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Neuroradiology Feb 2024Preterm children with cerebral palsy (CP) often have varying hand dysfunction, while the specific brain injury with periventricular leukomalacia (PVL) cannot quite...
PURPOSE
Preterm children with cerebral palsy (CP) often have varying hand dysfunction, while the specific brain injury with periventricular leukomalacia (PVL) cannot quite explain its mechanism. We aimed to investigate glymphatic activity using diffusion tensor image analysis along the perivascular space (DTI-ALPS) method and evaluate its association with brain lesion burden and hand dysfunction in children with CP secondary to PVL.
METHODS
We retrospectively enrolled 18 children with bilateral spastic CP due to PVL and 29 age- and sex-matched typically developing controls. The Manual Ability Classification System (MACS) was used to assess severity of hand dysfunction in CP. A mediation model was performed to explore the relationship among the DTI-ALPS index, brain lesion burden, and the MACS level in children with CP.
RESULTS
There were significant differences in the DTI-ALPS index between children with CP and their typically developing peers. The DTI-ALPS index of the children with CP was lower than that of the controls (1.448 vs. 1.625, P = 0.003). The mediation analysis showed that the DTI-ALPS index fully mediated the relationship between brain lesion burden and the MACS level (c' = 0.061, P = 0.665), explaining 80% of the effect.
CONCLUSION
This study provides new insights into the neural basis of hand dysfunction in children with CP, demonstrating an important role of glymphatic impairment in such patients. These results suggest that PVL might affect hand function in children with CP by disrupting glymphatic drainage.
Topics: Child; Infant, Newborn; Humans; Cerebral Palsy; Leukomalacia, Periventricular; Glymphatic System; Retrospective Studies; Hand
PubMed: 38129651
DOI: 10.1007/s00234-023-03269-9 -
Pediatrics and Neonatology Dec 2013To examine the neurodevelopmental outcomes of children with periventricular leukomalacia (PVL).
OBJECTIVES
To examine the neurodevelopmental outcomes of children with periventricular leukomalacia (PVL).
MATERIALS AND METHODS
Twenty-five children diagnosed with grade 1, 2 or 3 PVL on the basis of magnetic resonance imaging (MRI) findings between January 2002 and December 2011 were enrolled and followed from 15 months to 10 years of age.
RESULTS
Of the 25 children, one was a term and 24 were preterm-births. Nine (36%) had spastic diplegia and 12 (48%) had quadriplegia. Ten of the 25 (40%) were able to walk independently at 36 months utilizing short leg braces, whereas 13 children (52%) were unable to walk independently. MRI findings revealed grade 1 PVL in nine (36%), grade 2 in 12 (48%), and grade 3 in four (16%) of the 25 children. Eleven of the 16 children (69%) with grade 2 or 3 PVL had Papile III or IV intraventricular hemorrhage (IVH), and many of these children had severe neurologic motor abnormalities, severe psychomotor delay, and seizures. Five of the nine children (56%) with grade 1 PVL had normal psychomotor development. There were statistically significant differences in the motor impairment and walking ability between the children with grade 1 and those with grade 2 PVL (p = 0.008 and 0.005, respectively).
CONCLUSION
Most children with grade 2 or 3 PVL had severe neurodevelopmental delays, but attention should also be paid to the 56% of children with grade 1 PVL who presented with normal psychomotor development. Further studies of larger populations, including long-term follow-up, are necessary to evaluate the outcomes of children with PVL.
Topics: Brain; Child; Child Development; Child, Preschool; Cognition; Female; Humans; Infant; Leukomalacia, Periventricular; Magnetic Resonance Imaging; Male; Motor Activity
PubMed: 23727042
DOI: 10.1016/j.pedneo.2013.04.006 -
Behavioural Brain Research Jul 1992The spectrum of leukomalacia using cranial ultrasound is discussed. Transient densities not evolving into cystic lesions may represent a mild degree of leukomalacia when... (Review)
Review
The spectrum of leukomalacia using cranial ultrasound is discussed. Transient densities not evolving into cystic lesions may represent a mild degree of leukomalacia when persisting for at least a week. A unilateral parenchymal density may be due to bleeding into an ischaemic area, but can also be due to a venous infarction. Cystic leukomalacia can be confidently diagnosed using appropriate equipment and performing sequential scans. A distinction should be made between cysts in the periventricular white matter and cysts in the deep white matter, as the latter carries a higher risk for cerebral visual impairment. Careful ophthalmological examination of these infants will enable us to identify infants with cerebral visual impairment during the first few months of life, allowing the use of special programs aimed at promoting visual development.
Topics: Echoencephalography; Humans; Infant, Newborn; Leukomalacia, Periventricular
PubMed: 1388792
DOI: 10.1016/s0166-4328(05)80189-5 -
European Journal of Paediatric... Mar 2022To assess the prevalence and development of muscle tone impairments in infants at high risk of developmental disorders, and their associations with cerebral palsy (CP)...
AIM
To assess the prevalence and development of muscle tone impairments in infants at high risk of developmental disorders, and their associations with cerebral palsy (CP) and cystic periventricular leukomalacia (cPVL).
METHOD
Longitudinal exploration of muscle tone in 39 infants at high risk of CP (LEARN2MOVE 0-2 project) mostly due to an early lesion of the brain. Muscle tone was assessed ≥4 times between 0 and 21 months corrected age (CA) with the Touwen Infant Neurological Examination. Diagnosis of CP was determined at 21 months CA. Neonatal neuro-imaging was available. Developmental trajectories were calculated using generalized linear mixed effect models.
RESULTS
Infants showed atypical muscle tone in three or four body parts in 93% (172/185) of the assessments. The most prevalent muscle tone pattern was hypotonia of neck and trunk with hypertonia of the limbs (28%). From 7 months CA onwards hypertonia of the arms was associated with CP. Asymmetric arm tone during infancy was associated with unilateral CP. At 18-21 months CA ankle hypertonia was associated with CP at 21 months; leg hypertonia in infancy was not associated with CP. Leg hypertonia was associated with cPVL, regardless of age.
INTERPRETATION
High-risk infants due to an early lesion of the brain often present with muscle tone impairment. In these infants, hypertonia and asymmetric muscle tone of the arms were from 7 months onwards associated with the diagnosis of CP at 21 months; hypertonia of the legs was not.
Topics: Brain; Cerebral Palsy; Humans; Infant; Infant, Newborn; Leukomalacia, Periventricular; Muscle Tonus; Neurologic Examination
PubMed: 35007848
DOI: 10.1016/j.ejpn.2021.12.015 -
Indian Journal of Ophthalmology Feb 2022
Topics: Brain; Child; Eye; Humans; Infant, Newborn; Infant, Premature; Leukomalacia, Periventricular
PubMed: 35086249
DOI: 10.4103/ijo.IJO_2295_21 -
Orvosi Hetilap Jun 1989Prenatal, intrapartum and postnatal factors were investigated in less than 32 gestational age preterm infants known to have periventricular haemorrhage or... (Review)
Review
Prenatal, intrapartum and postnatal factors were investigated in less than 32 gestational age preterm infants known to have periventricular haemorrhage or periventricular leukomalacia. The diagnoses were established on cranial ultrasonography and/or autopsy. Factors associated with periventricular haemorrhage were: postnatal severe hypercapnia, acidosis and hypoxia. In the periventricular leukomalacia group the incidence of antepartum and intrapartum hypoxia and/or ischaemia (antepartum haemorrhage) were significantly higher than in the control group.
Topics: Brain Ischemia; Cerebral Hemorrhage; Cerebral Ventricles; Encephalomalacia; Female; Fetal Hypoxia; Gestational Age; Humans; Hypoxia; Infant, Newborn; Infant, Premature, Diseases; Leukomalacia, Periventricular; Pregnancy; Ultrasonography
PubMed: 2671854
DOI: No ID Found -
Pediatric Neurology Apr 2009Periventricular leukomalacia is characterized by damage to the brain's white matter and impairments in motor function. Motor-evoked potentials by transcranial magnetic...
Periventricular leukomalacia is characterized by damage to the brain's white matter and impairments in motor function. Motor-evoked potentials by transcranial magnetic stimulation evaluate corticospinal tract function. We analyzed alterations in motor-evoked potentials in newborns with periventricular leukomalacia. Thirty infants (aged 4.37 +/- 1.1 months mean +/- S.D.) were divided into three groups: 10 healthy, and 10 with focal and 10 with diffuse periventricular leukomalacia. Potentials recorded in the right abductor pollicis brevis of healthy infants indicated a total motor conduction time of 26.3 +/- 2.4 ms, central motor conduction time of 17.0 +/- 2.6 ms, and central motor conduction velocity of 12.3 +/- 2.2 m/s. In the tibialis anterior, total motor conduction time was 27.4 +/- 2.6 ms; central motor conduction time was 16.7 +/- 2.8 ms, and central motor conduction velocity was 25.2 +/- 3.4 m/s. In the focal periventricular leukomalacia and diffuse periventricular leukomalacia groups, an increase in central motor conduction time and a decrease in central motor conduction velocity (P < 0.05) were evident, without differences between the two groups. Motor-evoked potentials in periventricular leukomalacia revealed an increase in central motor conduction time and a decrease in central motor conduction velocity, without differences between diffuse and focal types.
Topics: Brain; Brain Diseases; Electric Stimulation; Electroencephalography; Evoked Potentials, Motor; Humans; Infant; Infant, Newborn; Leukomalacia, Periventricular; Neural Conduction; Spinal Cord; Transcranial Magnetic Stimulation
PubMed: 19302941
DOI: 10.1016/j.pediatrneurol.2008.10.019 -
Archives Francaises de Pediatrie Nov 1990
Review
Topics: Humans; Infant, Newborn; Infant, Premature; Leukomalacia, Periventricular; Prognosis
PubMed: 2078130
DOI: No ID Found -
Pediatric Neurology Mar 2012Periventricular leukomalacia, a major cause of neurologic disabilities in preterm infants, can be isolated or associated with intraventricular and periventricular...
Periventricular leukomalacia, a major cause of neurologic disabilities in preterm infants, can be isolated or associated with intraventricular and periventricular hemorrhage. To determine the risk factors for isolated periventricular leukomalacia, we retrospectively studied the characteristics of all very low birth weight infants affected by isolated periventricular leukomalacia who were delivered over a 5-year period and compared them with a control group of very low birth weight infants, matched within 2 weeks for gestational age, with no central nervous system pathology, and born during the same period. In total, 20 affected infants were compared with 98 control infants. Neonatal sepsis caused by coagulase-negative Staphylococcus (P = 0.014) and neonatal seizure (P = 0.026) were associated with isolated periventricular leukomalacia only on univariate analysis. Three variables demonstrated statistically significant associations with isolated periventricular leukomalacia on both univariate and multivariate logistic regression analysis as independent risk factors: birth weight (odds ratio, 4.31; 95% confidence interval, 1.54-12.06; P = 0.005), early neonatal hypotension requiring combined inotropic therapy (odds ratio, 4.90; 95% confidence interval; 1.22-19.68, P = 0.025), and delayed surgical closure of hemodynamically significant patent ductus arteriosus beyond age 7 days (odds ratio, 1.20; 95% confidence interval, 1.06-1.35; P = 0.003).
Topics: Case-Control Studies; Female; Humans; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; Leukomalacia, Periventricular; Male; Retrospective Studies; Risk Factors
PubMed: 22353288
DOI: 10.1016/j.pediatrneurol.2011.12.008 -
Brain & Development Nov 2018There are few studies on hiragana reading skill and phonological awareness in Japanese schoolchildren with periventricular leukomalacia (PVL).
BACKGROUND
There are few studies on hiragana reading skill and phonological awareness in Japanese schoolchildren with periventricular leukomalacia (PVL).
METHODS
Three seven-year-old children with PVL who had no intellectual disabilities or dysarthria were recruited. Their perinatal information, brain magnetic resonance image (MRI) at term equivalent age, accompanying neurodevelopmental disorders, ophthalmologic features, Kaufman Assessment Battery for Children (K-ABC), a hiragana reading test (four tasks), and a phonological awareness task (mora reversal tasks) were analyzed.
RESULTS
Patient (Pt) 1 and pt2 were male. Pt2 and pt3 were siblings of triplets. Their gestational age was 28 or 32 weeks, and their birth weights were 1196, 1554, and 1848 g, respectively. Their brain MRI revealed cystic or non-cystic periventricular white matter injury involving the deep white matter at the trigone of both lateral ventricles. Pt1 had attention-deficit/hyperactivity disorder and pt3 had pervasive developmental disorder not otherwise specified. All patients had strabismus with spared best-corrected visual acuity. Scores of Reading/Decoding in K-ABC ranged from 89 to 99. As for the single mora reading task or the non-word reading task in the kana reading test, Z scores of their reading time ranged from 2.3 to 5.9 compared to control children. Pt1 and pt3 made significant errors in the mora reversal task of three-mora words, whereas all patients could answer all words correctly in the mora reversal task of two-mora words.
CONCLUSION
All children showed significantly prolonged reading time despite their adequate letter recognition. Two patients showed delayed phonological awareness. It was suggested that hiragana decoding impairment due to subcortical and/or cortical injury related to PVL affected their reading ability.
Topics: Child; Dyslexia; Female; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Leukomalacia, Periventricular; Male; Pattern Recognition, Visual; Reading; Triplets
PubMed: 29908673
DOI: 10.1016/j.braindev.2018.05.018