How can we test the hypothesis that injury to subplate neurons is at the core of disturbances of cortical development and subsequent aberrations of cognition/attention in premature infants? Herein is a very difficult task. Brain imaging techniques, imcluding magnetic resonance imaging, tell us essentially nothing about subplate neurons acutely or about cortical neuronal connectivity later. Indeed even conventional neuropathology provides little information regarding the subplate neurons and the later cortical neuronal development. What is needed is an approach to the study of the premature brain that includes modern neurobiological techniques. Approaches that would be of great interest to address these questions include: immunocytochemical anlayses of presumed subplate neurons in cerebral white matter, specialized studies of cerebral corticocortical and thalamocortical connections by lipophilic dyes that track axonal membranes, and Golgi, ultrastructural and immunocytochemical staining of the cerebral cortex to assess cortical organization, lamination, and synaptogenesis. Subplate neurons, previously overlooked, could prove to be the missing link in the understanding of the higher cortical deficits that complicate the lives of premature infants at school age.
- Copyright © 1996 by the American Academy of Pediatrics