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Updated: Jun 13, 2026
Mouse Models of Periventricular Leukomalacia
Published on: May 18, 2010
Cross-sectional comparison of periventricular leukomalacia in preterm and term children
Oliver Lasry1, Michael I Shevell, Lynn Dagenais
1Division of Pediatric Neurology, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada.
Insights
Children born preterm and at term with cerebral palsy due to periventricular white matter injury (PVWMI/PVL) exhibit distinct clinical and functional characteristics, suggesting different underlying injury mechanisms.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder.
- Periventricular white matter injury (leukomalacia) (PVWMI/PVL) is a significant cause of CP, particularly in preterm infants.
- Understanding the differences in CP presentation based on gestational age and PVWMI/PVL is crucial for targeted interventions.
Purpose of the Study:
- To compare the clinical features, neurologic subtypes, functional outcomes, and comorbidities of preterm and term-born children diagnosed with CP secondary to PVWMI/PVL.
- To identify potential differences in the clinicopathologic entities despite a common radiologic finding.
Main Methods:
- Systematic search of a cerebral palsy registry (REPACQ) for children with radiologic evidence of PVWMI/PVL within a defined birth cohort (1999-2002).
- Comparison of clinical data, including neurologic subtype, Gross Motor Function Classification System (GMFCS) levels, and comorbidities, between preterm (<37 weeks) and term (>=37 weeks) born children.
- Statistical analysis to determine significant differences between the groups.
Main Results:
- Of 41 children with PVWMI/PVL, 26 were preterm and 15 were term-born.
- Significant differences were observed in neurologic subtypes, with higher frequencies of spastic hemiplegia and spastic diplegia in preterm and term-born children, respectively.
- Functional outcomes (GMFCS levels I-II) showed significant differences between the groups.
- Cortical blindness was a notable comorbidity exclusively observed in term-born children.
Conclusions:
- Preterm and term-born children with CP and PVWMI/PVL represent distinct clinicopathologic entities.
- The observed differences suggest variations in the gestational timing and mechanisms of acquired brain injury.
- Further research is warranted to elucidate the specific pathways leading to these divergent presentations.
Objective:
To document and contrast the characteristics of preterm and term-born children with cerebral palsy attributed to underlying radiologic periventricular white matter injury (leukomalacia) (PVWMI/PVL).
Methods:
A comprehensive cerebral palsy population-based registry (REPACQ) for a 4-year inclusive (1999-2002) birth cohort was systematically searched for all children with radiologic evidence for PVWMI/PVL. Clinical features, neurologic subtype, gross motor functional impairment, and comorbidities were compared in those children born preterm (<37 weeks) and those born at term (> or = 37 weeks).
Results:
Of 242 children with cerebral palsy in the registry, 213 had available neuroimaging, in which 41 had PVWMI/PVL: 26 preterm born and 15 term born. Neurologic subtype differed significantly between preterm and term-born children with respect to the frequency of spastic hemiplegia (5/26 vs 8/15; p < 0.05) and spastic diplegia (9/26 vs 2/15; p < 0.05). The groups also differed significantly from a functional perspective (Gross Motor Function Classification System for Cerebral Palsy level I-II; 12/26 vs 12/15; p < 0.05). The comorbidity spectrum was similar between the 2 groups except for the occurrence of cortical blindness in the term-born children (3/15 vs 0/26; p < 0.05).
Conclusion:
Differences between preterm and term-born children with cerebral palsy with periventricular white matter injury (leukomalacia) suggest that despite a common radiologic pattern, these are different clinicopathologic entities with perhaps a different gestational timing of acquired injury.
