Differential Effects of Intraventricular Hemorrhage and White Matter Injury on Preterm Cerebellar Growth - 20/08/11

Doi : 10.1016/j.jpeds.2010.09.005

Emily W.Y. Tam, MDCM, MAS, FRCPC ^a, Steven P. Miller, MDCM, MAS, FRCPC ^a,^d, Colin Studholme, PhD ^b, Vann Chau, MD, FRCPC ^d, David Glidden, PhD ^c, Kenneth J. Poskitt, MDCM, FRCPC ^d,^e, Donna M. Ferriero, MD ^a, A. James Barkovich, MD ^a,^b
^a Departments of Neurology and Pediatrics, University of California San Francisco, CA
^b Department of Radiology and Biomedical Imaging, University of California San Francisco, CA
^c Department of Epidemiology and Biostatistics, University of California San Francisco, CA
^d Department of Pediatrics, Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
^e Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada

Abstract

Objective

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.

Study design

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.

Results

Adjusting for supratentorial brain injury, cerebellar hemorrhage, and study site, cerebellar volume increased 1.7 cm³/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 cm³ lower in premature infants with grade 1 to 2 IVH and 5.4 cm³ 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).

Conclusions

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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Mots-clés : 3D, CSF, FOV, IVH, MRI, TE, TR, UBC, UCSF, WMI

Plan

Methods

Brain Imaging Techniques

Statistical Analysis

Results

Effect of Gestational Age

Effect of Supratentorial Brain Injury

Discussion

Supported by NIH R01 NS346432, NIH/NCRR UCSF-CTSI (grant UL1 RR024131), and CIHR CHI 151135. E.T. is a Cerebral Palsy International Research Foundation Ethel & Jack Hausman Clinical Research Scholar. S.M. is a Canadian Institutes for Health Research Clinician Scientist and Michael Smith Foundation for Health Research Scholar. The authors declare no conflicts of interest.

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Vol 158 - N° 3

P. 366-371 - mars 2011 Retour au numéro

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Differential Effects of Intraventricular Hemorrhage and White Matter Injury on Preterm Cerebellar Growth - 20/08/11

Abstract

Objective

Study design

Results

Conclusions

Plan

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