Cognitive visual dysfunctions in preterm children with periventricular leukomalacia

Dev Med Child Neurol. 2009 Dec;51(12):974-81. doi: 10.1111/j.1469-8749.2009.03272.x. Epub 2009 Mar 9.


Aim: Cognitive visual dysfunctions (CVDs) reflect an impairment of the capacity to process visual information. The question of whether CVDs might be classifiable according to the nature and distribution of the underlying brain damage is an intriguing one in child neuropsychology.

Method: We studied 22 children born preterm (12 males, 10 females; mean age at examination 8y, range 6-15y; mean gestational age 30wks, range 28-36wks) with periventricular leukomalacia, spastic diplegia, normal intelligence (mean Full-scale IQ 84; mean Verbal IQ 97; mean Performance IQ 74), and normal visual acuity, focusing on higher visual functions. Brain magnetic resonance images (MRI) were analysed to establish the presence of lesions along the primary optic pathway, in the occipitoparietal and occipitotemporal regions.

Results: Most children displayed an uneven cognitive profile, with deficits in visual object recognition, visual imagery, visual-spatial skills, and visual memory, and sparing of visual associative abilities, non-verbal intelligence, and face and letter recognition. Conventional brain MRI did not document major alterations of parietal and temporal white matter, or cortical alteration of areas involved in visual associative functions.

Interpretation: We suggest a widespread involvement of higher visual processing systems, involving both the ventral and dorsal streams, in preterm children with periventricular leukomalacia. The lack of major alterations on conventional MRI does not exclude the possibility of malfunctioning of higher visual processing systems, expressing itself through discrete CVDs. Possible mechanisms underlying these neuropsychological deficits are discussed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cerebral Palsy / complications*
  • Cerebral Palsy / pathology
  • Child
  • Child Development
  • Cognition Disorders / etiology*
  • Cognition Disorders / pathology
  • Concept Formation
  • Developmental Disabilities / etiology*
  • Developmental Disabilities / pathology
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Leukomalacia, Periventricular / complications*
  • Leukomalacia, Periventricular / pathology
  • Magnetic Resonance Imaging
  • Male
  • Neuropsychological Tests
  • Perceptual Disorders / etiology*
  • Perceptual Disorders / pathology
  • Vision Disorders / etiology*
  • Vision Disorders / pathology
  • Visual Pathways / pathology
  • Visual Perception