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Pain Exposure and Brain Connectivity in Preterm Infants

Thiviya Selvanathan1,2, Steven Ufkes1,3, Ting Guo2

  • 1Department of Pediatrics, BC Children's Hospital Research Institute and University of British Columbia, Vancouver, British Columbia, Canada.

JAMA Network Open
|March 15, 2024
PubMed

Insights

Early-life pain exposure in preterm infants affects brain connectivity maturation, especially in females. These brain changes are linked to later neurodevelopmental outcomes.

Area of Science:

  • Neonatal neuroscience
  • Developmental psychology
  • Pediatric neurology

Background:

  • Early-life painful procedures in preterm infants can impact brain development and neurodevelopmental outcomes.
  • Sex-specific differences in these effects are not well understood.

Purpose of the Study:

  • To investigate sex-specific associations between early-life pain exposure, neonatal brain structural connectivity, and 18-month neurodevelopment in very preterm infants.

Main Methods:

  • Prospective cohort study of 193 very preterm infants.
  • Structural connectivity assessed using magnetic resonance imaging and diffusion tensor imaging.
  • Neurodevelopment evaluated at 18 months using the Bayley Scales of Infant and Toddler Development, Third Edition.

Main Results:

  • Sex-specific effects observed: greater early-life pain was linked to slower maturation of global and local brain efficiency in female infants.
  • In the full cohort, increased pain exposure correlated with reduced global and local efficiency and regional connection strength.
  • Specific alterations in the striatum's connection strength were associated with cognitive outcomes.

Conclusions:

  • Early-life pain exposure is associated with altered brain structural connectivity maturation in very preterm infants, with notable sex-specific differences in females.
  • These connectivity alterations are linked to neurodevelopmental outcomes, suggesting potential regional impacts.
Abstract

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