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Ionescu MI, Grigoras IF, Ionescu RB, Chitimus DM, Haret RM, Ianosi B, Ceanga M, Zagrean AM. Oxytocin Exhibits Neuroprotective Effects on Hippocampal Cultures under Severe Oxygen-Glucose Deprivation Conditions. Curr Issues Mol Biol 2024; 46:6223-6236. [PMID: 38921042 PMCID: PMC11202210 DOI: 10.3390/cimb46060371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/12/2024] [Accepted: 06/16/2024] [Indexed: 06/27/2024] Open
Abstract
Perinatal asphyxia (PA) and hypoxic-ischemic encephalopathy can result in severe, long-lasting neurological deficits. In vitro models, such as oxygen-glucose deprivation (OGD), are used experimentally to investigate neuronal response to metabolic stress. However, multiple variables can affect the severity level of OGD/PA and may confound any measured treatment effect. Oxytocin (OXT) has emerged as a potential neuroprotective agent against the deleterious effects of PA. Previous studies have demonstrated OXT's potential to enhance neuronal survival in immature hippocampal cultures exposed to OGD, possibly by modulating gamma-aminobutyric acid-A receptor activity. Moreover, OXT's precise impact on developing hippocampal neurons under different severities of OGD/PA remains uncertain. In this study, we investigated the effects of OXT (0.1 µM and 1 µM) on 7-day-old primary rat hippocampal cultures subjected to 2 h OGD/sham normoxic conditions. Cell culture viability was determined using the resazurin assay. Our results indicate that the efficacy of 1 µM OXT treatment varied according to the severity of the OGD-induced lesion, exhibiting a protective effect (p = 0.022) only when cellular viability dropped below 49.41% in non-treated OGD cultures compared to normoxic ones. Furthermore, administration of 0.1 µM OXT did not yield significant effects, irrespective of lesion severity (p > 0.05). These findings suggest that 1 µM OXT treatment during OGD confers neuroprotection exclusively in severe lesions in hippocampal neurons after 7 days in vitro. Further research is warranted to elucidate the mechanisms involved in OXT-mediated neuroprotection.
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Affiliation(s)
- Mara Ioana Ionescu
- Department of Functional Sciences, Division of Physiology II-Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.I.I.); (I.-F.G.); (R.-B.I.); (D.M.C.); (R.M.H.); (B.I.)
| | - Ioana-Florentina Grigoras
- Department of Functional Sciences, Division of Physiology II-Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.I.I.); (I.-F.G.); (R.-B.I.); (D.M.C.); (R.M.H.); (B.I.)
- Wellcome Centre for Integrative Neuroimaging, Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK
| | - Rosana-Bristena Ionescu
- Department of Functional Sciences, Division of Physiology II-Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.I.I.); (I.-F.G.); (R.-B.I.); (D.M.C.); (R.M.H.); (B.I.)
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 1TN, UK
- NIHR Biomedical Research Centre, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Diana Maria Chitimus
- Department of Functional Sciences, Division of Physiology II-Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.I.I.); (I.-F.G.); (R.-B.I.); (D.M.C.); (R.M.H.); (B.I.)
| | - Robert Mihai Haret
- Department of Functional Sciences, Division of Physiology II-Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.I.I.); (I.-F.G.); (R.-B.I.); (D.M.C.); (R.M.H.); (B.I.)
- Department of Ophthalmology, University Medical Center Gottingen, 37075 Gottingen, Germany
| | - Bogdan Ianosi
- Department of Functional Sciences, Division of Physiology II-Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.I.I.); (I.-F.G.); (R.-B.I.); (D.M.C.); (R.M.H.); (B.I.)
- Department of Neurology, Stroke Unit, Neuromed Campus, Kepler University Hospital, 4020 Linz, Austria
| | - Mihai Ceanga
- Department of Functional Sciences, Division of Physiology II-Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.I.I.); (I.-F.G.); (R.-B.I.); (D.M.C.); (R.M.H.); (B.I.)
- Section of Translational Neuroimmunology, Department of Neurology, Jena University Hospital, 07747 Jena, Germany
| | - Ana-Maria Zagrean
- Department of Functional Sciences, Division of Physiology II-Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.I.I.); (I.-F.G.); (R.-B.I.); (D.M.C.); (R.M.H.); (B.I.)
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Weese-Mayer DE, Di Fiore JM, Lake DE, Hibbs AM, Claure N, Qiu J, Ambalavanan N, Bancalari E, Kemp JS, Zimmet AM, Carroll JL, Martin RJ, Krahn KN, Hamvas A, Ratcliffe SJ, Krishnamurthi N, Indic P, Dormishian A, Dennery PA, Moorman JR. Maturation of cardioventilatory physiological trajectories in extremely preterm infants. Pediatr Res 2024; 95:1060-1069. [PMID: 37857848 DOI: 10.1038/s41390-023-02839-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/14/2023] [Accepted: 09/27/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND In extremely preterm infants, persistence of cardioventilatory events is associated with long-term morbidity. Therefore, the objective was to characterize physiologic growth curves of apnea, periodic breathing, intermittent hypoxemia, and bradycardia in extremely preterm infants during the first few months of life. METHODS The Prematurity-Related Ventilatory Control study included 717 preterm infants <29 weeks gestation. Waveforms were downloaded from bedside monitors with a novel sharing analytics strategy utilized to run software locally, with summary data sent to the Data Coordinating Center for compilation. RESULTS Apnea, periodic breathing, and intermittent hypoxemia events rose from day 3 of life then fell to near-resolution by 8-12 weeks of age. Apnea/intermittent hypoxemia were inversely correlated with gestational age, peaking at 3-4 weeks of age. Periodic breathing was positively correlated with gestational age peaking at 31-33 weeks postmenstrual age. Females had more periodic breathing but less intermittent hypoxemia/bradycardia. White infants had more apnea/periodic breathing/intermittent hypoxemia. Infants never receiving mechanical ventilation followed similar postnatal trajectories but with less apnea and intermittent hypoxemia, and more periodic breathing. CONCLUSIONS Cardioventilatory events peak during the first month of life but the actual postnatal trajectory is dependent on the type of event, race, sex and use of mechanical ventilation. IMPACT Physiologic curves of cardiorespiratory events in extremely preterm-born infants offer (1) objective measures to assess individual patient courses and (2) guides for research into control of ventilation, biomarkers and outcomes. Presented are updated maturational trajectories of apnea, periodic breathing, intermittent hypoxemia, and bradycardia in 717 infants born <29 weeks gestation from the multi-site NHLBI-funded Pre-Vent study. Cardioventilatory events peak during the first month of life but the actual postnatal trajectory is dependent on the type of event, race, sex and use of mechanical ventilation. Different time courses for apnea and periodic breathing suggest different maturational mechanisms.
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Affiliation(s)
- Debra E Weese-Mayer
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Division of Autonomic Medicine, Department of Pediatrics, Ann & Robert H Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA.
| | - Juliann M Di Fiore
- Department of Pediatrics, Case Western Reserve University, School of Medicine, Cleveland, OH, USA.
- Department of Pediatrics, Division of Neonatology, UH Rainbow Babies & Children's Hospital, Cleveland, OH, USA.
| | - Douglas E Lake
- Division of Cardiovascular Medicine, Center for Advanced Medical Analytics and Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Anna Maria Hibbs
- Department of Pediatrics, Case Western Reserve University, School of Medicine, Cleveland, OH, USA
- Department of Pediatrics, Division of Neonatology, UH Rainbow Babies & Children's Hospital, Cleveland, OH, USA
| | - Nelson Claure
- Division of Neonatology, Department of Pediatrics, Holtz Children's Hospital - Jackson Memorial Medical Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jiaxing Qiu
- Division of Cardiovascular Medicine, Center for Advanced Medical Analytics and Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Namasivayam Ambalavanan
- Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Eduardo Bancalari
- Division of Neonatology, Department of Pediatrics, Holtz Children's Hospital - Jackson Memorial Medical Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James S Kemp
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Amanda M Zimmet
- Division of Cardiovascular Medicine, Center for Advanced Medical Analytics and Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - John L Carroll
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Richard J Martin
- Department of Pediatrics, Case Western Reserve University, School of Medicine, Cleveland, OH, USA
- Department of Pediatrics, Division of Neonatology, UH Rainbow Babies & Children's Hospital, Cleveland, OH, USA
| | - Katy N Krahn
- Division of Cardiovascular Medicine, Center for Advanced Medical Analytics and Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Aaron Hamvas
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Neonatology, Department of Pediatrics, Ann & Robert H Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Sarah J Ratcliffe
- Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Narayanan Krishnamurthi
- Division of Autonomic Medicine, Department of Pediatrics, Ann & Robert H Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Premananda Indic
- Department of Electrical Engineering, University of Texas Tyler, Tyler, TX, USA
| | - Alaleh Dormishian
- Division of Neonatology, Department of Pediatrics, Holtz Children's Hospital - Jackson Memorial Medical Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Phyllis A Dennery
- Hasbro Children's Hospital, Brown University, Warren Alpert School of Medicine, Providence, RI, USA
| | - J Randall Moorman
- Division of Cardiovascular Medicine, Center for Advanced Medical Analytics and Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
- Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
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Sun H, Ye E, Paixao L, Ganglberger W, Chu CJ, Zhang C, Rosand J, Mignot E, Cash SS, Gozal D, Thomas RJ, Westover MB. The sleep and wake electroencephalogram over the lifespan. Neurobiol Aging 2023; 124:60-70. [PMID: 36739622 PMCID: PMC9957961 DOI: 10.1016/j.neurobiolaging.2023.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 12/29/2022] [Accepted: 01/11/2023] [Indexed: 01/20/2023]
Abstract
Both sleep and wake encephalograms (EEG) change over the lifespan. While prior studies have characterized age-related changes in the EEG, the datasets span a particular age group, or focused on sleep and wake macrostructure rather than the microstructure. Here, we present sex-stratified data from 3372 community-based or clinic-based otherwise neurologically and psychiatrically healthy participants ranging from 11 days to 80 years of age. We estimate age norms for key sleep and wake EEG parameters including absolute and relative powers in delta, theta, alpha, and sigma bands, as well as sleep spindle density, amplitude, duration, and frequency. To illustrate the potential use of the reference measures developed herein, we compare them to sleep EEG recordings from age-matched participants with Alzheimer's disease, severe sleep apnea, depression, osteoarthritis, and osteoporosis. Although the partially clinical nature of the datasets may bias the findings towards less normal and hence may underestimate pathology in practice, age-based EEG reference values enable objective screening of deviations from healthy aging among individuals with a variety of disorders that affect brain health.
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Affiliation(s)
- Haoqi Sun
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, MA, USA
| | - Elissa Ye
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Luis Paixao
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Catherine J Chu
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Can Zhang
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Jonathan Rosand
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, MA, USA
| | - Emmanuel Mignot
- Center for Sleep Sciences and Medicine, Stanford University, Stanford, CA USA
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - David Gozal
- Department of Child Health, University of Missouri, Columbia, MO, USA
| | - Robert J Thomas
- Department of Medicine, Division of Pulmonary, Critical Care & Sleep, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - M Brandon Westover
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, MA, USA.
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4
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Di Fiore JM, Raffay TM. The relationship between intermittent hypoxemia events and neural outcomes in neonates. Exp Neurol 2021; 342:113753. [PMID: 33984336 DOI: 10.1016/j.expneurol.2021.113753] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 04/06/2021] [Accepted: 05/07/2021] [Indexed: 12/20/2022]
Abstract
This brief review examines 1) patterns of intermittent hypoxemia in extremely preterm infants during early postnatal life, 2) the relationship between neonatal intermittent hypoxemia exposure and outcomes in both human and animal models, 3) potential mechanistic pathways, and 4) future alterations in clinical care that may reduce morbidity. Intermittent hypoxemia events are pervasive in extremely preterm infants (<28 weeks gestation at birth) during early postnatal life. An increased frequency of intermittent hypoxemia events has been associated with a range of poor neural outcomes including language and cognitive delays, motor impairment, retinopathy of prematurity, impaired control of breathing, and intraventricular hemorrhage. Neonatal rodent models have shown that exposure to short repetitive cycles of hypoxia induce a pathophysiological cascade. However, not all patterns of intermittent hypoxia are deleterious and some may even improve neurodevelopmental outcomes. Therapeutic interventions include supplemental oxygen, pressure support and pharmacologic drugs but prolonged hyperoxia and pressure exposure have been associated with cardiopulmonary morbidity. Therefore, it becomes imperative to distinguish high risk from neutral and/or even beneficial patterns of intermittent hypoxemia during early postnatal life. Identification of such patterns could improve clinical care with targeted interventions for high-risk patterns and minimal or no exposure to treatment modalities for low-risk patterns.
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Affiliation(s)
- Juliann M Di Fiore
- Division of Neonatology, Rainbow Babies and Children's Hospital, Cleveland, OH, United States of America; Department of Pediatrics, Case Western Reserve University, Cleveland, OH, United States of America.
| | - Thomas M Raffay
- Division of Neonatology, Rainbow Babies and Children's Hospital, Cleveland, OH, United States of America; Department of Pediatrics, Case Western Reserve University, Cleveland, OH, United States of America
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5
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Mehrkanoon S, Boashash B, Colditz P. Identifying Emergent Mesoscopic-Macroscopic Functional Brain Network Dynamics in Infants at Term-Equivalent Age with Electric Source Neuroimaging. Brain Connect 2021; 11:663-677. [PMID: 33764807 DOI: 10.1089/brain.2020.0965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Aim: To identify and characterize the functional brain networks at the time when the brain is yet to develop higher order functions in term-born and preterm infants at term-equivalent age. Introduction: Although functional magnetic resonance imaging (fMRI) data have revealed the existence of spatially structured resting-state brain activity in infants, the temporal information of fMRI data limits the characterization of fast timescale brain oscillations. In this study, we use infants' high-density electroencephalography (EEG) to characterize spatiotemporal and spectral functional organizations of brain network dynamics. Methods: We used source-reconstructed EEG and graph theoretical analyses in 100 infants (84 preterm, 16 term born) to identify the rich-club topological organization, temporal dynamics, and spectral fingerprints of dynamic functional brain networks. Results: Five dynamic functional brain networks are identified, which have rich-club topological organizations, distinctive spectral fingerprints (in the delta and low-alpha frequency), and scale-invariant temporal dynamics (<0.1 Hz): The default mode, primary sensory-limbic system, thalamo-frontal, thalamo-sensorimotor, and visual-limbic system. The temporal dynamics of these networks are correlated in a hierarchically leading-following organization, showing that infant brain networks arise from long-range synchronization of band-limited cortical oscillation based on interacting fast- and slow-coherent cortical oscillations. Conclusion: Dynamic functional brain networks do not solely depend on the maturation of cognitive networks; instead, the brain network dynamics exist in infants at term age well before the childhood and adulthood, and hence, it offers a quantitative measurement of neurotypical development in infants. Clinical Trial Registration Number: ACTRN12615000591550. Impact statement Our work offers novel functional insights into the brain network characterization in infants, providing a new functional basis for future deployable prognostication approaches.
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Affiliation(s)
- Steve Mehrkanoon
- University of Queensland Centre for Clinical Research, The University of Queensland, Herston, Brisbane, Queensland, Australia.,Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia.,University of Queensland Perinatal Research Centre, Saint Lucia, Queensland, Australia
| | - Boualem Boashash
- University of Queensland Centre for Clinical Research, The University of Queensland, Herston, Brisbane, Queensland, Australia.,Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Paul Colditz
- University of Queensland Centre for Clinical Research, The University of Queensland, Herston, Brisbane, Queensland, Australia.,Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia.,University of Queensland Perinatal Research Centre, Saint Lucia, Queensland, Australia
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Bisiacchi P, Cainelli E. Structural and functional brain asymmetries in the early phases of life: a scoping review. Brain Struct Funct 2021; 227:479-496. [PMID: 33738578 PMCID: PMC8843922 DOI: 10.1007/s00429-021-02256-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/07/2021] [Indexed: 12/13/2022]
Abstract
Asymmetry characterizes the brain in both structure and function. Anatomical asymmetries explain only a fraction of functional variability in lateralization, with structural and functional asymmetries developing at different periods of life and in different ways. In this work, we perform a scoping review of the cerebral asymmetries in the first brain development phases. We included all English-written studies providing direct evidence of hemispheric asymmetries in full-term neonates, foetuses, and premature infants, both at term post-conception and before. The final analysis included 57 studies. The reviewed literature shows large variability in the used techniques and methodological procedures. Most structural studies investigated the temporal lobe, showing a temporal planum more pronounced on the left than on the right (although not all data agree), a morphological asymmetry already present from the 29th week of gestation. Other brain structures have been poorly investigated, and the results are even more discordant. Unlike data on structural asymmetries, functional data agree with each other, identifying a leftward dominance for speech stimuli and an overall dominance of the right hemisphere in all other functional conditions. This generalized dominance of the right hemisphere for all conditions (except linguistic stimuli) is in line with theories stating that the right hemisphere develops earlier and that its development is less subject to external influences because it sustains functions necessary to survive.
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Affiliation(s)
- Patrizia Bisiacchi
- Department of General Psychology, University of Padova, Via Venezia, 8, 35121, Padova, Italy. .,Padova Neuroscience Centre, PNC, Padova, Italy.
| | - Elisa Cainelli
- Department of General Psychology, University of Padova, Via Venezia, 8, 35121, Padova, Italy
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Wallois F, Routier L, Heberlé C, Mahmoudzadeh M, Bourel-Ponchel E, Moghimi S. Back to basics: the neuronal substrates and mechanisms that underlie the electroencephalogram in premature neonates. Neurophysiol Clin 2020; 51:5-33. [PMID: 33162287 DOI: 10.1016/j.neucli.2020.10.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 02/06/2023] Open
Abstract
Electroencephalography is the only clinically available technique that can address the premature neonate normal and pathological functional development week after week. The changes in the electroencephalogram (EEG) result from gradual structural and functional modifications that arise during the last trimester of pregnancy. Here, we review the structural changes over time that underlie the establishment of functional immature neural networks, the impact of certain anatomical specificities (fontanelles, connectivity, etc.) on the EEG, limitations in EEG interpretation, and the utility of high-resolution EEG (HR-EEG) in premature newborns (a promising technique with a high degree of spatiotemporal resolution). In particular, we classify EEG features according to whether they are manifestations of endogenous generators (i.e. theta activities that coalesce with a slow wave or delta brushes) or come from a broader network. Furthermore, we review publications on EEG in premature animals because the data provide a better understanding of what is happening in premature newborns. We then discuss the results and limitations of functional connectivity analyses in premature newborns. Lastly, we report on the magnetoelectroencephalographic studies of brain activity in the fetus. A better understanding of complex interactions at various structural and functional levels during normal neurodevelopment (as assessed using electroencephalography as a benchmark method) might lead to better clinical care and monitoring for premature neonates.
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Affiliation(s)
- Fabrice Wallois
- INSERM U1105, Research Group on Multimodal Analysis of Brain Function, Jules Verne University of Picardie, Amiens, France; Service d'Explorations Fonctionnelles du Système Nerveux Pédiatrique, Amiens-Picardie Medical Center, Amiens, France.
| | - Laura Routier
- INSERM U1105, Research Group on Multimodal Analysis of Brain Function, Jules Verne University of Picardie, Amiens, France; Service d'Explorations Fonctionnelles du Système Nerveux Pédiatrique, Amiens-Picardie Medical Center, Amiens, France
| | - Claire Heberlé
- INSERM U1105, Research Group on Multimodal Analysis of Brain Function, Jules Verne University of Picardie, Amiens, France; Service d'Explorations Fonctionnelles du Système Nerveux Pédiatrique, Amiens-Picardie Medical Center, Amiens, France
| | - Mahdi Mahmoudzadeh
- INSERM U1105, Research Group on Multimodal Analysis of Brain Function, Jules Verne University of Picardie, Amiens, France; Service d'Explorations Fonctionnelles du Système Nerveux Pédiatrique, Amiens-Picardie Medical Center, Amiens, France
| | - Emilie Bourel-Ponchel
- INSERM U1105, Research Group on Multimodal Analysis of Brain Function, Jules Verne University of Picardie, Amiens, France; Service d'Explorations Fonctionnelles du Système Nerveux Pédiatrique, Amiens-Picardie Medical Center, Amiens, France
| | - Sahar Moghimi
- INSERM U1105, Research Group on Multimodal Analysis of Brain Function, Jules Verne University of Picardie, Amiens, France; Service d'Explorations Fonctionnelles du Système Nerveux Pédiatrique, Amiens-Picardie Medical Center, Amiens, France
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Family nurture intervention alters relationships between preterm infant EEG delta brush characteristics and term age EEG power. Clin Neurophysiol 2020; 131:1909-1916. [PMID: 32599274 DOI: 10.1016/j.clinph.2020.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 04/21/2020] [Accepted: 05/01/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Family Nurture Intervention (FNI) facilitates mother/infant emotional connection, improves neurodevelopmental outcomes and increases electroencephalogram (EEG) power at term age. Here we explored whether delta brushes (DB), early EEG bursts that shape brain development, are altered by FNI and mediate later effects of FNI on EEG. METHODS We assessed DB characteristics in EEG data from a randomized controlled trial comparing infants with standard care (SC, n = 31) versus SC + FNI (n = 33) at ~35 and ~40 weeks GA. RESULTS Compared to SC infants, FNI infant DB amplitude increased more from ~35 to ~40 weeks, and FNI infants had longer duration DBs. DB parameters (rate, amplitude, brush frequency) at ~35 weeks were correlated with power at ~40 weeks, but only in SC infants. FNI effects on DB parameters do not mediate FNI effects on EEG power or coherence at term. CONCLUSIONS DBs are related to subsequent brain activity and FNI alters DB parameters. However, FNI's effects on electrocortical activity at term age are not dependent on its earlier effects on DBs. SIGNIFICANCE While early DBs can have important effects on later brain activity in preterm infants, facilitating emotional connection with FNI may allow brain maturation to be less dependent on early bursts.
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Murata Y, Colonnese MT. GABAergic interneurons excite neonatal hippocampus in vivo. SCIENCE ADVANCES 2020; 6:eaba1430. [PMID: 32582852 PMCID: PMC7292633 DOI: 10.1126/sciadv.aba1430] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 04/14/2020] [Indexed: 06/01/2023]
Abstract
GABAergic interneurons are proposed to be critical for early activity and synapse formation by directly exciting, rather than inhibiting, neurons in developing hippocampus and neocortex. However, the role of GABAergic neurons in the generation of neonatal network activity has not been tested in vivo, and recent studies have challenged the excitatory nature of early GABA. By locally manipulating interneuron activity in unanesthetized neonatal mice, we show that GABAergic neurons are excitatory in CA1 hippocampus at postnatal day 3 (P3) and are responsible for most of the spontaneous firing of pyramidal cells at that age. Hippocampal interneurons become inhibitory by P7, whereas visual cortex interneurons are already inhibitory by P3 and remain so throughout development. These regional and age-specific differences are the result of a change in chloride reversal potential, because direct activation of light-gated anion channels in glutamatergic neurons drives CA1 firing at P3, but silences it at P7 in CA1, and at all ages in visual cortex. This study in the intact brain reveals that GABAergic interneuron excitation is essential for network activity in neonatal hippocampus and confirms that visual cortical interneurons are inhibitory throughout early postnatal development.
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Corsi-Cabrera M, Cubero-Rego L, Ricardo-Garcell J, Harmony T. Week-by-week changes in sleep EEG in healthy full-term newborns. Sleep 2020; 43:5606931. [PMID: 31650177 DOI: 10.1093/sleep/zsz261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 10/04/2019] [Indexed: 11/12/2022] Open
Abstract
Spectral analysis of neonatal sleep is useful for studying brain maturation; however, most studies have analyzed conventional broad bands described for awake adults, so a distinct approach for EEG analysis may disclose new findings. STUDY OBJECTIVES To extract independent EEG broad bands using principal component analysis (PCA) and describe week-by-week EEG changes in quiet sleep (QS) and active sleep (AS) during the first 5 weeks of postnatal life in healthy, full-term newborns. METHODS Polysomnography of spontaneous sleep was recorded in 60 newborns in 5 groups at 41, 42, 43, 44, and 45 weeks (n = 12 each) postconceptional age (POST-C). QS and AS stages were identified. Absolute power (AP) for 1 Hz bins between 1 and 30 Hz was subjected to PCA to extract independent broad bands. RESULTS PCA rendered three independent broad bands distinct from conventional bands. They explained 82.8% of variance: 2-10 Hz, 10-16 Hz, and 17-30 Hz. ANOVAs (group × age × derivations) showed significant higher power at 2-10 Hz with greater age, higher power in QS than AS in all three bands, and significantly higher AP in the left central region, and in the right occipital and temporal areas, in both sleep stages. CONCLUSION A different method of analyzing sleep EEG generated new information on brain maturation. The Sigma frequencies identified suggest that sleep spindle maturation begins by at least 41 weeks of POST-C age. Interhemispheric asymmetries during sleep suggest earlier development of the central left region and the right occipital and temporal areas.
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Affiliation(s)
- María Corsi-Cabrera
- Research Unit in Neurodevelopment, Institute of Neurobiology, National Autonomous University of Mexico, Querétaro.,Sleep Laboratory, Faculty of Psychology, National Autonomous University of Mexico, Mexico, Mexico
| | - Lourdes Cubero-Rego
- Research Unit in Neurodevelopment, Institute of Neurobiology, National Autonomous University of Mexico, Querétaro
| | - Josefina Ricardo-Garcell
- Research Unit in Neurodevelopment, Institute of Neurobiology, National Autonomous University of Mexico, Querétaro
| | - Thalia Harmony
- Research Unit in Neurodevelopment, Institute of Neurobiology, National Autonomous University of Mexico, Querétaro
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11
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Wallois F, Routier L, Bourel-Ponchel E. Impact of prematurity on neurodevelopment. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:341-375. [PMID: 32958184 DOI: 10.1016/b978-0-444-64150-2.00026-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The consequences of prematurity on brain functional development are numerous and diverse, and impact all brain functions at different levels. Prematurity occurs between 22 and 36 weeks of gestation. This period is marked by extreme dynamics in the physiologic maturation, structural, and functional processes. These different processes appear sequentially or simultaneously. They are dependent on genetic and/or environmental factors. Disturbance of these processes or of the fine-tuning between them, when caring for premature children, is likely to induce disturbances in the structural and functional development of the immature neural networks. These will appear as impairments in learning skills progress and are likely to have a lasting impact on the development of children born prematurely. The level of severity depends on the initial alteration, whether structural or functional. In this chapter, after having briefly reviewed the neurodevelopmental, structural, and functional processes, we describe, in a nonexhaustive manner, the impact of prematurity on the different brain, motor, sensory, and cognitive functions.
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Affiliation(s)
- Fabrice Wallois
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France.
| | - Laura Routier
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France
| | - Emilie Bourel-Ponchel
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France
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12
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Wielek T, Del Giudice R, Lang A, Wislowska M, Ott P, Schabus M. On the development of sleep states in the first weeks of life. PLoS One 2019; 14:e0224521. [PMID: 31661522 PMCID: PMC6818777 DOI: 10.1371/journal.pone.0224521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 10/15/2019] [Indexed: 01/31/2023] Open
Abstract
Human newborns spend up to 18 hours sleeping. The organization of their sleep differs immensely from adult sleep, and its quick maturation and fundamental changes correspond to the rapid cortical development at this age. Manual sleep classification is specifically challenging in this population given major body movements and frequent shifts between vigilance states; in addition various staging criteria co-exist. In the present study we utilized a machine learning approach and investigated how EEG complexity and sleep stages evolve during the very first weeks of life. We analyzed 42 full-term infants which were recorded twice (at week two and five after birth) with full polysomnography. For sleep classification EEG signal complexity was estimated using multi-scale permutation entropy and fed into a machine learning classifier. Interestingly the baby’s brain signal complexity (and spectral power) revealed developmental changes in sleep in the first 5 weeks of life, and were restricted to NREM (“quiet”) and REM (“active sleep”) states with little to no changes in state wake. Data demonstrate that our classifier performs well over chance (i.e., >33% for 3-class classification) and reaches almost human scoring accuracy (60% at week-2, 73% at week-5). Altogether, these results demonstrate that characteristics of newborn sleep develop rapidly in the first weeks of life and can be efficiently identified by means of machine learning techniques.
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Affiliation(s)
- Tomasz Wielek
- Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, Salzburg, Austria
- Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
- * E-mail: (TW); (MS)
| | - Renata Del Giudice
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Adelheid Lang
- Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, Salzburg, Austria
- Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
| | - Malgorzata Wislowska
- Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, Salzburg, Austria
- Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
| | - Peter Ott
- ITS Informationstechnik & System-Management, Salzburg University of Applied Sciences, Salzburg, Austria
| | - Manuel Schabus
- Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, Salzburg, Austria
- Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
- * E-mail: (TW); (MS)
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13
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Grieve PG, Fifer WP, Cousy NP, Monk CE, Stark RI, Gingrich JA, Myers MM. Neonatal infant EEG bursts are altered by prenatal maternal depression and serotonin selective reuptake inhibitor use. Clin Neurophysiol 2019; 130:2019-2025. [PMID: 31539768 DOI: 10.1016/j.clinph.2019.08.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/03/2019] [Accepted: 08/24/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Increasingly, serotonin selective reuptake inhibitor (SSRI) medications are prescribed in pregnancy. These medications pass freely into the developing fetus but little is known about their effect on brain development in humans. In this study we determine if prenatal maternal depression and SSRI medication change the EEG infant delta brush bursts which are an early marker of normal brain maturation. METHODS We measured delta brush bursts from the term infants of three groups of mothers (controls (N = 52), depressed untreated (N = 15), and those taking serotonin SSRI medication (N = 10). High density EEGs were obtained during sleep at an average age of 44 weeks post conceptional age. We measured the rate of occurrence, brush amplitude, oscillation frequency and duration of the bursts. RESULTS Compared to infants of control mothers, the parameters of delta brush bursts of the offspring of depressed and SSRI-using mothers are significantly altered: burst amplitude is decreased; the oscillation frequency increased, and the duration increased (SSRI only). These significant differences were found during both sleep states. CONCLUSIONS Electrocortical bursting activity (i.e. delta brushes) is known to play an important role in early central nervous system (CNS) synaptic formation and function. SIGNIFICANCE Maternal depression or SSRI use may alter brain function in their offspring.
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Affiliation(s)
- P G Grieve
- Department of Pediatrics, Columbia University, New York, NY 10032, USA.
| | - W P Fifer
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - N P Cousy
- Cape Services, 22 rue Pierre Mendès, Torcy 77200, France
| | - C E Monk
- Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA
| | - R I Stark
- Department of Pediatrics, Columbia University, New York, NY 10032, USA
| | - J A Gingrich
- Columbia University Medical Center, Psychiatry, New York, NY 10032, USA
| | - M M Myers
- Columbia University Medical Center, Psychiatry, New York, NY 10032, USA
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14
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Daneshvarfard F, Abrishami Moghaddam H, Dehaene-Lambertz G, Kongolo G, Wallois F, Mahmoudzadeh M. Neurodevelopment and asymmetry of auditory-related responses to repetitive syllabic stimuli in preterm neonates based on frequency-domain analysis. Sci Rep 2019; 9:10654. [PMID: 31337810 PMCID: PMC6650479 DOI: 10.1038/s41598-019-47064-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 07/01/2019] [Indexed: 11/20/2022] Open
Abstract
Sensory development of the human brain begins prenatally, allowing cortical auditory responses to be recorded at an early age in preterm infants. Despite several studies focusing on the temporal characteristics of preterm infants' cortical responses, few have been conducted on frequency analysis of these responses. In this study, we performed frequency and coherence analysis of preterm infants' auditory responses to series of syllables and also investigated the functional brain asymmetry of preterm infants for the detection of the regularity of auditory stimuli. Cortical auditory evoked potentials (CAEPs) were recorded in 16 preterm infants with a mean recording age of 31.48 weeks gestational age (29.57-34.14 wGA) in response to a repetitive syllabic stimulus. Peak amplitudes of the frequency response at the target frequency and the first harmonic, as well as the phase coherence (PC) at the target frequency were extracted as age-dependent variables. A functional asymmetry coefficient was defined as a lateralization index for the amplitude of the target frequency at each electrode site. While the findings revealed a significant positive correlation between the mean amplitude at the target frequency vs. age (R2 = 0.263, p = 0.042), no significant correlation was observed for age-related changes of the mean amplitude at the first harmonic. A significant correlation was also observed between the mean PC and age (R2 = 0.318, p = 0.023). A right hemisphere lateralization over many channels was also generally observed. The results demonstrate that rightward lateralization for slow rate modulation, previously observed in adults, children and newborns, appears to be in place at a very young age, even in preterm infants.
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Affiliation(s)
- Farveh Daneshvarfard
- INSERM U1105, Université de Picardie, CURS, Amiens, France
- Faculty of Electrical and Computer Engineering, K.N. Toosi University of Technology, Tehran, Iran
| | - Hamid Abrishami Moghaddam
- INSERM U1105, Université de Picardie, CURS, Amiens, France.
- Faculty of Electrical and Computer Engineering, K.N. Toosi University of Technology, Tehran, Iran.
| | - Ghislaine Dehaene-Lambertz
- Cognitive Neuroimaging Unit, CEA DSV/I2BM, INSERM, CNRS, Université Paris-Sud, Université Paris-Saclay, NeuroSpin Center, 91191 Gif/Yvette, France
| | - Guy Kongolo
- INSERM U1105, Université de Picardie, CURS, Amiens, France
- INSERM U1105, Neonatal ICU, South University Hospital, Amiens, France
| | - Fabrice Wallois
- INSERM U1105, Université de Picardie, CURS, Amiens, France.
- INSERM U1105, Unit Exploration Fonctionnelles du Système Nerveux Pédiatrique, South University Hospital, Amiens, France.
| | - Mahdi Mahmoudzadeh
- INSERM U1105, Université de Picardie, CURS, Amiens, France
- INSERM U1105, Unit Exploration Fonctionnelles du Système Nerveux Pédiatrique, South University Hospital, Amiens, France
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15
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Pierce LJ, Thompson BL, Gharib A, Schlueter L, Reilly E, Valdes V, Roberts S, Conroy K, Levitt P, Nelson CA. Association of Perceived Maternal Stress During the Perinatal Period With Electroencephalography Patterns in 2-Month-Old Infants. JAMA Pediatr 2019; 173:561-570. [PMID: 30958515 PMCID: PMC6547221 DOI: 10.1001/jamapediatrics.2019.0492] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
IMPORTANCE Variation in child responses to adversity creates a clinical challenge to identify children most resilient or susceptible to later risk for disturbances in cognition and health. Advances in establishing scalable biomarkers can lead to early identification and mechanistic understanding of the association of early adversity with neurodevelopment. OBJECTIVES To examine whether maternal reports of stress are associated with patterns in resting electroencephalography at 2 months of age and whether unique electroencephalographic profiles associated with risk and resiliency factors can be identified. DESIGN, SETTING, AND PARTICIPANTS For this cohort study, a population-based sample of 113 mother-infant dyads was recruited from January 1, 2016, to March 1, 2018, during regularly scheduled pediatric visits before infants were 2 months of age from 2 primary care clinics in Boston, Massachusetts, and Los Angeles, California, that predominantly serve families from low-income backgrounds. Data are reported from a single time point, when infants were aged 2 months, of an ongoing cohort study longitudinally following the mother-infant dyads. EXPOSURES Maternal reported exposure to stressful life events and perceived stress. MAIN OUTCOMES AND MEASURES Spectral power (absolute and relative) in different frequency bands (Δ, θ, low and high α, β, and γ) from infant resting electroencephalography (EEG) and EEG profiles across frequency bands determined by latent profile analysis. RESULTS Of 113 enrolled infants, 70 (mean [SD] age, 2.42 [0.37] months; 35 girls [50%]) provided usable EEG data. In multivariable hierarchical linear regressions, maternal perceived stress was significantly and negatively associated with absolute β (β = -0.007; 95% CI, -0.01 to -0.001; semipartial r = -0.25) and γ power (β = -0.008; 95% CI, -0.01 to -0.002; semipartial r = -0.28). Maternal educational level was significantly and positively associated with power in high α, β, and γ bands after adjusting for covariates (high school: γ: β = 0.108; 95% CI, 0.014-0.203; semipartial r = -0.236; associate's degree or higher: high α: β = 0.133; 95% CI, 0.018-0.248; semipartial r = 0.241; β: β = 0.167; 95% CI, 0.055-0.279; semipartial r = 0.309; and γ: β = 0.183; 95% CI, 0.066-0.299; semipartial r = 0.323). Latent profile analysis identified 2 unique profiles for absolute and relative power. Maternal perceived stress (β = 0.13; 95% CI, 0.01-0.25; adjusted odds ratio [AOR], 1.14; 95% CI, 1.01-1.28) and maternal educational level (high school: β = 3.00; 95% CI, 0.35-5.65; AOR, 20.09; 95% CI, 1.42-283.16; associate's degree or higher: β = 4.12; 95% CI, 1.45-6.79; AOR, 61.56; 95% CI, 4.28-885.01) were each associated with unique profile membership. CONCLUSIONS AND RELEVANCE These findings suggest that unique contributions of caregiver stress and maternal educational level on infant neurodevelopment are detectable at 2 months; EEG might be a promising tool to identify infants most susceptible to parental stress and to reveal mechanisms by which neurodevelopment is associated with adversity. Additional studies validating subgroups across larger cohorts with different stressors and at different ages are required before use at the individual level in clinical settings.
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Affiliation(s)
- Lara J. Pierce
- Department of Pediatrics, Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts
| | - Barbara L. Thompson
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California,Keck School of Medicine, University of Southern California, Los Angeles,Department of Pediatrics and Human Development, Michigan State University, East Lansing
| | - Alma Gharib
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California,Keck School of Medicine, University of Southern California, Los Angeles
| | - Lisa Schlueter
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California,Keck School of Medicine, University of Southern California, Los Angeles
| | - Emily Reilly
- Department of Pediatrics, Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Viviane Valdes
- Department of Pediatrics, Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Suzanne Roberts
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California,Keck School of Medicine, University of Southern California, Los Angeles
| | - Kathleen Conroy
- Department of Pediatrics, Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts
| | - Pat Levitt
- Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California,Keck School of Medicine, University of Southern California, Los Angeles
| | - Charles A. Nelson
- Department of Pediatrics, Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts,Harvard Graduate School of Education, Cambridge, Massachusetts
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16
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Vucinovic M, Kardum G, Vukovic J, Vucinovic A. Maturational Changes of Delta Waves in Monozygotic and Dizygotic Infant Twins. J Exp Neurosci 2018; 12:1179069518797108. [PMID: 30181687 PMCID: PMC6111399 DOI: 10.1177/1179069518797108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 08/07/2018] [Indexed: 12/20/2022] Open
Abstract
AIMS To compare developmental changes of delta 1 (0.5-2.0 Hz) and delta 2 (2.25-3.75 Hz) power spectra between healthy monozygotic (MZ) and dizygotic (DZ) twin pairs and among MZ and DZ twin groups during active/REM (AS/REM) and quiet/NREM (QS/NREM) sleep stages at 38th, 46th, and 52nd weeks of postmenstrual age (PMA). MATERIALS AND METHODS Electroencephalography (EEG) recordings were analyzed using fast Fourier transforms. Differences in the developmental changes of delta power within twin pairs and between twin groups were estimated by calculating mean absolute differences of relative spectral values in delta 1 (0.5-2 Hz) and delta 2 (2.25-3.75 Hz) frequencies. RESULTS A review of electrodes showed that relative delta 1 power decreased, whereas delta 2 power increased from 38th toward 52nd week of PMA regardless of zygosity, sleep stages, and electrode position. Twin groups did not significantly differ (P > .05) in within-pair MZ and DZ similarity for delta 1 and delta 2 power spectra; similarity between MZ twin partners for delta 1 and delta 2 power spectra was as high as that of DZ twin partners on each electrode position, sleep stage, and period of measurement. CONCLUSIONS Developmental changes of delta 1 and delta 2 power spectra occurred equally in MZ and DZ twin groups during AS and QS sleep stages at 38th, 46th, and 52th PMA. The rhythm of EEG maturation evidenced by the maturation of delta 1 and delta 2 power spectra was not dependent on zygosity.
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Affiliation(s)
- Mirjana Vucinovic
- Neonatal Intensive Care Unit, Department
of Gynecology and Obstetrics, University Hospital Centre Split, Split, Croatia
| | - Goran Kardum
- Department of Psychology, Faculty of
Humanities and Social Sciences, University of Split, Split, Croatia
| | - Jonatan Vukovic
- Department of Internal Medicine,
University Hospital Centre Split, Split, Croatia
| | - Ana Vucinovic
- Department of Ophthalmology, University
Hospital Centre Split, Split, Croatia
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17
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Khazipov R, Milh M. Early patterns of activity in the developing cortex: Focus on the sensorimotor system. Semin Cell Dev Biol 2018; 76:120-129. [DOI: 10.1016/j.semcdb.2017.09.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 02/08/2023]
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18
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Welch MG, Stark RI, Grieve PG, Ludwig RJ, Isler JR, Barone JL, Myers MM. Family nurture intervention in preterm infants increases early development of cortical activity and independence of regional power trajectories. Acta Paediatr 2017; 106:1952-1960. [PMID: 28850710 DOI: 10.1111/apa.14050] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 08/17/2017] [Accepted: 08/23/2017] [Indexed: 12/15/2022]
Abstract
AIM Premature delivery and maternal separation during hospitalisation increase infant neurodevelopmental risk. Previously, a randomised controlled trial of Family Nurture Intervention (FNI) in the neonatal intensive care unit demonstrated improvement across multiple mother and infant domains including increased electroencephalographic (EEG) power in the frontal polar region at term age. New aims were to quantify developmental changes in EEG power in all brain regions and frequencies and correlate developmental changes in EEG power among regions. METHODS EEG (128 electrodes) was obtained at 34-44 weeks postmenstrual age from preterm infants born 26-34 weeks. Forty-four infants were treated with Standard Care and 53 with FNI. EEG power was computed in 10 frequency bands (1-48 Hz) in 10 brain regions and in active and quiet sleep. RESULTS Percent change/week in EEG power was increased in FNI in 132/200 tests (p < 0.05), 117 tests passed a 5% False Discovery Rate threshold. In addition, FNI demonstrated greater regional independence in those developmental rates of change. CONCLUSION This study strengthens the conclusion that FNI promotes cerebral cortical development of preterm infants. The findings indicate that developmental changes in EEG may provide biomarkers for risk in preterm infants as well as proximal markers of effects of FNI.
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Affiliation(s)
- Martha G. Welch
- Department of Pediatrics; Columbia University College of Physicians & Surgeons; New York USA
- Department of Psychiatry; Columbia University College of Physicians & Surgeons; New York USA
- Department of Developmental Neuroscience; New York State Psychiatric Institute; New York USA
- Department of Pathology & Cell Biology; Columbia University College of Physicians & Surgeons; New York USA
| | - Raymond I. Stark
- Department of Pediatrics; Columbia University College of Physicians & Surgeons; New York USA
| | - Philip G. Grieve
- Department of Pediatrics; Columbia University College of Physicians & Surgeons; New York USA
| | - Robert J. Ludwig
- Department of Pediatrics; Columbia University College of Physicians & Surgeons; New York USA
| | - Joseph R. Isler
- Department of Pediatrics; Columbia University College of Physicians & Surgeons; New York USA
| | - Joseph L. Barone
- Department of Pediatrics; Columbia University College of Physicians & Surgeons; New York USA
| | - Michael M. Myers
- Department of Pediatrics; Columbia University College of Physicians & Surgeons; New York USA
- Department of Psychiatry; Columbia University College of Physicians & Surgeons; New York USA
- Department of Developmental Neuroscience; New York State Psychiatric Institute; New York USA
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19
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Tóth B, Urbán G, Háden GP, Márk M, Török M, Stam CJ, Winkler I. Large-scale network organization of EEG functional connectivity in newborn infants. Hum Brain Mapp 2017; 38:4019-4033. [PMID: 28488308 PMCID: PMC6867159 DOI: 10.1002/hbm.23645] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 04/26/2017] [Accepted: 04/28/2017] [Indexed: 12/12/2022] Open
Abstract
The organization of functional brain networks changes across human lifespan. The present study analyzed functional brain networks in healthy full-term infants (N = 139) within 1-6 days from birth by measuring neural synchrony in EEG recordings during quiet sleep. Large-scale phase synchronization was measured in six frequency bands with the Phase Lag Index. Macroscopic network organization characteristics were quantified by constructing unweighted minimum spanning tree graphs. The cortical networks in early infancy were found to be significantly more hierarchical and had a more cost-efficient organization compared with MST of random control networks, more so in the theta and alpha than in other frequency bands. Frontal and parietal sites acted as the main hubs of these networks, the topological characteristics of which were associated with gestation age (GA). This suggests that individual differences in network topology are related to cortical maturation during the prenatal period, when functional networks shift from strictly centralized toward segregated configurations. Hum Brain Mapp 38:4019-4033, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Brigitta Tóth
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of SciencesBudapestHungary
| | - Gábor Urbán
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of SciencesBudapestHungary
- Department of Cognitive ScienceFaculty of Natural Sciences, Budapest University of Technology and EconomicsBudapestHungary
| | - Gábor P. Háden
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of SciencesBudapestHungary
| | - Molnár Márk
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of SciencesBudapestHungary
| | - Miklós Török
- Department of Obstetrics‐Gynaecology and Perinatal Intensive Care UnitMilitary HospitalBudapestHungary
| | - Cornelis Jan Stam
- Department of Clinical NeurophysiologyVU University Medical CenterAmsterdamNetherlands
| | - István Winkler
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Hungarian Academy of SciencesBudapestHungary
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20
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Whitehead K, Pressler R, Fabrizi L. Characteristics and clinical significance of delta brushes in the EEG of premature infants. Clin Neurophysiol Pract 2016; 2:12-18. [PMID: 30214965 PMCID: PMC6123866 DOI: 10.1016/j.cnp.2016.11.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 11/10/2016] [Accepted: 11/18/2016] [Indexed: 10/29/2022] Open
Abstract
Delta brushes are the hallmark of the EEG of premature infants. They are readily recognisable because of their characteristic appearance and are a key marker of neural maturation. However they are sometimes inconsistently described in the literature making identification of abnormalities challenging. The goal of this review is to provide an overview of research findings on this topic in the last five decades. Firstly, the characteristic features of delta brushes are described, including the developmental trajectory of their incidence and how they are modulated by vigilance state in normal neonates. Secondly, their clinical significance is discussed including how abnormalities in their incidence or appearance indicate particular pathophysiology. We propose that (i) the effect of age and vigilance state on the frequency, amplitude and topography of delta brushes, and (ii) heterogeneity within the cohorts of 'normal' premature infants studied, may explain the very variable descriptions of delta brush characteristics in the literature. By explicitly taking these factors into consideration to explain delta brush variability, the presented summary facilitates the clinical electrodiagnostic and prognostic use of delta brush abnormalities as a biomarker.
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Affiliation(s)
- Kimberley Whitehead
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| | - Ronit Pressler
- Department of Clinical Neurophysiology, Great Ormond Street Hospital, London, United Kingdom.,Department of Clinical Neuroscience, UCL Great Ormond Street Institute for Child Health, London, United Kingdom
| | - Lorenzo Fabrizi
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
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21
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Estimating functional brain maturity in very and extremely preterm neonates using automated analysis of the electroencephalogram. Clin Neurophysiol 2016; 127:2910-2918. [DOI: 10.1016/j.clinph.2016.02.024] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 01/25/2016] [Accepted: 02/12/2016] [Indexed: 01/29/2023]
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Wu X, Wei L, Wang N, Hu Z, Wang L, Ma J, Feng S, Cai Y, Song X, Shi Y. Frequency of Spontaneous BOLD Signal Differences between Moderate and Late Preterm Newborns and Term Newborns. Neurotox Res 2016; 30:539-51. [DOI: 10.1007/s12640-016-9642-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/06/2016] [Accepted: 06/09/2016] [Indexed: 11/29/2022]
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Goldstein RD, Kinney HC, Willinger M. Sudden Unexpected Death in Fetal Life Through Early Childhood. Pediatrics 2016; 137:e20154661. [PMID: 27230764 PMCID: PMC4894250 DOI: 10.1542/peds.2015-4661] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/07/2016] [Indexed: 11/24/2022] Open
Abstract
In March 2015, the Eunice Kennedy Shriver National Institute of Child Health and Human Development held a workshop entitled "Sudden Unexpected Death in Fetal Life Through Early Childhood: New Opportunities." Its objective was to advance efforts to understand and ultimately prevent sudden deaths in early life, by considering their pathogenesis as a potential continuum with some commonalities in biological origins or pathways. A second objective of this meeting was to highlight current issues surrounding the classification of sudden infant death syndrome (SIDS), and the implications of variations in the use of the term "SIDS" in forensic practice, and pediatric care and research. The proceedings reflected the most current knowledge and understanding of the origins and biology of vulnerability to sudden unexpected death, and its environmental triggers. Participants were encouraged to consider the application of new technologies and "omics" approaches to accelerate research. The major advances in delineating the intrinsic vulnerabilities to sudden death in early life have come from epidemiologic, neural, cardiac, metabolic, genetic, and physiologic research, with some commonalities among cases of unexplained stillbirth, SIDS, and sudden unexplained death in childhood observed. It was emphasized that investigations of sudden unexpected death are inconsistent, varying by jurisdiction, as are the education, certification practices, and experience of death certifiers. In addition, there is no practical consensus on the use of "SIDS" as a determination in cause of death. Major clinical, forensic, and scientific areas are identified for future research.
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Affiliation(s)
- Richard D Goldstein
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Department of Medicine, and
| | - Hannah C Kinney
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; and
| | - Marian Willinger
- Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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Abstract
UNLABELLED Survivors of preterm birth are at high risk of pervasive cognitive and learning impairments, suggesting disrupted early brain development. The limits of viability for preterm birth encompass the third trimester of pregnancy, a "precritical period" of activity-dependent development characterized by the onset of spontaneous and evoked patterned electrical activity that drives neuronal maturation and formation of cortical circuits. Reduced background activity on electroencephalogram (EEG) is a sensitive marker of brain injury in human preterm infants that predicts poor neurodevelopmental outcome. We studied a rodent model of very early hypoxic-ischemic brain injury to investigate effects of injury on both general background and specific patterns of cortical activity measured with EEG. EEG background activity is depressed transiently after moderate hypoxia-ischemia with associated loss of spindle bursts. Depressed activity, in turn, is associated with delayed expression of glutamate receptor subunits and transporters. Cortical pyramidal neurons show reduced dendrite development and spine formation. Complementing previous observations in this model of impaired visual cortical plasticity, we find reduced somatosensory whisker barrel plasticity. Finally, EEG recordings from human premature newborns with brain injury demonstrate similar depressed background activity and loss of bursts in the spindle frequency band. Together, these findings suggest that abnormal development after early brain injury may result in part from disruption of specific forms of brain activity necessary for activity-dependent circuit development. SIGNIFICANCE STATEMENT Preterm birth and term birth asphyxia result in brain injury from inadequate oxygen delivery and constitute a major and growing worldwide health problem. Poor outcomes are noted in a majority of very premature (<25 weeks gestation) newborns, resulting in death or life-long morbidity with motor, sensory, learning, behavioral, and language disabilities that limit academic achievement and well-being. Limited progress has been made to develop therapies that improve neurologic outcomes. The overall objective of this study is to understand the effect of early brain injury on activity-dependent brain development and cortical plasticity to develop new treatments that will optimize repair and recovery after brain injury.
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Tokariev A, Videman M, Palva JM, Vanhatalo S. Functional Brain Connectivity Develops Rapidly Around Term Age and Changes Between Vigilance States in the Human Newborn. Cereb Cortex 2015; 26:4540-4550. [DOI: 10.1093/cercor/bhv219] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Chu CJ, Leahy J, Pathmanathan J, Kramer MA, Cash SS. The maturation of cortical sleep rhythms and networks over early development. Clin Neurophysiol 2013; 125:1360-70. [PMID: 24418219 DOI: 10.1016/j.clinph.2013.11.028] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 10/25/2013] [Accepted: 11/19/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Although neuronal activity drives all aspects of cortical development, how human brain rhythms spontaneously mature remains an active area of research. We sought to systematically evaluate the emergence of human brain rhythms and functional cortical networks over early development. METHODS We examined cortical rhythms and coupling patterns from birth through adolescence in a large cohort of healthy children (n=384) using scalp electroencephalogram (EEG) in the sleep state. RESULTS We found that the emergence of brain rhythms follows a stereotyped sequence over early development. In general, higher frequencies increase in prominence with striking regional specificity throughout development. The coordination of these rhythmic activities across brain regions follows a general pattern of maturation in which broadly distributed networks of low-frequency oscillations increase in density while networks of high frequency oscillations become sparser and more highly clustered. CONCLUSION Our results indicate that a predictable program directs the development of key rhythmic components and physiological brain networks over early development. SIGNIFICANCE This work expands our knowledge of normal cortical development. The stereotyped neurophysiological processes observed at the level of rhythms and networks may provide a scaffolding to support critical periods of cognitive growth. Furthermore, these conserved patterns could provide a sensitive biomarker for cortical health across development.
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Affiliation(s)
- C J Chu
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02144, USA; Harvard Medical School, Boston, MA 02144, USA.
| | - J Leahy
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02144, USA
| | - J Pathmanathan
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02144, USA; Harvard Medical School, Boston, MA 02144, USA
| | - M A Kramer
- Department of Mathematics and Statistics, Boston University, Boston, MA 02215, USA
| | - S S Cash
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02144, USA; Harvard Medical School, Boston, MA 02144, USA
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27
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Welch MG, Myers MM, Grieve PG, Isler JR, Fifer WP, Sahni R, Hofer MA, Austin J, Ludwig RJ, Stark RI. Electroencephalographic activity of preterm infants is increased by Family Nurture Intervention: a randomized controlled trial in the NICU. Clin Neurophysiol 2013; 125:675-684. [PMID: 24140072 DOI: 10.1016/j.clinph.2013.08.021] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 07/23/2013] [Accepted: 08/17/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To assess the impact of Family Nurture Intervention (FNI) on electroencephalogram (EEG) activity in preterm infants (26-34 weeks gestation). METHODS Two groups were tested in a single, level IV neonatal intensive care unit (NICU; standard care or standard care plus FNI) using a randomized controlled trial design. The intervention consists of sessions designed to achieve mutual calm and promote communication of affect between infants and their mothers throughout the NICU stay. EEG recordings were obtained from 134 infants during sleep at ∼35 and ∼40 weeks postmenstrual age (PMA). Regional brain activity (power) was computed for 10 frequency bands between 1 and 48 Hz in each of 125 electrodes. RESULTS Near to term age, compared to standard care infants, FNI infants showed robust increases in EEG power in the frontal polar region at frequencies 10 to 48 Hz (20% to 36% with p-values <0.0004). Effects were significant in both quiet and active sleep, regardless of gender, singleton-twin status, gestational age (26-30 or 30-35 weeks) or birth weight (<1500 or >1500 g). CONCLUSION FNI leads to increased frontal brain activity during sleep, which other investigators find predictive of better neurobehavioral outcomes. SIGNIFICANCE FNI may be a practicable means of improving outcomes in preterm infants.
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Affiliation(s)
- Martha G Welch
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA; Department of Pediatrics, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA; Department of Pathology & Cell Biology, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA; Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032, USA.
| | - Michael M Myers
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA; Department of Pediatrics, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA; Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032, USA
| | - Philip G Grieve
- Department of Pediatrics, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA; Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA
| | - Joseph R Isler
- Department of Pediatrics, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA
| | - William P Fifer
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA; Department of Pediatrics, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA; Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032, USA
| | - Rakesh Sahni
- Department of Pediatrics, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA
| | - Myron A Hofer
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA; Department of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY 10032, USA
| | - Judy Austin
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Robert J Ludwig
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA
| | - Raymond I Stark
- Department of Pediatrics, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA
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Syllabic discrimination in premature human infants prior to complete formation of cortical layers. Proc Natl Acad Sci U S A 2013; 110:4846-51. [PMID: 23440196 DOI: 10.1073/pnas.1212220110] [Citation(s) in RCA: 250] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The ontogeny of linguistic functions in the human brain remains elusive. Although some auditory capacities are described before term, whether and how such immature cortical circuits might process speech are unknown. Here we used functional optical imaging to evaluate the cerebral responses to syllables at the earliest age at which cortical responses to external stimuli can be recorded in humans (28- to 32-wk gestational age). At this age, the cortical organization in layers is not completed. Many neurons are still located in the subplate and in the process of migrating to their final location. Nevertheless, we observed several points of similarity with the adult linguistic network. First, whereas syllables elicited larger right than left responses, the posterior temporal region escaped this general pattern, showing faster and more sustained responses over the left than over the right hemisphere. Second, discrimination responses to a change of phoneme (ba vs. ga) and a change of human voice (male vs. female) were already present and involved inferior frontal areas, even in the youngest infants (29-wk gestational age). Third, whereas both types of changes elicited responses in the right frontal region, the left frontal region only reacted to a change of phoneme. These results demonstrate a sophisticated organization of perisylvian areas at the very onset of cortical circuitry, 3 mo before term. They emphasize the influence of innate factors on regions involved in linguistic processing and social communication in humans.
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29
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Widening the horizon of neonatal neurophysiology. Clin Neurophysiol 2012; 123:1475-6. [DOI: 10.1016/j.clinph.2012.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 01/10/2012] [Accepted: 01/12/2012] [Indexed: 11/20/2022]
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