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Updated: Jul 13, 2026
Mouse Models of Periventricular Leukomalacia
Published on: May 18, 2010
Cognitive profiles and visuoperceptual abilities in preterm and term spastic diplegic children with periventricular
Emanuela Pagliano1, Ermellina Fedrizzi, Alessandra Erbetta
1Division of Developmental Neurology, National Neurological Institute C Besta, Milan, Italy.
Insights
Premature birth significantly impacts visuoperceptual skills in children with spastic diplegia, even with similar cognitive abilities and brain imaging findings compared to term-born children. Management strategies should differ, focusing on visual rehabilitation for preterm infants.
Area of Science:
- Neurology
- Developmental Pediatrics
- Neuroimaging
Background:
- Periventricular leukomalacia (PVL) is a common brain injury in preterm infants.
- The relationship between PVL severity and neurodevelopmental outcomes is well-studied in preterm children.
- Research on term-born children with spastic diplegia and PVL is limited.
Purpose of the Study:
- To compare cognitive and visuoperceptual abilities in preterm and term children with spastic diplegia and PVL.
- To investigate the relationship between PVL severity and these abilities.
- To identify factors contributing to differences in outcomes between preterm and term groups.
Main Methods:
- Studied 15 preterm and 9 term children with spastic diplegia and PVL on MRI.
- Assessed cognitive abilities using the Griffith scale.
- Evaluated visuoperceptual abilities with the Developmental Test of Visual Perception.
- Correlated findings with PVL severity.
Main Results:
- Cognitive performance was similar between preterm and term groups.
- Term children had normal visuoperceptual scores; preterm children scored below normal.
- Preterm children showed greater compromise in visuomotor than non-motor visuoperceptual skills.
- PVL severity did not fully explain the differences in visuoperceptual outcomes.
Conclusions:
- Prematurity itself, independent of PVL severity, appears to negatively impact visuoperceptual development in spastic diplegia.
- Visual pathway reorganization may be adversely affected by prematurity.
- Strabismus in preterm infants likely contributes to visuoperceptual deficits.
- Tailored management strategies, emphasizing visual rehabilitation, are crucial for preterm children with spastic diplegia.
Abstract:
Although relations between the extent of periventricular leukomalacia and neuropsychological performance in preterm children with spastic diplegia have been extensively investigated, studies on term children with spastic diplegia are rare. The authors examined 15 preterm children and 9 term children with spastic diplegia, all of whom had periventricular leukomalacia as a main magnetic resonance imaging (MRI) finding (excluding full-term spastic diplegic children with other MRI findings). Cognitive abilities (Griffith scale) and visuoperceptual abilities (Developmental Test of Visual Perception) were compared in the 2 groups and related to periventricular leukomalacia severity. Cognitive performance was substantially similar in the 2 groups. However, the overall Developmental Test of Visual Perception scores were below normal in the preterm and were normal in the term children; furthermore, visuoperceptual abilities were differentially affected in the preterm children, with visuomotor abilities more compromised than nonmotor visuoperceptual abilities. These children had similar cognitive performance and MRI findings, so the greater visuoperceptual compromise in the preterm group suggests a direct influence of prematurity, which may have adversely influenced the reorganization of visual centers and pathways following the initial developmental insult. The strabismus present in most preterm children would also have contributed to their greater visuoperceptual compromise. The authors conclude that the management of preterm and term children should differ, with concentration on visuoperceptual skills and rehabilitation in the former.
