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Neonatal pain-related stress, functional cortical activity and visual-perceptual abilities in school-age children
Sam M Doesburg1, Cecil M Chau, Teresa P L Cheung
1Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada Program in Neurosciences and Mental Health, The Hospital for Sick Children Research Institute, Toronto, ON, Canada Department of Medical Imaging, University of Toronto, Toronto, ON, Canada Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, BC, Canada Department of Physics, Simon Fraser University, Burnaby, BC, Canada Down Syndrome Research Foundation, Burnaby, BC, Canada Department of Psychology, Simon Fraser University, Burnaby, BC, Canada Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada Department of Audiology and Speech Sciences, University of British Columbia, Vancouver, BC, Canada Department of Neurology, The Hospital for Sick Children Research Institute, Toronto, ON, Canada Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
Insights
Neonatal pain in extremely low gestational age (ELGA) infants is linked to altered brain activity and poorer visual-perceptual skills in school-aged children. This study reveals a connection between early stress, brain development, and long-term cognitive outcomes.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Cognitive Science
Background:
- Children born very prematurely (<32 weeks) often face visual-perceptual challenges.
- The impact of neonatal stress on neurodevelopment in extremely low gestational age (ELGA; <28 weeks) infants is not well understood.
- Neonatal intensive care pain may affect neurocognitive development due to immature brain vulnerability.
Purpose of the Study:
- To investigate the relationship between neonatal pain, functional brain activity, and visual-perceptual abilities in school-aged ELGA children.
- To explore how cumulative pain-related stress in infancy affects brain activity and cognitive outcomes.
- To provide evidence linking neonatal pain exposure to long-term neurodevelopmental effects.
Main Methods:
- Assessed school-aged children born at ELGA since birth.
- Measured functional brain activity using magnetoencephalography (MEG).
- Evaluated visual-perceptual abilities and cumulative neonatal pain exposure.
Main Results:
- Identified alterations in the spectral structure of spontaneous cortical activity in ELGA children.
- Found associations between cumulative neonatal pain-related stress and changes in cortical rhythmicity.
- Demonstrated a negative correlation between altered brain oscillations and school-age visual-perceptual abilities, independent of other neonatal factors.
Conclusions:
- Neonatal pain-related stress is linked to altered functional brain activity in school-aged children born at ELGA.
- These brain activity changes correlate with poorer visual-perceptual outcomes.
- This research offers the first evidence connecting neonatal pain, brain development, and cognitive function in this vulnerable population.
Abstract:
Children born very prematurely (< or =32 weeks) often exhibit visual-perceptual difficulties at school-age, even in the absence of major neurological impairment. The alterations in functional brain activity that give rise to such problems, as well as the relationship between adverse neonatal experience and neurodevelopment, remain poorly understood. Repeated procedural pain-related stress during neonatal intensive care has been proposed to contribute to altered neurocognitive development in these children. Due to critical periods in the development of thalamocortical systems, the immature brain of infants born at extremely low gestational age (ELGA; < or =28 weeks) may have heightened vulnerability to neonatal pain. In a cohort of school-age children followed since birth we assessed relations between functional brain activity measured using magnetoencephalogragy (MEG), visual-perceptual abilities and cumulative neonatal pain. We demonstrated alterations in the spectral structure of spontaneous cortical oscillatory activity in ELGA children at school-age. Cumulative neonatal pain-related stress was associated with changes in background cortical rhythmicity in these children, and these alterations in spontaneous brain oscillations were negatively correlated with visual-perceptual abilities at school-age, and were not driven by potentially confounding neonatal variables. These findings provide the first evidence linking neonatal pain-related stress, the development of functional brain activity, and school-age cognitive outcome in these vulnerable children.
