Pain, Opioids, and Functional Connectivity in Preterm Infants

Area of Science:

• Neonatal Neuroscience
• Developmental Pediatrics
• Clinical Neurophysiology

Background:

• Preterm infants experience significant pain and procedural burden.
• Neurodevelopmental outcomes in preterm infants remain a critical concern.
• Electroencephalography (EEG) offers a non-invasive window into brain function.

Purpose of the Study:

• To examine the effects of pain exposure on EEG features at term equivalent age (TEA).
• To determine if EEG analysis can predict neurodevelopmental outcomes at 24 months corrected age.

Main Methods:

• Studied infants born < 32 weeks gestational age without major brain injury.
• Collected data on pain exposure (procedures, opioids) and performed 8-channel EEG at TEA.
• Analyzed Brain Symmetry Index (BSI) and Circular Omega Complexity (COC) using multivariate statistics.

Main Results:

• Higher pain exposure correlated with increased BSI and decreased COC values (p < 0.05).
• Opioids like fentanyl and morphine significantly altered BSI and COC across various frequency bands (p < 0.05).
• Delta wave COC positively predicted cognitive outcomes (p = 0.034).

Conclusions:

• Pain and opioid administration may impact brain dynamics in preterm infants.
• Multivariate EEG indices show potential for characterizing neurodevelopmental outcomes.
• Quantitative EEG analysis could aid in early identification of at-risk infants.