Structural brain damage and visual disorders in children with cerebral palsy due to periventricular leukomalacia

Tinelli, Francesca; Guzzetta, Andrea; Purpura, Giulia; Pasquariello, Rosa; Cioni, Giovanni; Fiori, Simona

doi:10.1016/j.nicl.2020.102430

Cited by 23 publications

(41 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Intermediate disorders include tunnel/tubular vision (i.e., concentric reduction of the visual field), or its opposite, retention of peripheral vision (i.e., loss of the central visual field, while the peripheral visual field is preserved), homonymous lateral hemianopia (i.e., loss of the contralesional visual field), or quadrantanopia (i.e., loss of a visual quadrant). Lower visual field impairment due to periventricular leukomalacia (often associated with premature birth or CP) can be peripheral or complete, or manifest as degraded clarity in the lower visual fields (Jacobson et al, 2006;Tinelli et al, 2020), and it can be combined with dorsal stream dysfunction, leading to a major deficit in global visual processing. These different disorders may exist as such or be observed successively in the same patient who may show a degree of recovery over time (Guzzetta et al, 2001b;Watson et al, 2007;Werth, 2008).…”

Section: Patterns Of Cortical or Cerebral Visual Impairmentmentioning

confidence: 99%

“…Children with CVI are frequently observed to have oculomotor disorders, difficulties in visual fixation or visual pursuit, hypometric saccades, or a disorder of gaze strategy ( Stiers et al, 2002 ; Fazzi et al, 2004 ), as well as nystagmus due to periventricular leukomalacia ( Jacobson et al, 1998 ; Tinelli et al, 2020 ). These conditions are associated with reduced visual performance.…”

Section: The Differences Between Typical Vision and Cortical Or Cerebral Visual Impairmentmentioning

confidence: 99%

See 1 more Smart Citation

Cortical Visual Impairments and Learning Disabilities

Chokron

Kovarski

Dutton

2021

Front. Hum. Neurosci.

View full text Add to dashboard Cite

Medical advances in neonatology have improved the survival rate of premature infants, as well as children who are born under difficult neurological conditions. As a result, the prevalence of cerebral dysfunctions, whether minimal or more severe, is increasing in all industrialized countries and in some developing nations. Whereas in the past, ophthalmological diseases were considered principally responsible for severe visual impairment, today, all recent epidemiological studies show that the primary cause of blindness and severe visual impairment in children in industrialized countries is now neurological, with lesions acquired around the time of birth currently comprising the commonest contributor. The resulting cortical or cerebral visual impairments (CVIs) have long been ignored, or have been confused either with other ophthalmological disorders causing low vision, or with a range of learning disabilities. We present here the deleterious consequences that CVI can have upon learning and social interaction, and how these can be given behavioral labels without the underlying visual causes being considered. We discuss the need to train and inform clinicians in the identification and diagnosis of CVI, and how to distinguish the diagnosis of CVI from amongst other visual disorders, including the specific learning disorders. This is important because the range of approaches needed to enhance the development of children with CVI is specific to each child’s unique visual needs, making incorrect labeling or diagnosis potentially detrimental to affected children because these needs are not met.

show abstract

Section: Patterns Of Cortical or Cerebral Visual Impairmentmentioning

confidence: 99%

Section: The Differences Between Typical Vision and Cortical Or Cerebral Visual Impairmentmentioning

confidence: 99%

Cortical Visual Impairments and Learning Disabilities

Chokron

Kovarski

Dutton

2021

Front. Hum. Neurosci.

View full text Add to dashboard Cite

show abstract

“…Performance on a task of global motion coherence was associated with integrity of the right superior longitudinal fasciculus in typically sighted children ( Braddick et al, 2016 ) and white matter connections of the visual cortex to temporal cortex in people with CVI ( Pamir et al, 2021 ). Using the coding template for MRI brain scans ( Fiori et al, 2014 ), brain damage scores of global structural, hemispheric and subcortical scores were found to correlate significantly with basic vision disorder in children with cerebral palsy and periventricular leukomalacia ( Tinelli et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Exploratory Investigation of Brain MRI Lesions According to Whole Sample and Visual Function Subtyping in Children With Cerebral Visual Impairment

Sakki

Dale

Mankad

et al. 2022

Front. Hum. Neurosci.

View full text Add to dashboard Cite

Background: There is limited research on brain lesions in children with cerebral visual impairment (CVI) of heterogeneous etiologies and according to associated subtyping and vision dysfunctions. This study was part of a larger project establishing data-driven subtypes of childhood CVI according to visual dysfunctions. Currently there is no consensus in relation to assessment, diagnosis and classification of CVI and more information about brain lesions may be of potential diagnostic value.Aim: This study aimed to investigate overall patterns of brain lesions and associations with level of visual dysfunction and to compare the patterns between the classification subgroups in children with CVI.Methods: School-aged children with CVI received ophthalmological and neuro-psychological/developmental assessments to establish CVI-related subtyping. Other pediatric information was collected from medical records. MRI scans were coded according to a semi-quantitative template including brain regions (right hemisphere, left hemisphere, visual pathways) and summed for total scores. Non-parametric analyses were conducted.Results: 28 children had clinical brain MRI scans available [44% of total sample, Group A (lower severity of visual dysfunctions) n = 16, Group B (higher severity) n = 12]. Total brain scores ranged between 0 and 18 (Group A mdn = 7, IQR = 0.8–10.0, Group B mdn = 10, IQR = 6.5–11.8) and were widespread across regions. 71 per cent had post-geniculate visual pathway damage. The median total brain and hemisphere scores of Group B were higher than subgroup A but differences did not reach statistical significance. No statistically significant associations were found between brain scores and vision variables (acuity, contrast sensitivity).Conclusion: This study found a spread of lesions across all regions on the brain scans in children with congenital CVI. The majority had damage in the postgeniculate visual pathways and visual cortex region suggesting this is an area of interest and potentially informative for diagnosis. However the subtyping classification did not show differences in number or region of lesions though the trend was higher toward Group B. This study confirms the complex diffuse and variable nature of brain lesions in children with congenital CVI, many of whom have other neurological impairments.

show abstract

“…With advances in perinatal care, the survival rates of infants with hypoxic-ischemic encephalopathy have increased ( Lee et al, 2013 ). Up to 60% of infants who survive have severe disabilities, including intellectual disability, epilepsy, and cerebral palsy ( Pierrat et al, 2005 ); however, hypoxic-ischemia (HI) is also a major cause of acquired visual impairment in children from developed countries ( Tinelli et al, 2020 ). Although cortical visual dysfunction is an important cause of visual impairment, our previous studies demonstrated that the immature retina is also susceptible to HI injury ( Huang et al, 2012 , 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Artemin Is Upregulated by TrkB Agonist and Protects the Immature Retina Against Hypoxic-Ischemic Injury by Suppressing Neuroinflammation and Astrogliosis

Huang

Poon

et al. 2021

Front. Mol. Neurosci.

View full text Add to dashboard Cite

Hypoxic-ischemia (HI) is a major cause of acquired visual impairment in children from developed countries. Previous studies have shown that systemic administration of 7,8-dihydroxyavone (DHF), a selective tropomyosin receptor kinase B (TrkB) agonist, provides long-term neuroprotection against HI injury in an immature retina. However, the target genes and the mechanisms of the neuroprotective effects of TrkB signaling are not known. In the present study, we induced an HI retinal injury through unilateral common carotid artery ligation followed by 8% oxygen for 2 h in P7 rat pups. DHF was administered intraperitoneally 2 h before and 18 h after the HI injury. A polymerase chain reaction (PCR) array was used to identify the target genes upregulated after the DHF treatment, which was then confirmed with quantitative real-time reverse transcriptase PCR and a western blot. Effects of the downstream mediator of DHF were assessed using an intravitreal injection of neutralizing antibody 4 h after DHF administration (24 h after HI). Meanwhile, the target protein was injected into the vitreous 24 h after HI to validate its protective effect when exogenously supplemented. We found that systemic DHF treatment after HI significantly increased the expression of the artemin (ARTN) gene and protein at P8 and P10, respectively. The neuroprotective effects of DHF were inhibited after the ARTN protein blockade, with an increase in neuroinflammation and astrogliosis. ARTN treatment showed long-term protection against HI injury at both the histopathological and functional levels. The neuroprotective effects of ARTN were related to a decrease in microglial activation at P17 and attenuation of astrogliosis at P29. ARTN enhances phosphorylation of RET, ERK, and JNK, but not AKT or p38 in the immature retina. Altogether, these results suggest that the neuroprotective effect of a TrkB agonist is partially exerted through a mechanism that involves ARTN because the protective effect is ameliorated by ARTN sequestration. ARTN treatment after HI injury protects the immature retina by attenuating late neuroinflammation and astrogliosis in the immature retina relating to the ARTN/RET/JNK/ERK signaling pathway. ARTN may be a strategy by which to provide long-term protection in the immature retina against HI injury.

show abstract

Structural brain damage and visual disorders in children with cerebral palsy due to periventricular leukomalacia

Cited by 23 publications

References 29 publications

Cortical Visual Impairments and Learning Disabilities

Cortical Visual Impairments and Learning Disabilities

Exploratory Investigation of Brain MRI Lesions According to Whole Sample and Visual Function Subtyping in Children With Cerebral Visual Impairment

Artemin Is Upregulated by TrkB Agonist and Protects the Immature Retina Against Hypoxic-Ischemic Injury by Suppressing Neuroinflammation and Astrogliosis

Contact Info

Product

Resources

About