Related Experiment Video
Updated: Jul 16, 2025
Early Pathological and Magnetic Resonance Detection of Cerebral Injury Using a Rat Model of Neonatal Hypoxic Ischemic Encephalopathy
Published on: October 28, 2022
Cerebellar growth, volume and diffusivity in children cooled for neonatal encephalopathy without cerebral palsy
Chelsea Q Wu1, Frances M Cowan2,3, Sally Jary2
1Bristol Medical School, University of Bristol, Bristol, UK.
Insights
Children treated for hypoxic-ischemic encephalopathy (HIE) without cerebral palsy show developmental delays and altered cerebellar growth. These findings highlight the long-term impact of HIE on brain development.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Hypoxic-ischemic encephalopathy (HIE) is a serious birth complication.
- Children treated for HIE often experience long-term neurodevelopmental challenges.
- Cerebral palsy (CP) is a known outcome of HIE, but subtle deficits persist even without CP.
Purpose of the Study:
- To investigate cerebellar development and its association with neurodevelopmental outcomes in children treated for HIE without CP.
- To compare cerebellar growth, volume, and white matter integrity between HIE cases and controls.
- To explore the relationship between cerebellar structure and cognitive function (IQ).
Main Methods:
- Longitudinal MRI (T1-weighted, diffusion-weighted) and clinical assessments (MABC-2, WISC-IV) in children aged 6-8 years.
- Measurement of cerebellar growth from infancy to childhood.
- Analysis of regional cerebellar volumes and diffusion properties (MD, FA) in 9 cerebellar regions.
- Comparison of cases (HIE without CP) and age/sex/SES-matched controls.
Main Results:
- Cases showed reduced cerebellar width growth, particularly in those with lower IQ (FSIQ ≤ 85).
- Regional cerebellar volumes were smaller in cases compared to controls, though not significant when normalized.
- No significant differences in mean diffusivity (MD) or fractional anisotropy (FA) between cases and controls.
- Interposed nucleus volume showed a stronger association with IQ in cases than controls.
Conclusions:
- Children treated for HIE without CP exhibit altered cerebellar growth patterns.
- Cerebellar development is linked to cognitive outcomes in this population.
- Subtle structural brain differences in the cerebellum may contribute to neurodevelopmental deficits post-HIE.
Abstract:
Children cooled for HIE and who did not develop cerebral palsy (CP) still underperform at early school age in motor and cognitive domains and have altered supra-tentorial brain volumes and white matter connectivity. We obtained T1-weighted and diffusion-weighted MRI, motor (MABC-2) and cognitive (WISC-IV) scores from children aged 6-8 years who were cooled for HIE secondary to perinatal asphyxia without CP (cases), and controls matched for age, sex, and socioeconomic status. In 35 case children, we measured cerebellar growth from infancy (age 4-15 days after birth) to childhood. In childhood, cerebellar volumes were measured in 26 cases and 23 controls. Diffusion properties (mean diffusivity, MD and fractional anisotropy, FA) were calculated in 24 cases and 19 controls, in 9 cerebellar regions. Cases with FSIQ ≤ 85 had reduced growth of cerebellar width compared to those with FSIQ > 85 (p = 0.0005). Regional cerebellar volumes were smaller in cases compared to controls (p < 0.05); these differences were not significant when normalised to total brain volume. There were no case-control differences in MD or FA. Interposed nucleus volume was more strongly associated with IQ in cases than in controls (p = 0.0196). Other associations with developmental outcome did not differ between cases and controls.
