Characteristic neuropathology and plasticity in periventricular leukomalacia

The brains of extremely low-birth-weight infants with periventricular leukomalacia, who survived for more than 30 days, were examined by means of neuropathologic and immunohistochemical methods. The characteristic neuropathology of the brain is comprised of spongy changes with astrogliosis, a widespread distribution (i.e., in the deep to intermediate white matter), and a diffuse distribution of associated recent lesions. Also, these lesions, both remote and recent, are located in the frontal to occipital lobes. Regarding the correlation between the lesions and transneuronal connecting fibers, the lesions involved fibers of the motor, sensory, visual, and higher cerebral functions. This involvement may cause motor and intellectual disabilities. Furthermore, immunohistochemistry demonstrated nestin-positive astrocytes, and neurons increased around the lesions, suggesting the plasticity of the brains.