Periventricular leukomalacia in preterm children: assessment of grey and white matter and cerebrospinal fluid changes by MRI

Abstract

Brain plasticity in patients with periventricular leukomalacia (PVL) may suggest grey matter (GM) changes. To assess the volume of 116 GM areas and total volume of GM, white matter (WM) and cerebrospinal fluid (CSF) in preterm children with PVL, using the Statistical Parametric Mapping (SPM5) and the Individual Brain Atlases Statistical Parametric Mapping (IBASPM) toolboxes. Ten preterm children (gestational age 31.7 +/- 4.2 weeks, corrected age 27.8 +/- 21.7 months) with PVL and 46 matched, preterm control subjects were studied using a three-dimensional T1-weighted sequence. Volumes were calculated using SPM5 and IBASPM. GM volume in frontal superior orbital, posterior cingulum and lingual gyrus, the putamen and thalamus was significantly higher in children with PVL (3.6 +/- 0.6 cm(3), 2.0 +/- 0.5 cm(3), 9.7 +/- 1.7 cm(3), 2.5 +/- 0.6 cm(3), 2.6 +/- 0.9 cm(3), respectively) than in controls (3.1 +/- 0.7 cm(3), 1.5 +/- 0.2 cm(3), 8.2 +/- 1.3 cm(3), 1.7 +/- 1.4 cm(3), 1.8 +/- 0.4 cm(3), respectively). White matter volume was lower (182.1 +/- 40.5 cm(3)) and CSF volume was higher (300.8 +/- 56.2 cm(3)) in children with PVL than in controls (222.9 +/- 67.2 cm(3), 219.0 +/- 61.8 cm(3), respectively), P < 0.05. No significant difference was found in the total GM volume and the volume of neocortex. Preterm children with PVL show regional GM volume increase, possibly explained by axonal sprouting, neuronal hypertrophy and neurogenesis, which in turn may reflect brain plasticity.