American Journal of Neuroradiology 28:537-542, March 2007
© 2007 American Society of Neuroradiology
PEDIATRICS
Cerebellar Atrophy after Moderate-to-Severe Pediatric Traumatic Brain Injury
a Department of Diagnostic Imaging, Texas Children's Hospital, Houston, Tex
b Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Tex
c Departments of Psychology, Brigham Young University, Provo, Utah
d Neuroscience, Brigham Young University, Provo, Utah
e Departments of Radiology and Psychiatry, University of Utah, Salt Lake City, Utah
f Department of Psychiatry, Dartmouth Medical School, West Lebanon, NH
g Geriatric Research, Education, and Clinical Center, Boston VA Healthcare System and Harvard Medical School, Boston, Mass
Please address correspondence to: Elisabeth A. Wilde, PhD, Cognitive Neuroscience Laboratory, Baylor College of Medicine, 1790 Dryden Rd, Ste 725, Houston, TX 77030; e-mail: ewilde{at}bcm.tmc.edu
BACKGROUND AND PURPOSE: 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.
MATERIALS AND METHODS: 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 yeas of age. Cerebellar volumes were also compared with volumetric data from other brain regions to which the cerebellum projects.
RESULTS: 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.
CONCLUSION: 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.
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