Periventricular white matter injury is the leading cause of cerebral palsy in premature infants for which no effective treatments are available. Our previous studies have demonstrated that pharmacological activation of the cAMP response element-binding protein (CREB) signaling pathway, before hypoxic-ischemia protected against neuronal injury in neonatal rats. We examined whether rolipram, a phosphodiesterase type IV inhibitor, treatment after hypoxic-ischemia is protective against white matter injury in neonatal rats. Rats were exposed to hypoxia-ischemia (HI) on P7 and then treated with daily injections of various doses of rolipram (P7-P11). Immunohistochemical staining for myelin basic protein, ED1, glial fibrillary acidic protein, CREB and O1 were examined on P11. We found that the periventricular white matter and deep cortical lesions were exacerbated by rolipram administration after HI injury. The lesions in the rolipram-treated group also showed increased astrogliosis and increased CREB phosphorylation in the activated microglia and astrocytes. Furthermore, the rolipram-posttreated HI group had markedly depleted preoligodendrocytes in the ipsilateral hemisphere, which may be related to decreased preoligodendrocytes proliferation after rolipram treatment per se. These data suggest that rolipram treatment after hypoxic-ischemia is not protective; in contrast, rolipram may exacerbate hypoxic-ischemic white matter injury in neonatal rat brains. N early 90% of low-birth weight infants now survive with the advances in neonatal intensive care. Of the survivors, however, 10 -15% have cerebral palsy, and 25-50% have manifest cognitive and behavioral deficits (1). Periventricular white matter injury, or leukomalacia (PVL), is the major form of brain injury in preterm babies. The neuropatholgical findings are characterized by distinct cystic white matter lesions and, commonly, a more diffuse loss of white matter volume and secondary ventriculomegaly (2). Notably, despite the significant long-term morbidity, there is currently no specific treatment for these disorders.Although, the exact cause of PVL in human infants is currently unknown, hypoxia-ischemia (HI) is believed to be a significant cause (3). Cell-type specific factors are also likely to underlie the mechanisms of PVL. Data from a recent study demonstrated that PVL in humans was related to oxidative damage that particularly targeted cells of the oligodendrocyte lineage; whereas neuronal and glial cells were markedly more resistant (4). The timing of appearance of preoligodendrocytes (preOLs) coincides with the high-risk period for PVL (5). Considerable data demonstrate that preOLs are highly susceptible to oxidative stress and hypoxic-ischemia injury (6 -9). Compared with mature oligodendrocytes, preOLs express lower levels of antioxidant enzymes (6). These data suggest that acceleration of preOLs maturation might be a feasible strategy to reduce the severity of PVL.cAMP plays an important role in inducing oligodendrocyte differentiation and myeli...