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Updated: Apr 18, 2026
Electrophysiological Measurement of Noxious-evoked Brain Activity in Neonates Using a Flat-tip Probe Coupled to Electroencephalography
Published on: November 29, 2017
Cortical activity evoked by inoculation needle prick in infants up to one-year old
Madeleine Verriotis1, Lorenzo Fabrizi, Amy Lee
1Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom Elizabeth Garrett Anderson Obstetric Wing, University College London Hospital, London, United Kingdom.
Insights
Infant brain activity during inoculation reveals distinct event-related potentials. This electroencephalography study shows age-related differences in pain processing, offering new insights into infant nociception.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Inoculation is a common source of procedural pain in infants.
- Limited understanding exists regarding how the infant central nervous system processes needle pain.
Purpose of the Study:
- To describe infant brain activity during routine inoculation using electroencephalography (EEG).
- To investigate age-related differences in brain responses to needle pain.
- To explore the relationship between brain activity and behavioral pain scores.
Main Methods:
- Utilized electroencephalography (EEG) to record brain activity in 15 healthy infants (1-2 months and 12 months old) during inoculation.
- Assessed pain behavior using the Modified Behavioral Pain Scale.
- Analyzed event-related potentials (ERPs) associated with needle contact.
Main Results:
- A distinct inoculation event-related vertex potential, comprising late negative-positive complexes, was observed in single trials.
- The amplitude of these ERP components was significantly greater in the 12-month-old group compared to the younger infants.
- Both ERP amplitude and behavioral pain scores increased with age, but were not correlated.
Conclusions:
- These findings represent the first recordings of infant brain activity in response to real-life needle pain.
- The study provides novel evidence of postnatal nociceptive processing in infants.
- Combined EEG and behavioral measures may offer a more sensitive approach to evaluating analgesic efficacy in infants.
Abstract:
Inoculation is one of the first and most common experiences of procedural pain in infancy. However, little is known about how needle puncture pain is processed by the central nervous system in children. In this study, we describe for the first time the event-related activity in the infant brain during routine inoculation using electroencephalography. Fifteen healthy term-born infants aged 1 to 2 months (n = 12) or 12 months (n = 5) were studied in an outpatient clinic. Pain behavior was scored using the Modified Behavioral Pain Scale. A distinct inoculation event-related vertex potential, consisting of 2 late negative-positive complexes, was observable in single trials after needle contact with the skin. The amplitude of both negative-positive components was significantly greater in the 12-month group. Both inoculation event-related potential amplitude and behavioral pain scores increased with age but the 2 measures were not correlated with each other. These components are the first recordings of brain activity in response to real-life needle pain in infants up to a year old. They provide new evidence of postnatal nociceptive processing and, combined with more traditional behavioral pain scores, offer a potentially more sensitive measure for testing the efficacy of analgesic protocols in this age group.
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