decrease of the corpus callosum midsagittal area (p < 0.05). This supports the hypothesis that callosal fibers can be damaged, during growth through the periventricular crossroads of pathways.

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    • "WMI has not been previously studied in relation to callosal diffusion characteristics in VPT infants, however altered λ ⊥ in the splenium of VPT infants has been associated with WM signal abnormality (Counsell et al., 2006). Furthermore, Benjak et al. found that PVL caused by hypoxia-ischemia in VPT infants damaged the CC, being topographically close to the lateral ventricles (Benjak et al., 2008). No studies have reported the effects of WMI on CC tractography findings in VPT infants. "
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    ABSTRACT: The aim of this study was to relate altered corpus callosum (CC) integrity in 106 very preterm (VPT) infants (<30 weeks' gestational age or <1250 g birth weight) at term equivalent to perinatal predictors and neurodevelopmental outcomes at two years. T1 and diffusion magnetic resonance images were obtained. The CC was traced, and divided into six sub-regions for cross-sectional area and shape analyses. Fractional anisotropy, mean, axial and radial diffusivity were sampled within the CC, and probabilistic tractography was performed. Perinatal predictors were explored. The Bayley Scales of Infant Development (BSID-II) was administered at two years. Intraventricular hemorrhage was associated with a smaller genu and altered diffusion values within the anterior and posterior CC of VPT infants. White matter injury was associated with widespread alterations to callosal diffusion values, especially posteriorly, and radial diffusivity was particularly elevated, indicating altered myelination. Reduced CC tract volume related to lower gestational age, particularly posteriorly. Reduced posterior callosal skew was associated with postnatal corticosteroid exposure. This more circular CC was associated with delayed cognitive development. Higher diffusivity, particularly in splenium tracts, was associated with impaired motor development. This study elucidates perinatal predictors and adverse neurodevelopmental outcomes associated with altered callosal integrity in VPT infants.
    NeuroImage 12/2011; 59(4):3571-81. DOI:10.1016/j.neuroimage.2011.11.057 · 6.36 Impact Factor
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    • "These crossroad areas are rich in guidance factors crucial for the spatial arrangement of axons (Judas et al., 2005). An injury in this region during the later half of pregnancy, or in the neonatal period for preterm born children, has the potential to severely disturb the midline crossing of callosal axons (Benjak et al., 2008; Deng & Elberger, 2001; Judas et al., 2005; Silver et al., 1982; Smith et al., 2006). Furthermore, preterm lesions in the subventricular zone and periventricular area may harm populations of future callosal cells directly (Gressens, 1992; Judas et al., 2005; Volpe, 1996). "
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    ABSTRACT: Premature birth is associated with visual impairments, due to both cerebral and ocular pathology. This study examined the relationship between cerebral white matter microstructure, evaluated by diffusion tensor imaging (DTI), and visual function, in 30 preterm born adolescents with very low birth weight (VLBW=birth weight⩽1500g) and an age-matched group of 45 term born controls. Visual acuity correlated positively with fractional anisotropy (FA) in corpus callosum and in frontal white matter areas in the VLBW participants, but not in the control participants. Callosal visual connections may play a more important role in the development of good visual acuity than previously acknowledged in preterm born children.
    Vision research 08/2011; 51(18):2063-70. DOI:10.1016/j.visres.2011.08.002 · 1.82 Impact Factor
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