title: Impaired trophic interactions between the cerebellum and the cerebrum among preterm infants.
abstract: BACKGROUND
  Advanced neuroimaging techniques have brought increasing recognition of cerebellar injury among premature infants. The developmental relationship between early brain injury and effects on the cerebrum and cerebellum remains unclear.
  
  
  OBJECTIVE
  To examine whether cerebral parenchymal brain lesions among preterm infants are associated with subsequent decreases in cerebellar volume and, conversely, whether primary cerebellar injury is associated with decreased cerebral brain volumes, with advanced, 3-dimensional, volumetric MRI at term gestational age equivalent.
  
  
  METHODS
  Total cerebellar volumes and cerebellar gray and myelinated white matter volumes were determined through manual outlining for 74 preterm infants with unilateral periventricular hemorrhagic infarction (14 infants), bilateral diffuse periventricular leukomalacia (20 infants), cerebellar hemorrhage (10 infants), or normal term gestational age equivalent MRI findings (30 infants). Total brain and right/left cerebral and cerebellar hemispheric volumes were calculated.
  
  
  RESULTS
  Unilateral cerebral brain injury was associated with significantly decreased volume of the contralateral cerebellar hemisphere. Conversely, unilateral primary cerebellar injury was associated with a contralateral decrease in supratentorial brain volume. Cerebellar gray matter and myelinated white matter volumes were reduced significantly not only among preterm infants with primary cerebellar hemorrhage but also among infants with cerebral parenchymal brain injury.
  
  
  CONCLUSIONS
  These data suggest strongly that both reduction in contralateral cerebellar volume with unilateral cerebral parenchymal injury and reduction in total cerebellar volume with bilateral cerebral lesions are related to trophic transsynaptic effects. Early-life cerebellar injury may contribute importantly to the high rates of cognitive, behavioral, and motor deficits reported for premature infants.
authors.affiliation: Department of Neurology, Children's Hospital, Boston, MA 02115, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Limperopoulos
authors.forename: Janet S
authors.initials: JS
authors.lastname: Soul
authors.forename: Haissam
authors.initials: H
authors.lastname: Haidar
authors.forename: Petra S
authors.initials: PS
authors.lastname: Huppi
authors.forename: Haim
authors.initials: H
authors.lastname: Bassan
authors.forename: Simon K
authors.initials: SK
authors.lastname: Warfield
authors.forename: Richard L
authors.initials: RL
authors.lastname: Robertson
authors.forename: Marianne
authors.initials: M
authors.lastname: Moore
authors.forename: Patricia
authors.initials: P
authors.lastname: Akins
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Volpe
authors.forename: Adré J
authors.initials: AJ
authors.lastname: du Plessis
mesh_terms: D002531:Cerebellum / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000473:pathology; D002544:Cerebral Infarction / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000473:pathology*; D007969:Leukomalacia, Periventricular / Q000473:pathology; D008279:Magnetic Resonance Imaging