Cerebellar Development in Preterm Infants at Term-Equivalent Age Is Impaired after Low-Grade Intraventricular Hemorrhage.
To investigate cerebellar development in preterm infants at term-equivalent age compared with healthy full-term infants and to examine the effect of a low-grade intraventricular hemorrhage (IVH) on cerebellar development.



This study used 3T magnetic resonance and diffusion tensor imaging (DTI) at 36-41 weeks' postmenstrual age (PMA) in 72 preterm infants without severe brain injury and 16 full-term infants. Cerebellar volumes and DTI parameters of the cerebellar peduncles including fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity, and radial diffusivities were measured. Clinical variables that may affect brain development were collected.



Compared with full-term infants, preterm infants showed smaller cerebellar volumes and a lower FA, greater ADC, and increased radial diffusivities in the cerebellar peduncles (all P < .05). This cerebellar impairment was associated significantly with PMA and IVH grade 2 but was independent of gestational age at birth. When we adjusted for clinical variables, an IVH grade 2 was related with 1.73 cm(3) reduction in cerebellar volumes and altered DTI parameters in the cerebellar peduncles, including decreased FA and increased radial diffusivities in the superior cerebellar peduncle and increases in ADC, axial diffusivity, and radial diffusivities of the middle cerebellar peduncle (all P < .05). Cerebellar hemispheric volumes were associated with both ipsilateral and contralateral IVH grade 2.



Preterm infants without severe brain abnormalities showed impaired cerebellar development at term-equivalent age after we controlled for PMA at the time of the scan, and this is associated with IVH grade 2. These findings suggest that even a low-grade IVH has potential harmful effects on cerebellar development.
Neuroscience Research Institute, Gachon University, Incheon, Korea.
Hye Jin
HJ
Jeong
Division of Neonatology, School of Medicine, Ewha Womans University, Seoul, Korea. Electronic address: simso@ewha.ac.kr.
So-Yeon
SY
Shim
Division of Neonatology, Gachon University, Gil Hospital, Incheon, Korea.
Hye Jung
HJ
Cho
Division of Neonatology, School of Medicine, Ewha Womans University, Seoul, Korea.
Su Jin
SJ
Cho
Division of Neonatology, Gachon University, Gil Hospital, Incheon, Korea.
Dong Woo
DW
Son
Division of Neonatology, School of Medicine, Ewha Womans University, Seoul, Korea.
Eun Ae
EA
Park
D016022:Case-Control Studies; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000254:growth & development*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging; D038524:Diffusion Magnetic Resonance Imaging; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D015233:Models, Statistical; D009929:Organ Size
cerebellar peduncle; cerebellar volume; diffusion tensor imaging