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Cortical pain responses in human infants
Rebeccah Slater1, Anne Cantarella, Shiromi Gallella
1The London Pain Consortium, Department of Anatomy and Developmental Biology, University College London, London WC1E 6BT, United Kingdom. r.slater@ucl.ac.uk
Summary
Premature infants as young as 25 weeks can process pain at a cortical level, as shown by brain activity changes during noxious stimulation. This indicates higher-level pain processing capabilities in preterm infants from an early age.
Area of Science:
- Neuroscience
- Developmental Biology
- Pediatrics
Background:
- Understanding pain processing in premature infants is crucial for neonatal care.
- Previous research has not definitively established cortical pain processing in preterm neonates.
- Cerebral oxygenation changes can indicate brain activity in response to stimuli.
Purpose of the Study:
- To investigate whether premature infants exhibit cortical pain processing.
- To measure brain responses to noxious stimuli in preterm infants.
- To determine the developmental trajectory of cortical pain processing in preterm neonates.
Main Methods:
- Real-time near-infrared spectroscopy (NIRS) measured cerebral oxygenation.
- 18 infants aged 25-45 weeks postmenstrual age were studied.
- Noxious stimuli included routine heel lances; non-noxious stimuli were also applied.
Main Results:
- Noxious stimulation elicited a clear cortical response (increased total hemoglobin) from 25 weeks.
- Cortical responses were significantly greater in awake versus sleeping infants.
- In awake infants, response magnitude increased and latency decreased with age.
Conclusions:
- Noxious information reaches the preterm infant cortex by 25 weeks postmenstrual age.
- Preterm infants possess the capacity for higher-level pain processing.
- Early pain exposure may induce plasticity in the developing human brain.