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Electrophysiological Measurement of Noxious-evoked Brain Activity in Neonates Using a Flat-tip Probe Coupled to Electroencephalography
Published on: November 29, 2017
Premature infants display increased noxious-evoked neuronal activity in the brain compared to healthy age-matched
Rebeccah Slater1, Lorenzo Fabrizi, Alan Worley
1Neuroscience, Physiology and Pharmacology, University College London, London, UK. r.slater@ucl.ac.uk
Insights
Premature infants receiving intensive care show heightened brain responses to pain, unlike healthy newborns. This suggests functional changes in pain processing that could inform neonatal pain management strategies.
Area of Science:
- Neuroscience
- Neonatal Medicine
- Pain Research
Background:
- Infants born prematurely often undergo intensive care, potentially altering their sensory processing.
- Understanding pain responses in preterm infants is crucial for their long-term well-being and development.
Purpose of the Study:
- To investigate differences in brain neuronal responses to noxious stimuli between preterm infants with intensive care experience and healthy newborns.
- To explore the relationship between prematurity, intensive care, and pain processing in the infant brain.
Main Methods:
- Evoked potentials were measured in response to noxious heel lances in preterm infants and healthy term infants matched for postmenstrual age.
- Distinguishing between potentials evoked by noxious and non-noxious tactile stimuli.
Main Results:
- Preterm infants with intensive care experience exhibited significantly larger noxious-evoked potentials compared to healthy newborns.
- These enhanced responses were not linked to brain lesions but indicated functional changes in pain processing.
- Non-noxious tactile stimuli evoked shorter latency potentials, independent of infant age.
Conclusions:
- Infants born prematurely with significant intensive care experience demonstrate altered cortical pain processing.
- These findings suggest experience-dependent changes in pain pathways, relevant to pain sensitivity in older preterm children.
- Quantifying these changes can lead to improved pain management protocols in neonatal intensive care units.
Abstract:
This study demonstrates that infants who are born prematurely and who have experienced at least 40days of intensive or special care have increased brain neuronal responses to noxious stimuli compared to healthy newborns at the same postmenstrual age. We have measured evoked potentials generated by noxious clinically-essential heel lances in infants born at term (8 infants; born 37-40weeks) and in infants born prematurely (7 infants; born 24-32weeks) who had reached the same postmenstrual age (mean age at time of heel lance 39.2+/-1.2weeks). These noxious-evoked potentials are clearly distinguishable from shorter latency potentials evoked by non-noxious tactile sensory stimulation. While the shorter latency touch potentials are not dependent on the age of the infant at birth, the noxious-evoked potentials are significantly larger in prematurely-born infants. This enhancement is not associated with specific brain lesions but reflects a functional change in pain processing in the brain that is likely to underlie previously reported changes in pain sensitivity in older ex-preterm children. Our ability to quantify and measure experience-dependent changes in infant cortical pain processing will allow us to develop a more rational approach to pain management in neonatal intensive care.
