Mild cerebellar injury does not significantly affect cerebral white matter microstructural organization and neurodevelopmental outcome in a contemporary cohort of preterm infants

Senden, Richelle E M, Keunen, Kristin, van der Aa, Niek E, Leemans, Alexander, Isgum, Ivana, Viergever, Max A, Dudink, Jeroen, de Vries, Linda S, Groenendaal, Floris, Benders, Manon J N L


Pediatric Research


BACKGROUND: Preterm birth is associated with an increased risk of cerebellar injury. The aim of this study was to assess the impact of cerebellar hemorrhages (CBH) on cerebral white matter microstructural tissue organization and cerebellar volume at term equivalent age (TEA) in extremely preterm infants. Furthermore, we aimed to evaluate the association between CBH and neurodevelopmental outcome in late infancy.

METHODS: 24 preterm infants with punctate CBH were included and each matched to two preterm control infants. T1-, T2-weighted images and diffusion weighted imaging were acquired on a 3 T MRI system. Regions of interest were drawn on a population-specific neonatal template and automatically registered to individual fractional anisotropy (FA) maps. Brain volumes were automatically computed. Neurodevelopmental outcome was assessed using the Bayley scales of Infant and Toddler Development at two years corrected age.

RESULTS: CBH were not significantly related to FA in the posterior limb of the internal capsule and corpus callosum or to cerebellar volume. Infants with CBH did not have poorer neurodevelopmental outcome compared to control infants.

CONCLUSION: These findings suggest that the impact of mild CBH on early macroscale brain development may be limited. Future studies are needed to assess the effects of CBH on long-term neurodevelopment.Pediatric Research accepted article preview online, 23 January 2018. doi:10.1038/pr.2018.10.