Quantitative evaluation of thalami and basal ganglia in infants with periventricular leukomalacia

Abstract

Quantitative analyses of cross-sectional areas of the thalami, caudate nuclei, and lentiform nuclei were performed in 29 preterm infants (16 males, 13 females; mean age 29.6 weeks, age range 27 to 24 weeks,) with periventricular leukomalacia (PVL). MRI was carried out in the infants between 9 and 18 months of corrected age and in 16 control infants. Bilateral thalami, caudate nuclei, lentiform nuclei, cerebral hemispheres, and cerebellum were measured by computer. Ratios of the areas of the thalami (Th), caudate nuclei (Ca), lentiform nuclei (Le), and cerebral hemispheres (CH) to that of the cerebellum (Ce) were calculated in each infant. The ratio of Th:Ce was significantly smaller in infants with moderate and severe PVL than in the control group bilaterally. Abnormal intensity areas were not observed in the thalami in any infants with PVL. CH:Ce was also smaller in infants with severe PVL than in the control group. No significant difference was observed between the groups in ratios Le:Ce or Ca:Ce. Results of our study suggest that the volume of the thalami is reduced and that thalamic involvement is present in infants with white matter lesions who have moderate to severe PVL.

Regional Differences in Susceptibility to Hypoxic-Ischemic Injury in the Preterm Brain: Exploring the Spectrum from White Matter Loss to Selective Grey Matter Injury in a Rat Model

“…In this investigation, we found that MBP loss appears to be the most sensitive measure of injury, and severity of MBP loss can be used as a benchmark in order to stage other pathophysiological responses such as microglial and astrocytic reactivity and neuronal injury. Interestingly, the damage to grey matter in the preterm rodent occurs in cortical and subcortical structures with similar pattern and distribution to that observed in the human preterm infant [14, 24, 39]. Importantly, these data corroborate the most important cellular aspects of the encephalopathy of prematurity described in the human, and the neuropathology documenting that neuronal loss and/or gliosis is present in 13–30% of cases of noncystic PVL [22].…”

New MR Imaging Assessment Tool to Define Brain Abnormalities in Very Preterm Infants at Term

“…Appropriate growth of the thalamus could be impaired by a primary insult, such as ischemia or hemorrhage, or by the secondary effects of degeneration or deafferentation caused by WM and/or cortical GM injury. 31 Thus, deep GM volume may, in effect, integrate the consequences of injury to WM and cortical GM, thereby more fully defining the impact of overall abnormalities 32, 33 and reflecting the global nature of disturbances in brain development.…”

Magnetic resonance imaging of preterm brain injury

“…By term equivalent age, the cystic lesions are often incorporated into the lateral ventricles, resulting in the characteristic squared off appearance of the posterior horns ( fig 4D). Frequent associated findings are thalamic atrophy 35 and abnormal signal intensity within the PLIC. 36 The latter may help predict neuromotor outcome.…”