Neonatal Intensive Care Unit (NICU) treatments save millions of infants born prematurely every year. But this treatment is not without cost. Painful procedures such as needle pricks can impact on early brain development, reports ScienceDaily.
In a multi-institution study conducted researchers for the first time have quantified a reduction in electrical activity in the part of the brain that responds to light touch in premature infants in the NICU compared with infants born full-term.
But when premature infants were given more "supportive touch" experiences, including skin-to-skin care and breastfeeding, their brains responded more strongly to light touch, according to an international research team from Nationwide Children's Hospital in Columbus, Ohio, Monroe Carell's Jr Children's Hospital at Vanderbilt University in Nashville, Tennessee, and Lausanne University in Switzerland.
Their findings suggest ways to support healthy brain development in premature infants in the NICU.
"Parents should know that every minute they hold their baby counts," said first author Dr Nathalie Maitre, associate professor of paediatrics, medical director of the NICU Follow-up Programme and a principal investigator in the Centre for Perinatal Research at Nationwide Children's Hospital.
In addition, "it is absolutely essential to minimise exposure to painful procedures that infants can often experience during hospitalisations," added Dr Mark Wallace, dean of the Graduate School at Vanderbilt and the study's co-senior author with Dr Micah Murray, of the University of Lausanne.
Exposure to painful procedures can impact brain development even when sedatives and analgesics are used. "Until new research can prove which medications work at preventing these changes in brain function, we need to focus on effective non-pharmacological alternatives," Wallace said.
Wallace, an internationally known authority on how the brain processes multi-sensory information, is the Louise B McGavock professor in the departments of hearing and speech sciences, psychiatry and psychology in the School of Medicine and an investigator of the Vanderbilt Kennedy Centre for Research on Human Development.
Sensory processing enables young children to learn from their experiences, and provides the foundation for developing higher-level perceptual and cognitive abilities. The somato-sensory system perceives temperature, the body's position in space, movement and all degrees of touch, from the lightest to most painful. It develops before all other senses. Disruptions in the normal trajectory of somato-sensory development including painful experiences can affect socio-emotional development.
"Touch is a critical building block of infant learning," explained Maitre, adjunct professor of hearing and speech sciences and former assistant professor of paediatrics at Vanderbilt. "It helps babies learn how to move their bodies, how to discover the world around them and how to communicate with their families."
She and her colleagues have applied methods for objectively measuring sensory processing, including event-related potential (ERP), a type of electroencephalography (EEG), to predict cognitive and communication functioning during early childhood.
In the current study the researchers compared the cortical responses to light touch among 125 premature and full-term infants at Vanderbilt. They found that preterm infants exhibited decreased responses to light touch when they were discharged from the NICU compared to full-term infants and that the decreases were greatest among the most premature.
Promoting optimal development and function may help keep these newborns' brains on track to establish the sensory building blocks of cognition, behavior and communication, the researchers concluded.
Abstract
Every year, 15 million preterm infants are born, and most spend their first weeks in neonatal intensive care units (NICUs) [ 1 ]. Although essential for the support and survival of these infants, NICU sensory environments are dramatically different from those in which full-term infants mature and thus likely impact the development of functional brain organization [ 2 ]. Yet the integrity of sensory systems determines effective perception and behavior [ 3, 4 ]. In neonates, touch is a cornerstone of interpersonal interactions and sensory-cognitive development [ 5–7 ]. NICU treatments used to improve neurodevelopmental outcomes rely heavily on touch [ 8 ]. However, we understand little of how brain maturation at birth (i.e., prematurity) and quality of early-life experiences (e.g., supportive versus painful touch) interact to shape the development of the somatosensory system [ 9 ]. Here, we identified the spatial, temporal, and amplitude characteristics of cortical responses to light touch that differentiate them from sham stimuli in full-term infants. We then utilized this data-driven analytical framework to show that the degree of prematurity at birth determines the extent to which brain responses to light touch (but not sham) are attenuated at the time of discharge from the hospital. Building on these results, we showed that, when controlling for prematurity and analgesics, supportive experiences (e.g., breastfeeding, skin-to-skin care) are associated with stronger brain responses, whereas painful experiences (e.g., skin punctures, tube insertions) are associated with reduced brain responses to the same touch stimuli. Our results shed crucial insights into the mechanisms through which common early perinatal experiences may shape the somatosensory scaffolding of later perceptual, cognitive, and social development.
Authors
Nathalie L Maitre, Alexandra P Key, Olena D Chorna, James C Slaughter, Pawel J Matusz, Mark T Wallace, Micah M Murray
[link url="https://www.sciencedaily.com/releases/2017/03/170322103655.htm"]Vanderbilt University Medical Centre material[/link]
[link url="http://www.cell.com/current-biology/abstract/S0960-9822(17)30204-X?_returnURL=http%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS096098221730204X%3Fshowall%3Dtrue"]Current Biology abstract[/link]