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Published on: November 20, 2015
Late gestation cerebellar growth is rapid and impeded by premature birth
Catherine Limperopoulos1, Janet S Soul, Kimberlee Gauvreau
1Department of Neurology, Children's Hospital Boston and Harvard Medical School, 300 Longwood Ave, Fegan 11, Boston, Massachusetts 02115, USA. catherine.limperopoulos@childrens.harvard.edu.
Insights
Premature birth and brain injuries impede early cerebellar growth, potentially leading to long-term neurodevelopmental issues in survivors. This study used quantitative MRI to assess cerebellar development in preterm infants.
Area of Science:
- Neuroscience
- Developmental Biology
- Radiology
Background:
- Preterm birth survivors often experience cognitive impairments and academic failure.
- The cerebellum plays a crucial role in cognitive and social development.
- Understanding cerebellar growth in preterm infants is vital for predicting neurodevelopmental outcomes.
Purpose of the Study:
- To investigate the impact of prematurity and associated brain injuries on early postnatal cerebellar growth.
- To quantify cerebellar growth using advanced 3D volumetric MRI.
- To correlate cerebellar volume with gestational age and brain injury in preterm infants.
Main Methods:
- Quantitative 3D volumetric MRI was performed on preterm (<37 weeks) and healthy term-born infants.
- Manual outlining was used to determine cerebellar volumes.
- Intracranial and total brain volumes were also calculated for comparison.
Main Results:
- Cerebellar volume in preterm infants grew significantly faster (177%) than intracranial (110%) or brain (107%) volumes from 28 weeks' postconceptional age to term.
- Smaller cerebellar volume was associated with lower gestational age and reduced intracranial/brain volumes.
- Preterm infants had significantly smaller cerebellar volumes at term-equivalent age compared to term-born infants, even without direct cerebellar injury.
Conclusions:
- The immature cerebellum exhibits rapid growth during late gestation, which is vulnerable to disruption by premature birth.
- Prematurity and associated brain injuries significantly impede cerebellar growth.
- Impaired cerebellar development may contribute to the long-term neurodevelopmental disabilities observed in preterm birth survivors.
Objective:
Cognitive impairments and academic failure are commonly reported in survivors of preterm birth. Recent studies suggest an important role for the cerebellum in the development of cognitive and social functions. The objective of this study was to examine the impact of prematurity itself, as well as prematurity-related brain injuries, on early postnatal cerebellar growth with quantitative MRI.
Methods:
Advanced 3-dimensional volumetric MRI was performed and cerebellar volumes were obtained by manual outlining in preterm (<37 weeks) and healthy term-born infants. Intracranial and total brain volumes were also calculated.
Results:
A total of 169 preterm and 20 healthy full-term infants were studied; 145 had preterm MRI (pMRI), 75 had term MRI (tMRI), and 51 underwent both pMRI and tMRI. From 28 weeks' postconceptional age to term, mean cerebellar volume (177%) in preterm infants increased at a much faster rate than did mean intracranial (110%) or mean brain (107%) volumes. Smaller cerebellar volume was significantly related to lower gestational age at birth and to intracranial and total brain volumes. Mean cerebellar volume of preterm infants at tMRI was significantly smaller than the volumes of term-born infants. Cerebellar growth impairment was correlated strongly with associated brain injuries, even in the absence of direct cerebellar injury.
Conclusions:
Our data suggest that the growth of the immature cerebellum is particularly rapid during late gestation. However, this accelerated growth seems to be impeded by premature birth and associated brain injury. The long-term neurodevelopmental disabilities seen in survivors of premature birth may be attributable in part to impaired cerebellar development.
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