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Periventricular leukomalacia in preterm children: assessment of grey and white matter and cerebrospinal fluid changes by MRI

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Abstract

Background

Brain plasticity in patients with periventricular leukomalacia (PVL) may suggest grey matter (GM) changes.

Objective

To assess the volume of 116 GM areas and total volume of GM, white matter (WM) and cerebrospinal fluid (CSF) in preterm children with PVL, using the Statistical Parametric Mapping (SPM5) and the Individual Brain Atlases Statistical Parametric Mapping (IBASPM) toolboxes.

Materials and methods

Ten preterm children (gestational age 31.7 ± 4.2 weeks, corrected age 27.8 ± 21.7 months) with PVL and 46 matched, preterm control subjects were studied using a three-dimensional T1-weighted sequence. Volumes were calculated using SPM5 and IBASPM.

Results

GM volume in frontal superior orbital, posterior cingulum and lingual gyrus, the putamen and thalamus was significantly higher in children with PVL (3.6 ± 0.6 cm3, 2.0 ± 0.5 cm3, 9.7 ± 1.7 cm3, 2.5 ± 0.6 cm3, 2.6 ± 0.9 cm3, respectively) than in controls (3.1 ± 0.7 cm3, 1.5 ± 0.2 cm3, 8.2 ± 1.3 cm3, 1.7 ± 1.4 cm3, 1.8 ± 0.4 cm3, respectively). White matter volume was lower (182.1 ± 40.5 cm3) and CSF volume was higher (300.8 ± 56.2 cm3) in children with PVL than in controls (222.9 ± 67.2 cm3, 219.0 ± 61.8 cm3, respectively), P < 0.05. No significant difference was found in the total GM volume and the volume of neocortex.

Conclusion

Preterm children with PVL show regional GM volume increase, possibly explained by axonal sprouting, neuronal hypertrophy and neurogenesis, which in turn may reflect brain plasticity.

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References

  1. Volpe JJ (2001) Neurobiology of periventricular leukomalacia in the premature infant. Pediatr Res 50:553–562

    Article  CAS  PubMed  Google Scholar 

  2. Volpe JJ (2005) Encephalopathy of prematurity includes neuronal abnormalities. Pediatrics 116:221–225

    Article  PubMed  Google Scholar 

  3. Blumenthal I (2004) Periventricular leucomalacia: a review. Eur J Pediatr 163:435–442

    Article  PubMed  Google Scholar 

  4. Volpe JJ (2009) Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances. Lancet Neurol 8:110–124

    Article  PubMed  Google Scholar 

  5. Volpe JJ (2003) Cerebral white matter injury of the premature infant-more common than you think. Pediatrics 112:176–180

    Article  PubMed  Google Scholar 

  6. Marlow N (2004) Neurocognitive outcome after very preterm birth. Arch Dis Child Fetal Neonatal Ed 89:F224–228

    Article  CAS  PubMed  Google Scholar 

  7. Inder TE, Warfield SK, Wang H et al (2005) Abnormal cerebral structure is present at term in premature infants. Pediatrics 115:286–294

    Article  PubMed  Google Scholar 

  8. Argyropoulou MI, Xydis V, Drougia A et al (2003) MRI measurements of the pons and cerebellum in children born preterm; associations with the severity of periventricular leukomalacia and perinatal risk factors. Neuroradiology 45:730–734

    Article  CAS  PubMed  Google Scholar 

  9. Peterson BS, Anderson AW, Ehrenkranz R et al (2003) Regional brain volumes and their later neurodevelopmental correlates in term and preterm infants. Pediatrics 111:939–948

    Article  PubMed  Google Scholar 

  10. Peterson BS, Vohr B, Staib LH et al (2000) Regional brain volume abnormalities and long-term cognitive outcome in preterm infants. JAMA 284:1939–1947

    Article  CAS  PubMed  Google Scholar 

  11. Lin Y, Okumura A, Hayakawa F et al (2001) Quantitative evaluation of thalami and basal ganglia in infants with periventricular leukomalacia. Dev Med Child Neurol 43:481–485

    Article  CAS  PubMed  Google Scholar 

  12. Nosarti C, Al-Asady MH, Frangou S et al (2002) Adolescents who were born very preterm have decreased brain volumes. Brain 125:1616–1623

    Article  PubMed  Google Scholar 

  13. Alemán-Gómez Y, Melie-Garcia L, Valdés-Hernandez P (2006) IBASPM: Toolbox for automatic parcellation of brain structures 12th Annual Meeting of the Organization for Human Brain Mapping. Florence, Italy

    Google Scholar 

  14. Inder TE, Volpe JJ (2000) Mechanisms of perinatal brain injury. Semin Neonatol 5:3–16

    Article  CAS  PubMed  Google Scholar 

  15. Rezaie P, Dean A (2002) Periventricular leukomalacia, inflammation and white matter lesions within the developing nervous system. Neuropathology 22:106–132

    Article  PubMed  Google Scholar 

  16. De Vries LS, Van Haastert IL, Rademaker KJ et al (2004) Ultrasound abnormalities preceding cerebral palsy in high-risk preterm infants. J Pediatr 144:815–820

    PubMed  Google Scholar 

  17. Johnston MV, Hoon AH Jr (2006) Cerebral palsy. Neuromolecular Med 8:435–450

    Article  CAS  PubMed  Google Scholar 

  18. Johnston MV (2003) Injury and plasticity in the developing brain. Exp Neurol 184(Suppl 1):S37–41

    Article  PubMed  Google Scholar 

  19. Taupin P (2006) Adult neurogenesis and neuroplasticity. Restor Neurol Neurosci 24:9–15

    PubMed  Google Scholar 

  20. Staudt M (2007) (Re-)organization of the developing human brain following periventricular white matter lesions. Neurosci Biobehav Rev 31:1150–1156

    Article  PubMed  Google Scholar 

  21. Johnston MV (2003) Brain plasticity in paediatric neurology. Eur J Paediatr Neurol 7:105–113

    Article  PubMed  Google Scholar 

  22. Staudt M, Grodd W, Gerloff C et al (2002) Two types of ipsilateral reorganization in congenital hemiparesis: a TMS and fMRI study. Brain 125:2222–2237

    Article  PubMed  Google Scholar 

  23. Xydis V, Astrakas L, Zikou A et al (2006) Magnetization transfer ratio in the brain of preterm subjects: age-related changes during the first 2 years of life. Eur Radiol 16:215–220

    Article  PubMed  Google Scholar 

  24. Okoshi Y, Itoh M, Takashima S (2001) Characteristic neuropathology and plasticity in periventricular leukomalacia. Pediatr Neurol 25:221–226

    Article  CAS  PubMed  Google Scholar 

  25. Okoshi Y, Mizuguchi M, Itoh M et al (2007) Altered nestin expression in the cerebrum with periventricular leukomalacia. Pediatr Neurol 36:170–174

    Article  PubMed  Google Scholar 

  26. Resch B, Vollaard E, Maurer U et al (2000) Risk factors and determinants of neurodevelopmental outcome in cystic periventricular leucomalacia. Eur J Pediatr 159:663–670

    Article  CAS  PubMed  Google Scholar 

  27. Kostovic I, Judas M (2007) Transient patterns of cortical lamination during prenatal life: do they have implications for treatment? Neurosci Biobehav Rev 31:1157–1168

    Article  PubMed  Google Scholar 

  28. Kostovic I, Judas M (2006) Prolonged coexistence of transient and permanent circuitry elements in the developing cerebral cortex of fetuses and preterm infants. Dev Med Child Neurol 48:388–393

    Article  PubMed  Google Scholar 

  29. Ligam P, Haynes RL, Folkerth RD et al (2009) Thalamic damage in periventricular leukomalacia: novel pathologic observations relevant to cognitive deficits in survivors of prematurity. Pediatr Res 65:524–529

    Article  PubMed  Google Scholar 

  30. Pierson CR, Folkerth RD, Billiards SS et al (2007) Gray matter injury associated with periventricular leukomalacia in the premature infant. Acta Neuropathol 114:619–631

    Article  PubMed  Google Scholar 

  31. Ricci D, Anker S, Cowan F et al (2006) Thalamic atrophy in infants with PVL and cerebral visual impairment. Early Hum Dev 82:591–595

    Article  PubMed  Google Scholar 

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Correspondence to Maria I. Argyropoulou.

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Tzarouchi, L.C., Astrakas, L.G., Zikou, A. et al. Periventricular leukomalacia in preterm children: assessment of grey and white matter and cerebrospinal fluid changes by MRI. Pediatr Radiol 39, 1327–1332 (2009). https://doi.org/10.1007/s00247-009-1389-0

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  • DOI: https://doi.org/10.1007/s00247-009-1389-0

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