Differential Effects of Intraventricular Hemorrhage and White Matter Injury on Preterm Cerebellar Growth

Department of Neurology, University of California San Francisco, CA, USA.
The Journal of pediatrics (Impact Factor: 3.79). 10/2010; 158(3):366-71. DOI: 10.1016/j.jpeds.2010.09.005
Source: PubMed


To hypothesize that detailed examination of early cerebellar volumes in time would distinguish differences in cerebellar growth associated with intraventricular hemorrhage (IVH) and white matter injury in preterm infants.
Preterm newborns at the University of California San Francisco (n = 57) and the University of British Columbia (n = 115) were studied with serial magnetic resonance imaging scans near birth and again at near term-equivalent age. Interactive semi-automated tools were used to determine volumes of the cerebellar hemispheres.
Adjusting for supratentorial brain injury, cerebellar hemorrhage, and study site, cerebellar volume increased 1.7 cm(3)/week postmenstrual age (95% CI, 1.6-1.7; P < .001). More severe supratentorial IVH was associated with slower growth of cerebellar volumes (P < .001). Volumes by 40 weeks were 1.4 cm(3) lower in premature infants with grade 1 to 2 IVH and 5.4 cm(3) lower in infants with grade 3 to 4 IVH. The same magnitude of decrease was found between ipsilateral and contralateral IVH. No association was found with severity of white matter injury (P = .3).
Early effects of decreased cerebellar volume associated with supratentorial IVH in either hemisphere may be a result of concurrent cerebellar injury or direct effects of subarachnoid blood on cerebellar development.

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    • "Recent work has demonstrated that the neocerebellum, comprising of the lateral hemispheres, vermal lobules VI–VII, and the dentate nucleus, is involved in cognitive tasks, such as executive function (Berman et al., 1995; Raichle et al., 1994; Schlosser et al., 1998), verbal fluency (Appollonio et al., 1993), verb generation (Fiez et al., 1996), working memory (Fiez et al., 1996), and source memory (Tamagni et al., 2010). Moreover, the cerebellum is of special interest to the study of brain development since it has been shown to have greater vulnerability to damage in the perinatal period (Tam et al., 2011). Despite the clear evidence that the cerebellum underlies cognitive and motor functions and is vulnerable during neurodevelopment, very few human neuroimaging studies have measured cerebellar volumes in part due to the paucity and limitations of automated cerebellar segmentation algorithms. "
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