Cerebellar volume and proton magnetic resonance spectroscopy at term, and neurodevelopment at 2 years of age in preterm infants.

Aim: To assess the relation between cerebellar volume and spectroscopy at term equivalent age, and neurodevelopment at 24 months corrected age in preterm infants.

Methods: Magnetic resonance imaging of the brain was performed around term equivalent age in 112 preterm infants (mean gestational age 28wks 3d [SD 1wk 5d]; birthweight 1129g [SD 324g]). Cerebellar volume (60 males, 52 females), and proton magnetic resonance spectroscopy ((1) H-MRS) of the cerebellum in a subgroup of 58 infants were assessed in relation to cognitive, fine motor, and gross motor scores on the Bayley Scales of Infant and Toddler Development-III. Different neonatal variables and maternal education were regarded possible confounders.

Results: Cerebellar volume was significantly associated with postmenstrual age at time of magnetic resonance imaging. Cerebellar volume corrected for postmenstrual age was significantly and positively associated with cognition. Cognitive scores related significantly with N-acetylaspartate/choline (NAA/Cho) ratio obtained from cerebellar (1) H-MRS in 53 infants. Correction for neonatal and maternal variables did not change these results. Cerebellar variables were not related to motor performance.

Interpretation: In preterm infants, both cerebellar volume and cerebellar NAA/Cho ratio at term equivalent age were positively associated with cognition; however, no relation was found with motor outcome at 2 years of age. These findings support the importance of the cerebellum in cognitive development in preterm infants.