Abstract

Periventricular leukomalacia (PVL), a brain injury affecting premature infants is commonly associated with cerebral palsy. PVL results from hypoxia-ischemia (HI) with or without infection and is characterized by white matter necrotic lesions, hypomyelination, microglial activation, astrogliosis, and neuronal death. It is important to study a PVL mouse model that mimics human PVL in symptomatology, anatomic and molecular basis. In our neonate mice model, bilateral carotid arteries were temporary ligated at P5 followed by hypoxic exposure (FiO2 of 8% for 20 min.). At P5 in mice, the white matter is more vulnerable to HI injury than the grey matter. In our PVL model, mice suffer from significant hind limb paresis, incoordination and feeding difficulties. Histologically they present with ventriculomegally, white matter loss, microglial activation and neuronal apoptosis. HI injury increases proinflammtory cytokines, activates NF-kB, activates microglia and causes nitrative stress. All these inflammatory mediators lead to oligodendroglial injury and white matter loss. Neurobehavioral analysis in the PVL mice model at P60 showed that the HI group had a significant decrease in hind limb strength, worsening rotarod testing and worsening performance in the open field test. This new PVL model has great advantages far beyond just mimicking human PVL in clinical features and histopathology. Long term survival, the development of cerebral palsy and the ability of using this model in transgenic animals will increase our understanding of the mechanistic pathways underlying PVL and defining specific targets for the development of suitable therapeutics.

Highlights

  • Periventricular leukomalacia (PVL) is a major neuropathological white matter brain injury that is closely associated with cerebral palsy (CP) in premature infants

  • Risk factors for the development of PVL include: prematurity associated with immature cerebrovascular

  • Affected infants show definitive signs of cerebral palsy such as spastic diplegia and other signs of cerebral injury associated with PVL, including: seizures, developmental delay, visual and hearing impairment, scoliosis or incontinence by 6–9 months of age [1]

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Summary

Introduction

Periventricular leukomalacia (PVL) is a major neuropathological white matter brain injury that is closely associated with cerebral palsy (CP) in premature infants. Risk factors for the development of PVL include: prematurity associated with immature cerebrovascular. Affected infants show definitive signs of cerebral palsy such as spastic diplegia and other signs of cerebral injury associated with PVL, including: seizures, developmental delay, visual and hearing impairment, scoliosis or incontinence by 6–9 months of age [1]. In US, about 60,000 very low birth weight infants (

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