Does cerebellar injury in premature infants contribute to the high prevalence of long-term cognitive, learning, and behavioral disability in survivors?
ABSTRACT Although cerebellar hemorrhagic injury is increasingly diagnosed in infants who survive premature birth, its long-term neurodevelopmental impact is poorly defined. We sought to delineate the potential role of cerebellar hemorrhagic injury in the long-term disabilities of survivors of prematurity.
We compared neurodevelopmental outcome in 3 groups of premature infants (N = 86; 35 isolated cerebellar hemorrhagic injury, 35 age-matched controls, 16 cerebellar hemorrhagic injury plus supratentorial parenchymal injury). Subjects underwent formal neurologic examinations and a battery of standardized developmental, functional, and behavioral evaluations (mean age: 32.1 +/- 11.1 months). Autism-screening questionnaires were completed.
Neurologic abnormalities were present in 66% of the isolated cerebellar hemorrhagic injury cases compared with 5% of the infants in the control group. Infants with isolated cerebellar hemorrhagic injury versus controls had significantly lower mean scores on all tested measures, including severe motor disabilities (48% vs 0%), expressive language (42% vs 0%), delayed receptive language (37% vs 0%), and cognitive deficits (40% vs 0%). Isolated cerebellar hemorrhagic injury was significantly associated with severe functional limitations in day-to-day activities. Significant differences were noted between cases of cerebellar hemorrhagic injury versus controls on autism screeners (37% vs 0%) and internalizing behavioral problems (34% vs 9%). Global developmental, functional, and social-behavioral deficits were more common and profound in preterm infants with injury to the vermis. Preterm infants with cerebellar hemorrhagic injury and supratentorial parenchymal injury were not at overall greater risk for neurodevelopmental disabilities, although neuromotor impairment was more severe.
Cerebellar hemorrhagic injury in preterm infants is associated with a high prevalence of long-term pervasive neurodevelopment disabilities and may play an important and underrecognized role in the cognitive, learning, and behavioral dysfunction known to affect survivors.
Article: Effects of gestational age and birth weight on brain volumes in healthy 9 year-old children.[show abstract] [hide abstract]
ABSTRACT: To assess the effects of gestational age and birth weight on brain volumes in a population-based sample of normal developing children at the age of 9 years. A total of 192 children from twin births were included in the analyses. Data on gestational age and birth weight were reported shortly after birth. Total brain, cerebellum, cerebrum, gray and white matter, and lateral ventricle volumes were assessed with structural magnetic resonance imaging. The Wechsler Intelligence Scale for Children-III was administered to assess general cognitive abilities. Structural equation modeling was used to analyze the effects of gestational age and birth weight on brain volumes. Shorter gestational age was associated with a relatively smaller cerebellar volume (P = .002). This effect was independent of IQ scores. Lower birth weight was associated with lower IQ score (P = .03). Birth weight was not associated with brain volumes. The effect of gestational age on cerebellar volume is not limited to children with very premature birth or very low birth weight, but is also present in children born >32 weeks of gestation and with birth weight >1500 g.The Journal of pediatrics 03/2010; 156(6):896-901. · 4.02 Impact Factor