Disrupted cerebellar development in preterm infants is associated with impaired neurodevelopmental outcome

Abstract

The unfavorable impact of prematurity on the developing cerebellum was recently recognized, but the outcome after impaired cerebellar development as a prematurity-related complication is hitherto not adequately documented. Therefore we compared 31 preterm patients with disrupted cerebellar development to a control group of 31 gender and gestational age matched premature infants with normal cerebellar development. Supratentorial brain injuries during the neonatal period were comparable between the groups. At a minimum age of 24 months motor and mental development was assessed by standardized tests. Disrupted cerebellar development was associated with significantly poorer scores both in the subtests for neuromotor (p < 0.001) and mental development (p < 0.001), respectively. Mixed CP was diagnosed in 48% of affected patients, whereas none of the patients of the control group had mixed CP. Microcephaly and epilepsy were significantly related to disrupted cerebellar development. Preterm patients with disrupted cerebellar development exhibit poorer outcome results in all investigated variables. The role of the cerebellum in neurodevelopment after prematurity seems to be underestimated so far.

Long-term sequelae after acquired pediatric hemorrhagic cerebellar lesions

“…Even though support for the involvement of the cerebellum in affective and behavioral regulation processes has emerged from psychiatric studies and from studies on children with congenital cerebellar malformations, it is still unclear if these problems correspond to the phenotype of problems resulting from acquired cerebellar lesions during development [34][35][36][37]45]. The results of the questionnaires revealed that the patients experienced just minor emotional distress.…”

“…Thus far, it is known that children who suffer from congenital vermal aplasia (Joubert-Boltshauser syndrome) have severe cognitive deficits [35]. Other reports have linked an underdevelopment of the cerebellum in preterm babies with potential cognitive problems later in life [36][37][38]. The majority of pediatric studies focusing on cognition after acquired cerebellar lesions have mainly recruited patients suffering from oncological diseases.…”

A theory inspired proposal for a novel medical treatment in autism. The cerebellar model of autism and the hypothesis of dorsal stream dysfunction: evidence from idiopathic and syndromic cases.

“…Core items of the M-CHAT include joint attention, interest in other children, responding to being called by name and imitating. Extreme prematurity is a major risk factor for cerebellar lesions ( figure 15) and is related to poorer outcome (Messerschmidt et al 2008). Compared to controls, cerebellar injury resulted in 37% positive screen on M-CHAT and between 37-48% incidence of impairments in expressive language, delayed receptive language, cognitive deficits and motor disabilities (Limperopoulos et al 2007).…”

Expression of SV2 in the Seveloping Chick Cerebellum: Comparison with Calbindin and AMPA Glutamate Receptors 2/3

“…However, no data are available that describe the developmental expression of SV2 in the chick central nervous system, including the cerebellar cortex, a brain region involved in epileptic disorders (Messerschmidt et al, 2008). We used the calcium-binding protein Calbindin as a marker for Purkinje cells (Celio, 1990), to better follow the development of Purkinje cell processes and localize the SV2 staining.…”