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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 26, 2014
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Multiple serotonergic brainstem abnormalities in sudden infant death syndrome.
David S Paterson1, Felicia L Trachtenberg, Eric G Thompson
1Department of Pathology, Children's Hospital Boston and Harvard Medical School, Boston, MA, USA. david.paterson@childrens.harvard.edu
JAMA
|November 2, 2006
Summary
Sudden infant death syndrome (SIDS) cases show higher serotonin (5-HT) neuron counts and lower receptor binding in the medulla. This suggests widespread medullary 5-HT dysfunction may contribute to SIDS, particularly in males.
Area of Science:
- Neuroscience
- Pathology
- Pediatrics
Background:
- Serotonergic (5-hydroxytryptamine [5-HT]) neurons in the medulla oblongata regulate vital homeostatic functions.
- Previous studies indicated altered 5-HT receptor binding in SIDS cases, suggesting medullary 5-HT dysfunction.
- This dysfunction may underlie a subset of sudden infant death syndrome (SIDS) cases.
Purpose of the Study:
- To investigate cellular defects in medullary 5-HT pathways in SIDS cases.
- To examine alterations in 5-HT receptor binding associated with SIDS.
Main Methods:
- Comparison of medullary markers of 5-HT function between SIDS cases and controls.
- Analyses included 5-HT neuron count, density, 5-HT(1A) receptor binding, and 5-HT transporter (5-HTT) binding.
- Exploratory analysis correlated markers with known SIDS risk factors.
Main Results:
- SIDS cases exhibited significantly higher 5-HT neuron count and density compared to controls.
- A significantly lower density of 5-HT(1A) receptor binding sites was observed in SIDS cases.
- Male SIDS cases showed reduced 5-HT(1A) binding compared to females and controls, suggesting sex-specific differences.
Conclusions:
- Medullary 5-HT pathology in SIDS is more extensive than previously understood, potentially affecting neuron firing, synthesis, release, and clearance.
- Findings provide preliminary neurochemical evidence for increased male vulnerability to SIDS.
- Abnormalities in the medullary 5-HT system may play a critical role in SIDS pathogenesis.
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