Abnormal microstructure of the atrophic thalamus in preterm survivors with periventricular leukomalacia

BACKGROUND AND PURPOSE

The neuroanatomic substrate of cognitive deficits in long-term survivors of prematurity with PVL is poorly understood. The thalamus is critically involved in cognition via extensive interconnections with the cerebral cortex. We hypothesized that the thalamus is atrophic (reduced in volume) in childhood survivors of prematurity with neuroimaging evidence of PVL and that the atrophy is associated with selective microstructural abnormalities within its subdivisions.

MATERIALS AND METHODS

We performed quantitative volumetric and DTI measurements of the thalamus in 17 children with neuroimaging evidence of PVL (mean postconceptional age, 5.6 ± 4.0 years) who were born prematurely and compared these with 74 term control children (5.7 ± 3.4 years).

RESULTS

The major findings were the following: 1) a significant reduction in the overall volume of the thalamus in patients with PVL compared with controls (P < .0001), which also correlated with the severity of PVL (P = .001); 2) significantly decreased FA (P = .003) and increased λ(⊥) (P = .02) in the thalamus overall and increased axial, radial, and mean diffusivities in the pulvinar (P < .03), suggesting injury to afferent and efferent myelinated axons; and 3) a positive correlation of pulvinar abnormalities with those of the parieto-occipital white matter in periventricular leukomalacia, suggesting that the pulvinar abnormalities reflect secondary effects of damaged interconnections between the pulvinar and parieto-occipital cortices in the cognitive visual network.

CONCLUSIONS

There are volumetric and microstructural abnormalities of the thalamus in preterm children with PVL, very likely reflecting neuronal loss and myelinated axonal injury. The selective microstructural damage in the pulvinar very likely contributes to abnormal cognitive visual processing known to occur in such survivors.

Oral epithelial atypia and acantholytic dyskeratosis in rats painted with 4-nitroquinoline N-oxide

Oral epithelial atypia and foci of acantholytic dyskeratosis (FAD) were investigated in 54 rats treated with the carcinogen 0.5% (w/v) 4-nitroquinoline-N-oxide in propylene glycol and in 18 rats treated with propylene glycol only. The palate of each animal was painted 3 times weekly for up to 9 months and rats were killed at monthly intervals. A gradual significant increase in the epithelial atypia indices of the palatal and lingual tissues (anterior and posterior of the intermolar tubercle) was observed with a maximum value of 17-22 of a possible 75 at 28-32 weeks. No significant differences were noted between the atypia indices of the palatal and lingual tissues. FAD were not evident in the palate or lingual tissues before 12 weeks and 16-24 weeks, respectively, and although the palate consistently showed more FAD compared with the lingual tissues the differences were not significant. Features of epithelial atypia and FAD were absent in the 18 control rats treated with propylene glycol only and in 8 untreated control animals. At 28 weeks of 4NQO treatment 2 of 5 rats, at 32 weeks 3 of 4 rats and at 36 weeks 3 of 3 rats had developed infiltrating squamous cell carcinomas in either/both the palate or tongue. The results suggest that epithelial dysplasia and acantholytic dyskeratosis may be late morphological features of a more fundamental change occurring earlier in the process of tumour development.