Cerebellar Atrophy after Moderate-to-Severe Pediatric Traumatic Brain Injury

Although the cerebellum has not attracted the same degree of attention as cortical areas and the hippocampus in traumatic brain injury (TBI) literature, there is limited structural and functional imaging evidence that the cerebellum is also vulnerable to insult. The cerebellum is emerging as part of...

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Bibliographic Details
Published in:	American Journal of Neuroradiology Vol. 28; no. 3; pp. 537 - 542
Main Authors:	Spanos, G.K, Wilde, E.A, Bigler, E.D, Cleavinger, H.B, Fearing, M.A, Levin, H.S, Li, X, Hunter, J.V
Format:	Journal Article
Language:	English
Published:	Oak Brook, IL Am Soc Neuroradiology 01-03-2007 American Society of Neuroradiology
Subjects:	Adolescent Atrophy Biological and medical sciences Brain Injuries - complications Brain Injuries - pathology Cerebellum - pathology Cerebral Cortex - injuries Cerebral Cortex - pathology Child Cognition Disorders - etiology Cognition Disorders - pathology Electrodiagnosis. Electric activity recording Female Fundamental and applied biological sciences. Psychology Humans Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Imaging Male Medical sciences Nervous system Neural Pathways - injuries Neural Pathways - pathology Pediatrics Personality. Affectivity Pons - injuries Pons - pathology Prefrontal Cortex - injuries Prefrontal Cortex - pathology Psychology. Psychoanalysis. Psychiatry Psychology. Psychophysiology Radiodiagnosis. Nmr imagery. Nmr spectrometry Severity of Illness Index Sexuality. Sexual behavior Thalamus - injuries Thalamus - pathology Human Atrophy Cerebellum Pediatrics Nervous system diseases Radiodiagnosis Central nervous system Child Trauma Encephalon
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Summary:	Although the cerebellum has not attracted the same degree of attention as cortical areas and the hippocampus in traumatic brain injury (TBI) literature, there is limited structural and functional imaging evidence that the cerebellum is also vulnerable to insult. The cerebellum is emerging as part of a frontocerebellar system that, when disrupted, results in significant cognitive and behavioral consequences. We hypothesized that cerebellar volume would be reduced in children following TBI and wished to examine the relation between the cerebellum and known sites of projection, including the prefrontal cortex, thalamus, and pons. Quantitative MR imaging was used to measure cerebellar white and gray matter and lesion volumes 1-10 years following TBI in 16 children 9-16 years of age and 16 demographically matched typically developing children 9-16 years of age. Cerebellar volumes were also compared with volumetric data from other brain regions to which the cerebellum projects. A significant group difference was found in cerebellar white and gray matter volume, with children in the TBI group consistently exhibiting smaller volumes. Repeating the analysis after excluding children with focal cerebellar lesions revealed that significant group differences still remained for cerebellar white matter (WM). We also found a relation between the cerebellum and projection areas, including the dorsolateral prefrontal cortex, thalamus, and pons in 1 or both groups. Our finding of reduced cerebellar WM volume in children with TBI is consistent with evidence from experimental studies suggesting that the cerebellum and its related projection areas are highly vulnerable to fiber degeneration following traumatic insult.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0195-6108 1936-959X 1432-1920