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Updated: Jul 11, 2026
Mouse Models of Periventricular Leukomalacia
Published on: May 18, 2010
Gray matter injury associated with periventricular leukomalacia in the premature infant
Christopher R Pierson1, Rebecca D Folkerth, Saraid S Billiards
1Department of Pathology, Children's Hospital Boston, Boston, MA, USA. Piersonc@CCRI.net
Insights
Prematurity survivors with periventricular leukomalacia (PVL) show increased gray matter lesions, particularly in the thalamus and basal ganglia. This suggests white matter injury in premature infants is more widespread than previously thought.
Area of Science:
- Neuropathology
- Pediatric Neurology
- Neurodevelopmental Disorders
Background:
- Neuroimaging reveals reduced gray matter volumes in premature infants with periventricular leukomalacia (PVL).
- The extent and severity of gray matter lesions in PVL cases require further investigation at autopsy.
Purpose of the Study:
- To investigate the incidence and severity of subacute and/or chronic gray matter lesions in premature infants with PVL compared to those without PVL.
Main Methods:
- Autopsy examination of 41 premature infants categorized into PVL, diffuse white matter gliosis (DWMG), and control groups.
- Histological analysis of cerebral white and gray matter for neuronal loss and gliosis.
Main Results:
- Neuronal loss was significantly increased in PVL cases, predominantly in the thalamus, globus pallidus, and cerebellar dentate nucleus.
- Gliosis was also significantly elevated in PVL cases within deep gray nuclei (thalamus/basal ganglia) and basis pontis.
- Thalamic and basal ganglionic lesions were almost exclusively observed in infants with PVL.
Conclusions:
- Gray matter lesions are common (≥33%) in premature infants with PVL, indicating white matter injury is not isolated.
- The term "perinatal panencephalopathy" may more accurately encompass the neuropathological findings in these cases.
Abstract:
Neuroimaging studies indicate reduced volumes of certain gray matter regions in survivors of prematurity with periventricular leukomalacia (PVL). We hypothesized that subacute and/or chronic gray matter lesions are increased in incidence and severity in PVL cases compared to non-PVL cases at autopsy. Forty-one cases of premature infants were divided based on cerebral white matter histology: PVL (n = 17) with cerebral white matter gliosis and focal periventricular necrosis; diffuse white matter gliosis (DWMG) (n = 17) without necrosis; and "Negative" group (n = 7) with no abnormalities. Neuronal loss was found almost exclusively in PVL, with significantly increased incidence and severity in the thalamus (38%), globus pallidus (33%), and cerebellar dentate nucleus (29%) compared to DWMG cases. The incidence of gliosis was significantly increased in PVL compared to DWMG cases in the deep gray nuclei (thalamus/basal ganglia; 50-60% of PVL cases), and basis pontis (100% of PVL cases). Thalamic and basal ganglionic lesions occur almost exclusively in infants with PVL. Gray matter lesions occur in a third or more of PVL cases suggesting that white matter injury generally does not occur in isolation, and that the term "perinatal panencephalopathy" may better describe the scope of the neuropathology.
