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Extremely Preterm Infants with a Near-total Absence of Cerebellum: Usefulness of Quantitative Magnetic Resonance in Predicting the Motor Outcome

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Abstract

This study aims to evaluate in extremely premature infants the severity of brain structural injury causing total absence or near-total absence of cerebellar hemispheres by using MRI visual and volumetric scoring systems. It also aims to assess the role of the score systems in predicting motor outcome. We developed qualitative and quantitative MRI scoring systems to grade the overall brain damage severity in 16 infants with total absence or near-total absence of cerebellar hemispheres. The qualitative scoring system assessed the severity of macrostructural abnormalities of cerebellum, brainstem, supratentorial gray and white matters, ventricles while the quantitative scoring system weighted the loss of brain tissue volumes, and gross motor function classification system (GMFCS) was used to assess motor function at 1- and 5-year follow-ups.

Positive correlations between both MRI scores and GMFCS scales were detected at follow-ups (p > 0.05), but only the volumetric score could identify those infants developing higher levels of motor impairment.

Brain volumetric MRI offers an unbiassed assessment of prenatal brain damage. The quantitative scoring system, performed at term equivalent age, can be a helpful tool for predicting the long-term motor outcome in extremely preterm infants with a near-total absence of cerebellum.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Radiology and Neuroradiology Unit, Department of Imaging, Radiation Therapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 1, 00168, Rome, Italy

    Rosalinda Calandrelli, Laura Tuzza & Cesare Colosimo

  2. Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy

    Domenico Marco Romeo & Chiara Arpaia

  3. Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168, Rome, Italy

    Domenico Marco Romeo & Chiara Arpaia

  4. Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy

    Cesare Colosimo

  5. Research Unit of Neurology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, –00128, Rome, Italy

    Fabio Pilato

  6. Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, –00128, Rome, Italy

    Fabio Pilato

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  1. Rosalinda Calandrelli
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  2. Laura Tuzza
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  3. Domenico Marco Romeo
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  4. Chiara Arpaia
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  5. Cesare Colosimo
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Contributions

Rosalinda Calandrelli: project development, data collection, and manuscript writing; Laura Tuzza: data collection; Domenico Marco Romeo: data collection; Chiara Arpaia: data collection; Cesare Colosimo: project development; Fabio Pilato: data collection, statistical analysis, and manuscript writing. All authors read and approved the final manuscript.

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Correspondence to Rosalinda Calandrelli.

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We declare that all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Competing Interests

Rosalinda Calandrelli, Laura Tuzza, Domenico Marco Romeo, Chiara Arpaia, and Fabio Pilato declare that they have no conflict of interests. Cesare Colosimo declares that he is a scientific consultant for Bracco Diagnostics Inc. and Bayer HealthCare.

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Calandrelli, R., Tuzza, L., Romeo, D.M. et al. Extremely Preterm Infants with a Near-total Absence of Cerebellum: Usefulness of Quantitative Magnetic Resonance in Predicting the Motor Outcome. Cerebellum (2023). https://doi.org/10.1007/s12311-023-01593-7

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