Cerebellum and Prematurity: A Complex Interplay Between Disruptive and Dysmaturational Events

Abstract

The cerebellum plays a critical regulatory role in motor coordination, cognition, behavior, language, memory, and learning, hence overseeing a multiplicity of functions. Cerebellar development begins during early embryonic development, lasting until the first postnatal years. Particularly, the greatest increase of its volume occurs during the third trimester of pregnancy, which represents a critical period for cerebellar maturation. Preterm birth and all the related prenatal and perinatal contingencies may determine both dysmaturative and lesional events, potentially involving the developing cerebellum, and contributing to the constellation of the neuropsychiatric outcomes with several implications in setting-up clinical follow-up and early intervention.

Long-term predictivity of early neurological assessment and developmental trajectories in low-risk preterm infants

“…This correlation has an important significance, especially considering that GMA is the first evaluation that provides us with information on the motor development trajectory. Moreover, movements, posture, and tone are finely controlled by encephalic structures and alterations detected during these early assessments may act as red flags for minor lesions of the central nervous system that frequently occur in preterm babies, even the low-risk ones ( 37 , 38 ).…”

Neurodevelopmental outcomes and volumetric analysis of brain in preterm infants with isolated cerebellar hemorrhage

“…CBH is known to be more prevalent in smaller and more immature preterm infants, and several factors have been reported as risk factors such as preeclampsia, sepsis, prolonged mechanical ventilation, patent ductus arteriosus, lower Apgar scores, acidosis, and hypotension ( 8 , 22 – 25 ). In the present study, we investigated the risk of isolated CBH, wherein fluctuation in P CO 2 within 72 h after birth was the only factor associated with isolated CBH.…”

Neuroimaging in cerebellar ataxia in childhood: A review

“…60 Extreme prematurity is associated with a high risk of developing peri-and postnatal supra-and infratentorial brain damages, including white matter loss, thinning of the corpus callosum, volume reduction of the cerebellum and brainstem, and atrophic dentate nuclei. 61,[65][66][67][68] Over time, patients present with motor and cognitive impairments of variable degrees. 61,[65][66][67][68] The cerebellum has its greatest increase of volume and surface during the third trimester of pregnancy.…”

“…61,[65][66][67][68] Over time, patients present with motor and cognitive impairments of variable degrees. 61,[65][66][67][68] The cerebellum has its greatest increase of volume and surface during the third trimester of pregnancy. 66,67 As this process is highly energy demanding, the developing cerebellum is prone to injury.…”

“…61,[65][66][67][68] The cerebellum has its greatest increase of volume and surface during the third trimester of pregnancy. 66,67 As this process is highly energy demanding, the developing cerebellum is prone to injury. 66,67 A combination of the selective vulnerability of the developing cerebellum during this window, and several perinatal risk factors such as blood products (including status post GMH/IVH), infections, inflammations, hypoxic-ischemic insults, perinatal glucocorticoid exposure, pain, opioid treatment, and inadequate nutrition, can lead to destruction of immature structures and developmental arrest.…”