Abstract
Disrupted cerebellar development and injury is associated with impairments in both motor and non-motor domains. Methods to non-invasively characterize cerebellar afferent and efferent connections during early development are lacking. The aim of this study was to assess the feasibility of delineating cortico-ponto-cerebellar (CPC) and cerebello-thalamo-cortical (CTC) white matter tracts during brain development using high angular resolution diffusion imaging (HARDI). HARDI data were obtained in 24 infants born between 24+6 and 39 weeks gestational age (median 33+4 weeks) and scanned between 29+1 and 44 weeks postmenstrual age (PMA) (median 37+1 weeks). Probabilistic tractography of CPC and CTC fibers was performed using constrained spherical deconvolution. Connections between cerebellum and contralateral cerebral hemisphere were identified in all infants studied. Fractional anisotropy (FA) values of CTC and CPC pathways increased with increasing PMA at scan (p < 0.001). The supratentorial regions connecting to contralateral cerebellum in most subjects, irrespective of PMA at scan, included the precentral cortex, superior frontal cortex, supplementary motor area, insula, postcentral cortex, precuneus, and paracentral lobule. This study demonstrates the feasibility of assessing CTC and CPC white matter connectivity in vivo during the early stages of development. The ability to assess cerebellar connectivity during this critical developmental period may help improve our understanding of the role of the cerebellum in a wide range of neuromotor and neurocognitive disorders.
Highlights
The cerebellum has traditionally been considered to be involved in motor coordination (Evarts and Thach 1969)
The aim of this study was to assess the performance of these methods (HARDI data analysed with constrained spherical deconvolution (CSD)) in delineating the CTC and CPC pathways in infants between 29 and 44 weeks postmenstrual age (PMA), and to assess the maturation of these pathways over this age range
Similar to previous studies (Palesi et al 2015), to isolate the Coherent white matter pathways between cerebellar and cerebral cortices were reconstructed in all infants studied, suggesting that extensive white matter connections between cerebellum and cerebrum are already established at 29 weeks gestational age
Summary
The cerebellum has traditionally been considered to be involved in motor coordination (Evarts and Thach 1969). Using ex vivo high angular resolution diffusion imaging (HARDI), Takahashi and colleagues were recently able to identify coherent white matter pathways forming the inferior, middle and superior cerebellar peduncles in postmortem human cerebellar specimens ranging from 17 to 38 weeks gestational age (Takahashi et al 2014). These findings indicate that, during the third trimester of pregnancy, the growth rate of the cerebellum is high (Chang et al 2000; Volpe 2009), and of particular relevance here, that the cerebello-thalamo-cortical (CTC) and cerebro-ponto-cerebellar (CPC) tracts are maturing. There is a clear need for a tool that allows non-invasive assessment of cerebellar afferent and efferent maturation following preterm birth and in infants considered high-risk for neurocognitive and behavioral disorders
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