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Jaschke AC, Mitra S, Bos AF. Music therapy in tertiary neonatal intensive care: A matter of unlikely allies? Acta Paediatr 2024; 113:1772-1777. [PMID: 38775297 DOI: 10.1111/apa.17297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/06/2024] [Accepted: 05/14/2024] [Indexed: 07/12/2024]
Abstract
Over the past decades, music therapy in the neonatal intensive care unit (NICU) has been proven effective in physiological and psychological outcomes, including sucking, behaviour, stress reduction, neurodevelopment and promoting emotional bonding. However, not every NICU administers music therapy in their ward. Research on music therapy for neonates and their caregivers has lately accumulated, increasing the evidence of health benefits on brain development and across a variety of NICU-related pathologies, including neurological, cardiological, pulmonary and gastrointestinal problems. Conclusively, we will present the studied methods of music therapy for clinical benefits in neonatal intensive care.
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Affiliation(s)
- Artur C Jaschke
- Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK
- Division of Neonatology, Department of Paediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Music Therapy, ArtEZ University of the Arts, Arnhem, The Netherlands
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Subhabrata Mitra
- Department of Neonatology, Institute for Women's Health, University College London, London, UK
| | - Arend F Bos
- Division of Neonatology, Department of Paediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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2
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Loukas S, Filippa M, de Almeida JS, Boehringer AS, Tolsa CB, Barcos-Munoz F, Grandjean DM, van de Ville D, Hüppi PS. Newborn's neural representation of instrumental and vocal music as revealed by fMRI: A dynamic effective brain connectivity study. Hum Brain Mapp 2024; 45:e26724. [PMID: 39001584 PMCID: PMC11245569 DOI: 10.1002/hbm.26724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 07/16/2024] Open
Abstract
Music is ubiquitous, both in its instrumental and vocal forms. While speech perception at birth has been at the core of an extensive corpus of research, the origins of the ability to discriminate instrumental or vocal melodies is still not well investigated. In previous studies comparing vocal and musical perception, the vocal stimuli were mainly related to speaking, including language, and not to the non-language singing voice. In the present study, to better compare a melodic instrumental line with the voice, we used singing as a comparison stimulus, to reduce the dissimilarities between the two stimuli as much as possible, separating language perception from vocal musical perception. In the present study, 45 newborns were scanned, 10 full-term born infants and 35 preterm infants at term-equivalent age (mean gestational age at test = 40.17 weeks, SD = 0.44) using functional magnetic resonance imaging while listening to five melodies played by a musical instrument (flute) or sung by a female voice. To examine the dynamic task-based effective connectivity, we employed a psychophysiological interaction of co-activation patterns (PPI-CAPs) analysis, using the auditory cortices as seed region, to investigate moment-to-moment changes in task-driven modulation of cortical activity during an fMRI task. Our findings reveal condition-specific, dynamically occurring patterns of co-activation (PPI-CAPs). During the vocal condition, the auditory cortex co-activates with the sensorimotor and salience networks, while during the instrumental condition, it co-activates with the visual cortex and the superior frontal cortex. Our results show that the vocal stimulus elicits sensorimotor aspects of the auditory perception and is processed as a more salient stimulus while the instrumental condition activated higher-order cognitive and visuo-spatial networks. Common neural signatures for both auditory stimuli were found in the precuneus and posterior cingulate gyrus. Finally, this study adds knowledge on the dynamic brain connectivity underlying the newborns capability of early and specialized auditory processing, highlighting the relevance of dynamic approaches to study brain function in newborn populations.
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Affiliation(s)
- Serafeim Loukas
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Manuela Filippa
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, Department of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Joana Sa de Almeida
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - Andrew S Boehringer
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
- Lemanic Neuroscience Doctoral School, University of Geneva, Geneva, Switzerland
| | - Cristina Borradori Tolsa
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - Francisca Barcos-Munoz
- Division of Pediatric Intensive Care and Neonatology, Department of Women, Children and Adolescents, University Hospital of Geneva, Geneva, Switzerland
| | - Didier M Grandjean
- Swiss Center for Affective Sciences, Department of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Dimitri van de Ville
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Petra S Hüppi
- Division of Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
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Siffredi V, Liverani MC, Fernandez N, Freitas LGA, Borradori Tolsa C, Van De Ville D, Hüppi PS, Ha-Vinh Leuchter R. Impact of a mindfulness-based intervention on neurobehavioral functioning and its association with large-scale brain networks in preterm young adolescents. Psychiatry Clin Neurosci 2024; 78:416-425. [PMID: 38757554 DOI: 10.1111/pcn.13675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024]
Abstract
AIM Adolescents born very preterm (VPT; <32 weeks of gestation) face an elevated risk of executive, behavioral, and socioemotional difficulties. Evidence suggests beneficial effects of mindfulness-based intervention (MBI) on these abilities. This study seeks to investigate the association between the effects of MBI on executive, behavioral, and socioemotional functioning and reliable changes in large-scale brain networks dynamics during rest in VPT young adolescents who completed an 8-week MBI program. METHODS Neurobehavioral assessments and resting-state functional magnetic resonance imaging were performed before and after MBI in 32 VPT young adolescents. Neurobehavioral abilities in VPT participants were compared with full-term controls. In the VPT group, dynamic functional connectivity was extracted by using the innovation-driven coactivation patterns framework. The reliable change index was used to quantify change after MBI. A multivariate data-driven approach was used to explore associations between MBI-related changes on neurobehavioral measures and temporal brain dynamics. RESULTS Compared with term-born controls, VPT adolescents showed reduced executive and socioemotional functioning before MBI. After MBI, a significant improvement was observed for all measures that were previously reduced in the VPT group. The increase in executive functioning, only, was associated with reliable changes in the duration of activation of large-scale brain networks, including frontolimbic, amygdala-hippocampus, dorsolateral prefrontal, and visual networks. CONCLUSION The improvement in executive functioning after an MBI was associated with reliable changes in large-scale brain network dynamics during rest. These changes encompassed frontolimbic, amygdala-hippocampus, dorsolateral prefrontal, and visual networks that are related to different executive processes including self-regulation, attentional control, and attentional awareness of relevant sensory stimuli.
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Affiliation(s)
- Vanessa Siffredi
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Neuro-X Institute, École polytechnique fédérale de Lausanne, Geneva, Switzerland
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maria Chiara Liverani
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- SensoriMotor, Affective and Social Development Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Natalia Fernandez
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Lorena G A Freitas
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Neuro-X Institute, École polytechnique fédérale de Lausanne, Geneva, Switzerland
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Cristina Borradori Tolsa
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Dimitri Van De Ville
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Neuro-X Institute, École polytechnique fédérale de Lausanne, Geneva, Switzerland
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Petra Susan Hüppi
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Russia Ha-Vinh Leuchter
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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Curzel F, Tillmann B, Ferreri L. Lights on music cognition: A systematic and critical review of fNIRS applications and future perspectives. Brain Cogn 2024; 180:106200. [PMID: 38908228 DOI: 10.1016/j.bandc.2024.106200] [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: 04/06/2024] [Revised: 06/10/2024] [Accepted: 06/16/2024] [Indexed: 06/24/2024]
Abstract
Research investigating the neural processes related to music perception and production constitutes a well-established field within the cognitive neurosciences. While most neuroimaging tools have limitations in studying the complexity of musical experiences, functional Near-Infrared Spectroscopy (fNIRS) represents a promising, relatively new tool for studying music processes in both laboratory and ecological settings, which is also suitable for both typical and pathological populations across development. Here we systematically review fNIRS studies on music cognition, highlighting prospects and potentialities. We also include an overview of fNIRS basic theory, together with a brief comparison to characteristics of other neuroimaging tools. Fifty-nine studies meeting inclusion criteria (i.e., using fNIRS with music as the primary stimulus) are presented across five thematic sections. Critical discussion of methodology leads us to propose guidelines of good practices aiming for robust signal analyses and reproducibility. A continuously updated world map is proposed, including basic information from studies meeting the inclusion criteria. It provides an organized, accessible, and updatable reference database, which could serve as a catalyst for future collaborations within the community. In conclusion, fNIRS shows potential for investigating cognitive processes in music, particularly in ecological contexts and with special populations, aligning with current research priorities in music cognition.
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Affiliation(s)
- Federico Curzel
- Laboratoire d'Étude des Mécanismes Cognitifs (EMC), Université Lumière Lyon 2, Bron, Auvergne-Rhône-Alpes, 69500, France; Lyon Neuroscience Research Center (CRNL), INSERM, U1028, CNRS, UMR 5292, Université Claude Bernard Lyon1, Université de Lyon, Bron, Auvergne-Rhône-Alpes, 69500, France.
| | - Barbara Tillmann
- Lyon Neuroscience Research Center (CRNL), INSERM, U1028, CNRS, UMR 5292, Université Claude Bernard Lyon1, Université de Lyon, Bron, Auvergne-Rhône-Alpes, 69500, France; LEAD CNRS UMR5022, Université de Bourgogne-Franche Comté, Dijon, Bourgogne-Franche Comté 21000, France.
| | - Laura Ferreri
- Laboratoire d'Étude des Mécanismes Cognitifs (EMC), Université Lumière Lyon 2, Bron, Auvergne-Rhône-Alpes, 69500, France; Department of Brain and Behavioural Sciences, Università di Pavia, Pavia, Lombardia 27100, Italy.
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Baud O, Knoop M. [Oxytocin as a neuroprotective strategy in neonates: concept and preclinical evidence]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2024; 52:418-424. [PMID: 38145743 DOI: 10.1016/j.gofs.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE Prematurity and intra-uterine growth retardation are responsible for brain damage associated with various neurocognitive and behavioral disorders in more than 9 million children each year. Most pharmacological strategies aimed at preventing perinatal brain injury have not demonstrated substantial clinical benefits so far. In contrast, enrichment of the newborn's environment appears to have positive effects on brain structure and function, influences newborn hormonal responses, and has lasting neurobehavioral consequences during infancy and adulthood. Oxytocin (OT), a neuropeptide released by the hypothalamus, may represent the hormonal basis for these long-term effects. METHOD This review of the literature summarizes the knowledge concerning the effect of OT in the newborn and the preclinical data supporting its neuroprotective effect. RESULTS OT plays a role during the perinatal period, in parent-child attachment and in social behavior. Furthermore, preclinical studies strongly suggest that endogenous and synthetic OT is capable of regulating the inflammatory response of the central nervous system in response to situations of prematurity or more generally insults to the developing brain. The long-term effect of synthetic OT administration during labor is also discussed. CONCLUSION All the conceptual and experimental data converge to indicate that OT would be a promising candidate for neonatal neuroprotection, in particular through the regulation of neuroinflammation.
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Affiliation(s)
- Olivier Baud
- Laboratoire du développement, Université de Genève, Genève, Suisse; Inserm U1141, Université Paris Cité, Paris, France; Service de Soins Intensifs Pédiatriques et Néonatologie, Hôpitaux Universitaires de Genève, Genève, Suisse.
| | - Marit Knoop
- Laboratoire du développement, Université de Genève, Genève, Suisse
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Damera SR, De Asis-Cruz J, Cook KM, Kapse K, Spoehr E, Murnick J, Basu S, Andescavage N, Limperopoulos C. Regional homogeneity as a marker of sensory cortex dysmaturity in preterm infants. iScience 2024; 27:109662. [PMID: 38665205 PMCID: PMC11043889 DOI: 10.1016/j.isci.2024.109662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/23/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Atypical perinatal sensory experience in preterm infants is thought to increase their risk of neurodevelopmental disabilities by altering the development of the sensory cortices. Here, we used resting-state fMRI data from preterm and term-born infants scanned between 32 and 48 weeks post-menstrual age to assess the effect of early ex-utero exposure on sensory cortex development. Specifically, we utilized a measure of local correlated-ness called regional homogeneity (ReHo). First, we demonstrated that the brain-wide distribution of ReHo mirrors the known gradient of cortical maturation. Next, we showed that preterm birth differentially reduces ReHo across the primary sensory cortices. Finally, exploratory analyses showed that the reduction of ReHo in the primary auditory cortex of preterm infants is related to increased risk of autism at 18 months. In sum, we show that local connectivity within sensory cortices has different developmental trajectories, is differentially affected by preterm birth, and may be associated with later neurodevelopment.
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Affiliation(s)
- Srikanth R. Damera
- Developing Brain Institute, Children’s National, 111 Michigan Avenue NW, Washington, DC 20010, USA
| | - Josepheen De Asis-Cruz
- Developing Brain Institute, Children’s National, 111 Michigan Avenue NW, Washington, DC 20010, USA
| | - Kevin M. Cook
- Developing Brain Institute, Children’s National, 111 Michigan Avenue NW, Washington, DC 20010, USA
| | - Kushal Kapse
- Developing Brain Institute, Children’s National, 111 Michigan Avenue NW, Washington, DC 20010, USA
| | - Emma Spoehr
- Developing Brain Institute, Children’s National, 111 Michigan Avenue NW, Washington, DC 20010, USA
| | - Jon Murnick
- Developing Brain Institute, Children’s National, 111 Michigan Avenue NW, Washington, DC 20010, USA
| | - Sudeepta Basu
- Developing Brain Institute, Children’s National, 111 Michigan Avenue NW, Washington, DC 20010, USA
| | - Nickie Andescavage
- Developing Brain Institute, Children’s National, 111 Michigan Avenue NW, Washington, DC 20010, USA
| | - Catherine Limperopoulos
- Developing Brain Institute, Children’s National, 111 Michigan Avenue NW, Washington, DC 20010, USA
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Erdei C, Sunwoo J, Corriveau GC, Forde M, El-Dib M, Inder T. Effect of music-based interventions on physiologic stability of hospitalized preterm infants. A pilot study. J Perinatol 2024; 44:665-670. [PMID: 38418527 DOI: 10.1038/s41372-024-01907-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND AND OBJECTIVE Hospitalized preterm infants experience reduced meaningful auditory exposures during a critical period of brain development. Music-based interventions (MBI) may be beneficial, though it remains unclear which stimuli optimally enhance infant stabilization. We investigated the relationship between three conceptually-different MBIs and short-term responses in hospitalized preterm infants. STUDY DESIGN This is a case-crossover pilot study including 21 preterm infants between 30 and 35 weeks postmenstrual age. Participants listened to three MBIs and 'no music'; each condition was provided three times in random order. We monitored physiologic and behavioral parameters around each exposure and analyzed results using linear mixed models. RESULTS Respiratory rates decreased after each MBI compared with 'no music' (p = 0.02). The most notable decrease occurred following exposure to a low, repetitive musical pattern resembling a lullaby (p = 0.01). We noted no significant changes for the remaining parameters. CONCLUSION Specific MBI characteristics may preferentially enhance physiologic stabilization in hospitalized preterm infants.
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Affiliation(s)
- Carmina Erdei
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA.
- Harvard Medical School, Pediatrics, 25 Shattuck St, Boston, MA, USA.
| | - John Sunwoo
- Harvard Medical School, Pediatrics, 25 Shattuck St, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th St, Charlestown, MA, USA
| | - Gabriel Cote Corriveau
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Madison Forde
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Mohamed El-Dib
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
- Harvard Medical School, Pediatrics, 25 Shattuck St, Boston, MA, USA
| | - Terrie Inder
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
- Harvard Medical School, Pediatrics, 25 Shattuck St, Boston, MA, USA
- Division of Neonatology, Children's Hospital of Orange County and University of California Irvine, 1001, Health Sciences Rd, Irvine, CA, USA
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Franco F, Chifa M, Politimou N. Home Musical Activities Boost Premature Infants' Language Development. CHILDREN (BASEL, SWITZERLAND) 2024; 11:542. [PMID: 38790537 PMCID: PMC11120229 DOI: 10.3390/children11050542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/21/2024] [Accepted: 04/03/2024] [Indexed: 05/26/2024]
Abstract
Infants born prematurely are considered at risk for language development delay and impairments. Using online parental reports, the present study investigated the influence of early musical experience in the home environment (Music@Home Infant Questionnaire) on language development (MacArthur-Bates Communicative Development Inventory) while controlling for general enrichment at home (Stim-Q Cognitive Home Environment Questionnaire) and perinatal post-traumatic stress disorder (Perinatal PTSD Questionnaire). Caregivers of 117 infants between 8 and 18 months of age (corrected age) without reported developmental difficulties completed an online survey. Results revealed that the musical home environment significantly predicted outcomes in reported infants' receptive vocabulary and gestural communication, independently from infants' corrected age and general enrichment of home activities. These findings constitute the first evidence that an enriched musical experience can enhance the development of early communication skills in a population at risk for language delays, namely infants born prematurely, opening the path for future intervention research in home and/or early childcare settings. Given that the majority of participants in this study were highly educated and from socioeconomically stable backgrounds, considerations regarding the generalizability of these results are discussed.
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Affiliation(s)
- Fabia Franco
- Psychology Department, Faculty of Science and Technology, Middlesex University, London NW4 4BT, UK;
| | - Maria Chifa
- Psychology Department, Faculty of Science and Technology, Middlesex University, London NW4 4BT, UK;
| | - Nina Politimou
- Department of Psychology and Human Development, IOE Faculty of Education and Society, University College London, London WC1H 0AA, UK
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Bieleninik Ł, Kvestad I, Gold C, Stordal AS, Assmus J, Arnon S, Elefant C, Ettenberger M, Gaden TS, Haar-Shamir D, Håvardstun T, Lichtensztejn M, Mangersnes J, Wiborg AMN, Vederhus BJ, Ghetti CM. Music Therapy in Infancy and Neurodevelopmental Outcomes in Preterm Children: A Secondary Analysis of the LongSTEP Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2410721. [PMID: 38753331 PMCID: PMC11099691 DOI: 10.1001/jamanetworkopen.2024.10721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/08/2024] [Indexed: 05/19/2024] Open
Abstract
Importance Preterm children are at risk for neurodevelopment impairments. Objective To evaluate the effect of a music therapy (MT) intervention (parent-led, infant-directed singing) for premature children during the neonatal intensive care unit (NICU) stay and/or after hospital discharge on language development at 24 months' corrected age (CA). Design, Setting, and Participants This predefined secondary analysis followed participants in the LongSTEP (Longitudinal Study of Music Therapy's Effectiveness for Premature Infants and Their Caregivers) randomized clinical trial, which was conducted from August 2018 to April 2022 in 8 NICUs across 5 countries (Argentina, Colombia, Israel, Norway, and Poland) and included clinic follow-up visits and extended interventions after hospital discharge. Intervention Participants were children born preterm (<35 weeks' gestation) and their parents. Participants were randomized at enrollment to MT with standard care (SC) or SC alone; they were randomized to MT or SC again at discharge. The MT was parent-led, infant-directed singing tailored to infant responses and supported by a music therapist and was provided 3 times weekly in the NICU and/or in 7 sessions across 6 months after discharge. The SC consisted of early intervention methods of medical, nursing, and social services, without MT. Main Outcome and Measures Primary outcome was language development, as measured by the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) language composite score, with the remaining BSID-III composite and subscale scores as the secondary outcomes. Group differences in treatment effects were assessed using linear mixed-effects models using all available data. Results Of 206 participants (103 female infants [50%]; mean [SD] GA, 30.5 [2.7] weeks), 51 were randomized to MT and 53 to SC at enrollment; at discharge, 52 were randomized to MT and 50 to SC. A total of 112 (54%) were retained at the 24 months' CA follow-up. Most participants (79 [70%] to 93 [83%]) had BSID-III scores in the normal range (≥85). Mean differences for the language composite score were -2.36 (95% CI, -12.60 to 7.88; P = .65) for the MT at NICU with postdischarge SC group, 2.65 (95% CI, -7.94 to 13.23; P = .62) for the SC at NICU and postdischarge MT group, and -3.77 (95% CI, -13.97 to 6.43; P = .47) for the MT group at both NICU and postdischarge. There were no significant effects for cognitive or motor development. Conclusions and Relevance This secondary analysis did not confirm an effect of parent-led, infant-directed singing on neurodevelopment in preterm children at 24 months' CA; wide CIs suggest, however, that potential effects cannot be excluded. Future research should determine the MT approaches, implementation time, and duration that are effective in targeting children at risk for neurodevelopmental impairments and introducing broader measurements for changes in brain development. Trial Registration ClinicalTrials.gov Identifier: NCT03564184.
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Affiliation(s)
- Łucja Bieleninik
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
- Department of Clinical and Health Psychology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, Gdańsk, Poland
| | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Christian Gold
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
| | - Andreas Størksen Stordal
- NORCE Energy, NORCE Norwegian Research Centre AS, Bergen, Norway
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Jörg Assmus
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Shmuel Arnon
- Meir Medical Center, Kfar-Saba, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Mark Ettenberger
- Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Clínica de la Mujer, Bogotá, Colombia
| | - Tora Söderström Gaden
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
| | | | - Tonje Håvardstun
- Department of Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway
| | - Marcela Lichtensztejn
- Facultad de Ciencias de la Salud, Universidad de Ciencias Empresariales y Sociales, Buenos Aires, Argentina
| | | | | | | | - Claire M. Ghetti
- GAMUT—The Grieg Academy, Department of Music, University of Bergen, Bergen, Norway
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Sun L, Wang Q, Ai J. The underlying roles and neurobiological mechanisms of music-based intervention in Alzheimer's disease: A comprehensive review. Ageing Res Rev 2024; 96:102265. [PMID: 38479478 DOI: 10.1016/j.arr.2024.102265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 02/25/2024] [Accepted: 03/04/2024] [Indexed: 03/19/2024]
Abstract
Non-pharmacological therapy has gained popularity in the intervention of Alzheimer's disease (AD) due to its apparent therapeutic effectiveness and the limitation of biological drug. A wealth of research indicates that music interventions can enhance cognition, mood and behavior in individuals with AD. Nonetheless, the underlying mechanisms behind these improvements have yet to be fully and systematically delineated. This review aims to holistically review how music-based intervention (MBI) ameliorates abnormal emotion, cognition decline, and behavioral changes in AD patients. We cover several key dimensions: the regulation of MBIs on cerebral blood flow (CBF), their impact on neurotransmission (including GABAergic and monoaminergic transmissions), modulation of synaptic plasticity, and hormonal release. Additionally, we summarize the clinical applications and limitations of active music-based intervention (AMBI), passive music-based intervention (PMBI), and hybrid music-based intervention (HMBI). This thorough analysis enhances our understanding of the role of MBI in AD and supports the development of non-pharmacological therapeutic strategies.
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Affiliation(s)
- Liyang Sun
- Department of Pharmacology (The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China), College of Pharmacy of Harbin Medical University, 157 Baojian Road, Harbin 150086, China
| | - Qin Wang
- Department of Pharmacology (The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China), College of Pharmacy of Harbin Medical University, 157 Baojian Road, Harbin 150086, China; Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin 150040, China; Heilongjiang Academy of Medical Sciences, 157 Baojian Road, Harbin 150086, China
| | - Jing Ai
- Department of Pharmacology (The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China), College of Pharmacy of Harbin Medical University, 157 Baojian Road, Harbin 150086, China; National Key Laboratory of Frigid Zone Cardiovascular Diseases, 157 Baojian Road, Harbin 150086, China.
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11
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Hüppi PS, Filippa M. Multisensory stimuli and pain perception in the newborn. Pediatr Res 2024; 95:603-604. [PMID: 37833529 PMCID: PMC10899096 DOI: 10.1038/s41390-023-02833-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 09/02/2023] [Indexed: 10/15/2023]
Affiliation(s)
- Petra S Hüppi
- Division of Development and Growth, Department of Pediatrics, Obstetrics & Gynecology, University of Geneva, Rue Willy-Donzé, Geneva, 1211, Switzerland.
| | - Manuela Filippa
- Division of Development and Growth, Department of Pediatrics, Obstetrics & Gynecology, University of Geneva, Rue Willy-Donzé, Geneva, 1211, Switzerland
- Swiss Center for Affective Sciences, Department of Psychology and Educational Sciences, University of Geneva, Boulevard Carl-Vogt 101, Geneva, Switzerland
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12
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Haslbeck FB, Adams M, Schmidli L, Bassler D, Bucher HU, Natalucci G. Creative music therapy for long-term neurodevelopment in extremely preterm infants: Results of a feasibility trial. Acta Paediatr 2023; 112:2524-2531. [PMID: 37787033 DOI: 10.1111/apa.16984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/19/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023]
Abstract
AIM We tested the feasibility of a future randomised clinical trial (RCT) in which Creative Music Therapy (CMT), a family-integrating individualised approach in neonatal care, could improve neurodevelopment in extremely preterm infants (EPTs). METHODS In this feasibility trial, 12 EPTs received CMT, while the remaining 19 received standard neonatal care. Socio-demographic data and perinatal complications were compared between groups as risk factors. Bayley Scales of Infant and Toddler Development at 2-year follow-up (FU2) and KABC-II-Kaufman Assessment Battery for Children at 5-year follow-up (FU5) were analysed using the Mann-Whitney U-tests. RESULTS Twenty-seven (87.1%) and 18 (58.1%) EPTs attended the FU2 and FU5 examination, respectively. The rate of neurodevelopmental risk factors at birth of the two groups was quite similar. While there was no difference in the FU2 outcomes between groups, there were higher values in the CMT group's Fluid-Crystallised Index of the KABC-II. CONCLUSION Our results indicate neither a beneficial nor a detrimental effect of CMT on neurodevelopment at 2 years but a trend of improved cognitive outcomes at 5 years more similar to cognitive scores of term-born infants than of standard treatment EPTs. The findings favour an RCT but must be interpreted cautiously due to the reduced sample size and non-randomised design.
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Affiliation(s)
- Friederike B Haslbeck
- Newborn Research Zurich, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Mark Adams
- Newborn Research Zurich, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Lars Schmidli
- Newborn Research Zurich, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Dirk Bassler
- Newborn Research Zurich, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Hans Ulrich Bucher
- Newborn Research Zurich, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Giancarlo Natalucci
- Newborn Research Zurich, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Larsson-Rosenquist Foundation Center for Neurodevelopment, Growth and Nutrition of the Newborn, Department of Neonatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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13
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Vuong V, Hewan P, Perron M, Thaut MH, Alain C. The neural bases of familiar music listening in healthy individuals: An activation likelihood estimation meta-analysis. Neurosci Biobehav Rev 2023; 154:105423. [PMID: 37839672 DOI: 10.1016/j.neubiorev.2023.105423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023]
Abstract
Accumulating evidence suggests that the neural activations during music listening differs as a function of familiarity with the excerpts. However, the implicated brain areas are unclear. After an extensive literature search, we conducted an Activation Likelihood Estimation analysis on 23 neuroimaging studies (232 foci, 364 participants) to identify consistently activated brain regions when healthy adults listen to familiar music, compared to unfamiliar music or an equivalent condition. The results revealed a left cortical-subcortical co-activation pattern comprising three significant clusters localized to the supplementary motor areas (BA 6), inferior frontal gyrus (IFG, BA 44), and the claustrum/insula. Our results are discussed in a predictive coding framework, whereby temporal expectancies and familiarity may drive motor activations, despite any overt movement. Though conventionally associated with syntactic violation, our observed activation in the IFG may support a recent proposal of its involvement in a network that subserves both violation and prediction. Finally, the claustrum/insula plays an integral role in auditory processing, functioning as a hub that integrates sensory and limbic information to (sub)cortical structures.
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Affiliation(s)
- Veronica Vuong
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; Rotman Research Institute, Baycrest Health Sciences, Toronto, ON M6A 2E1, Canada; Music and Health Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON M5S 2C5, Canada.
| | - Patrick Hewan
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada
| | - Maxime Perron
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON M6A 2E1, Canada; Department of Psychology, University of Toronto, Toronto, ON M5S 3G3, Canada
| | - Michael H Thaut
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; Music and Health Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON M5S 2C5, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Claude Alain
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; Rotman Research Institute, Baycrest Health Sciences, Toronto, ON M6A 2E1, Canada; Music and Health Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON M5S 2C5, Canada; Department of Psychology, University of Toronto, Toronto, ON M5S 3G3, Canada
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14
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Haslbeck FB, Mueller K, Karen T, Loewy J, Meerpohl JJ, Bassler D. Musical and vocal interventions to improve neurodevelopmental outcomes for preterm infants. Cochrane Database Syst Rev 2023; 9:CD013472. [PMID: 37675934 PMCID: PMC10483930 DOI: 10.1002/14651858.cd013472.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND Preterm birth interferes with brain maturation, and subsequent clinical events and interventions may have additional deleterious effects. Music as therapy is offered increasingly in neonatal intensive care units aiming to improve health outcomes and quality of life for both preterm infants and the well-being of their parents. Systematic reviews of mixed methodological quality have demonstrated ambiguous results for the efficacy of various types of auditory stimulation of preterm infants. A more comprehensive and rigorous systematic review is needed to address controversies arising from apparently conflicting studies and reviews. OBJECTIVES We assessed the overall efficacy of music and vocal interventions for physiological and neurodevelopmental outcomes in preterm infants (< 37 weeks' gestation) compared to standard care. In addition, we aimed to determine specific effects of various interventions for physiological, anthropometric, social-emotional, neurodevelopmental short- and long-term outcomes in the infants, parental well-being, and bonding. SEARCH METHODS We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, RILM Abstracts, and ERIC in November 2021; and Proquest Dissertations in February 2019. We searched the reference lists of related systematic reviews, and of studies selected for inclusion and clinical trial registries. SELECTION CRITERIA We included parallel, and cluster-randomised controlled trials with preterm infants < 37 weeks` gestation during hospitalisation, and parents when they were involved in the intervention. Interventions were any music or vocal stimulation provided live or via a recording by a music therapist, a parent, or a healthcare professional compared to standard care. The intervention duration was greater than five minutes and needed to occur more than three times. DATA COLLECTION AND ANALYSIS Three review authors independently extracted data. We analysed the treatment effects of the individual trials using RevMan Web using a fixed-effects model to combine the data. Where possible, we presented results in meta-analyses using mean differences with 95% CI. We performed heterogeneity tests. When the I2 statistic was higher than 50%, we assessed the source of the heterogeneity by sensitivity and subgroup analyses. We used GRADE to assess the certainty of the evidence. MAIN RESULTS We included 25 trials recruiting 1532 infants and 691 parents (21 parallel-group RCTs, four cross-over RCTs). The infants gestational age at birth varied from 23 to 36 weeks, taking place in NICUs (level 1 to 3) around the world. Within the trials, the intervention varied widely in type, delivery, frequency, and duration. Music and voice were mainly characterised by calm, soft, musical parameters in lullaby style, often integrating the sung mother's voice live or recorded, defined as music therapy or music medicine. The general risk of bias in the included studies varied from low to high risk of bias. Music and vocal interventions compared to standard care Music/vocal interventions do not increase oxygen saturation in the infants during the intervention (mean difference (MD) 0.13, 95% CI -0.33 to 0.59; P = 0.59; 958 infants, 10 studies; high-certainty evidence). Music and voice probably do not increase oxygen saturation post-intervention either (MD 0.63, 95% CI -0.01 to 1.26; P = 0.05; 800 infants, 7 studies; moderate-certainty evidence). The intervention may not increase infant development (Bayley Scales of Infant and Toddler Development (BSID)) with the cognitive composition score (MD 0.35, 95% CI -4.85 to 5.55; P = 0.90; 69 infants, 2 studies; low-certainty evidence); the motor composition score (MD -0.17, 95% CI -5.45 to 5.11; P = 0.95; 69 infants, 2 studies; low-certainty evidence); and the language composition score (MD 0.38, 95% CI -5.45 to 6.21; P = 0.90; 69 infants, 2 studies; low-certainty evidence). Music therapy may not reduce parental state-trait anxiety (MD -1.12, 95% CI -3.20 to 0.96; P = 0.29; 97 parents, 4 studies; low-certainty evidence). The intervention probably does not reduce respiratory rate during the intervention (MD 0.42, 95% CI -1.05 to 1.90; P = 0.57; 750 infants; 7 studies; moderate-certainty evidence) and post-intervention (MD 0.51, 95% CI -1.57 to 2.58; P = 0.63; 636 infants, 5 studies; moderate-certainty evidence). However, music/vocal interventions probably reduce heart rates in preterm infants during the intervention (MD -1.38, 95% CI -2.63 to -0.12; P = 0.03; 1014 infants; 11 studies; moderate-certainty evidence). This beneficial effect was even stronger after the intervention. Music/vocal interventions reduce heart rate post-intervention (MD -3.80, 95% CI -5.05 to -2.55; P < 0.00001; 903 infants, 9 studies; high-certainty evidence) with wide CIs ranging from medium to large beneficial effects. Music therapy may not reduce postnatal depression (MD 0.50, 95% CI -1.80 to 2.81; P = 0.67; 67 participants; 2 studies; low-certainty evidence). The evidence is very uncertain about the effect of music therapy on parental state anxiety (MD -0.15, 95% CI -2.72 to 2.41; P = 0.91; 87 parents, 3 studies; very low-certainty evidence). We are uncertain about any further effects regarding all other secondary short- and long-term outcomes on the infants, parental well-being, and bonding/attachment. Two studies evaluated adverse effects as an explicit outcome of interest and reported no adverse effects from music and voice. AUTHORS' CONCLUSIONS Music/vocal interventions do not increase oxygen saturation during and probably not after the intervention compared to standard care. The evidence suggests that music and voice do not increase infant development (BSID) or reduce parental state-trait anxiety. The intervention probably does not reduce respiratory rate in preterm infants. However, music/vocal interventions probably reduce heart rates in preterm infants during the intervention, and this beneficial effect is even stronger after the intervention, demonstrating that music/vocal interventions reduce heart rates in preterm infants post-intervention. We found no reports of adverse effects from music and voice. Due to low-certainty evidence for all other outcomes, we could not draw any further conclusions regarding overall efficacy nor the possible impact of different intervention types, frequencies, or durations. Further research with more power, fewer risks of bias, and more sensitive and clinically relevant outcomes are needed.
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Affiliation(s)
| | - Katharina Mueller
- Zentrum für Kinder und Jugendmedizin, University Freiburg, Freiburg, Germany
| | - Tanja Karen
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
| | - Joanne Loewy
- Mount Sinai Health System, The Louis Armstrong Center for Music & Medicine, New York City, USA
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dirk Bassler
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
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15
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Horowitz-Kraus T, Randell K, Morag I. Neurobiological perspective on the development of executive functions. Acta Paediatr 2023; 112:1860-1864. [PMID: 37338188 DOI: 10.1111/apa.16883] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 06/21/2023]
Abstract
Executive functions are a set of top-down cognitive processes necessary for emotional self-regulation and goal-directed behaviour supporting, among others, academic abilities. Premature infants are at high risk for subsequent cognitive, psychosocial, or behavioural problems even in the absence of medical complications and in spite of normal brain imaging. Given that this is a sensitive period of brain growth and maturation, these factors may place preterm infants at high risk for executive function dysfunction, disrupted long-term development, and lower academic achievements. Therefore, careful attention to interventions at this age is essential for intact executive functions and academic development.
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Affiliation(s)
- Tzipi Horowitz-Kraus
- Educational Neuroimaging Group, Faculty of Education in Science and Technology and Faculty of Biomedical Engineering, The Technion, Haifa, Israel
- Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Iris Morag
- Department of Pediatrics, Shamir Medical Center affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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16
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Pineda R, Kellner P, Guth R, Gronemeyer A, Smith J. NICU sensory experiences associated with positive outcomes: an integrative review of evidence from 2015-2020. J Perinatol 2023; 43:837-848. [PMID: 37029165 PMCID: PMC10325947 DOI: 10.1038/s41372-023-01655-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/09/2023] [Accepted: 03/17/2023] [Indexed: 04/09/2023]
Abstract
To inform changes to the Supporting and Enhancing NICU Sensory Experiences (SENSE) program, studies investigating sensory-based interventions in the NICU with preterm infants born ≤32 weeks were identified. Studies published between October 2015 to December 2020, and with outcomes related to infant development or parent well-being, were included in this integrative review. The systematic search used databases including MEDLINE, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, and Google Scholar. Fifty-seven articles (15 tactile, 9 auditory, 5 visual, 1 gustatory/olfactory, 5 kinesthetic, and 22 multimodal) were identified. The majority of the sensory interventions that were identified within the articles were reported in a previous integrative review (1995-2015) and already included in the SENSE program. New evidence has led to refinements of the SENSE program, notably the addition of position changes across postmenstrual age (PMA) and visual tracking starting at 34 weeks PMA.
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Affiliation(s)
- Roberta Pineda
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.
- Keck School of Medicine, Department of Pediatrics, Los Angeles, CA, USA.
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
| | - Polly Kellner
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Rebecca Guth
- Center for Clinical Excellence, BJC HealthCare, St. Louis, MO, USA
| | | | - Joan Smith
- Department of Quality, Safety, and Practice Excellence, St. Louis Children's Hospital, St. Louis, MO, USA
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17
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Padilla N, Escrichs A, del Agua E, Kringelbach M, Donaire A, Deco G, Åden U. Disrupted resting-sate brain network dynamics in children born extremely preterm. Cereb Cortex 2023; 33:8101-8109. [PMID: 37083266 PMCID: PMC10321088 DOI: 10.1093/cercor/bhad101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 04/22/2023] Open
Abstract
The developing brain has to adapt to environmental and intrinsic insults after extremely preterm (EPT) birth. Ongoing maturational processes maximize their fit to the environment and this can provide a substrate for neurodevelopmental failures. Resting-state functional magnetic resonance imaging was used to scan 33 children born EPT, at < 27 weeks of gestational age, and 26 full-term controls at 10 years of age. We studied the capability of a brain area to propagate neural information (intrinsic ignition) and its variability across time (node-metastability). This framework was computed for the dorsal attention network (DAN), frontoparietal, default-mode network (DMN), and the salience, limbic, visual, and somatosensory networks. The EPT group showed reduced intrinsic ignition in the DMN and DAN, compared with the controls, and reduced node-metastability in the DMN, DAN, and salience networks. Intrinsic ignition and node-metastability values correlated with cognitive performance at 12 years of age in both groups, but only survived in the term group after adjustment. Preterm birth disturbed the signatures of functional brain organization at rest in 3 core high-order networks: DMN, salience, and DAN. Identifying vulnerable resting-state networks after EPT birth may lead to interventions that aim to rebalance brain function.
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Affiliation(s)
- Nelly Padilla
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm S- 171 76, Sweden
| | - Anira Escrichs
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/ de Ramon Trias Fargas, 25, 08018 Barcelona, España
| | - Elvira del Agua
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/ de Ramon Trias Fargas, 25, 08018 Barcelona, España
| | - Morten Kringelbach
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Ln, Oxford OX3 7JX, United Kingdom
- Center for Music in the Brain, Aarhus University Hospital Nørrebrogade 44, Building 10G, 4th and 5th floor, 8000 Aarhus C, Denmark
| | - Antonio Donaire
- Department of Neurology, Institute of Neuroscience, Hospital Clinic, Universidad de Barcelona and Institut D’investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Gustavo Deco
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, C/ de Ramon Trias Fargas, 25, 08018 Barcelona, España
- School of Psychological Sciences, Monash University, Melbourne, Clayton, VIC 3800, Australia
- Institució Catalana de la Recerca i Estudis Avançats (ICREA), Passeig de Lluís Companys, 23, 08010, Barcelona, Catalonia, Spain
- Department of Neuropsychology, Max Planck Institute for human Cognitive and Brain Sciences, Leipzig 04103, Germany
| | - Ulrika Åden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm S- 171 76, Sweden
- Department of Neonatology, Karolinska University Hospital, Stockholm S- 171 76, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SE 58183, Sweden
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18
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Sa de Almeida J, Baud O, Fau S, Barcos-Munoz F, Courvoisier S, Lordier L, Lazeyras F, Hüppi PS. Music impacts brain cortical microstructural maturation in very preterm infants: A longitudinal diffusion MR imaging study. Dev Cogn Neurosci 2023; 61:101254. [PMID: 37182337 DOI: 10.1016/j.dcn.2023.101254] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/25/2023] [Accepted: 05/09/2023] [Indexed: 05/16/2023] Open
Abstract
Preterm birth disrupts important neurodevelopmental processes occurring from mid-fetal to term-age. Musicotherapy, by enriching infants' sensory input, might enhance brain maturation during this critical period of activity-dependent plasticity. To study the impact of music on preterm infants' brain structural changes, we recruited 54 very preterm infants randomized to receive or not a daily music intervention, that have undergone a longitudinal multi-shell diffusion MRI acquisition, before the intervention (at 33 weeks' gestational age) and after it (at term-equivalent-age). Using whole-brain fixel-based (FBA) and NODDI analysis (n = 40), we showed a longitudinal increase of fiber cross-section (FC) and fiber density (FD) in all major cerebral white matter fibers. Regarding cortical grey matter, FD decreased while FC and orientation dispersion index (ODI) increased, reflecting intracortical multidirectional complexification and intracortical myelination. The music intervention resulted in a significantly higher longitudinal increase of FC and ODI in cortical paralimbic regions, namely the insulo-orbito-temporopolar complex, precuneus/posterior cingulate gyrus, as well as the auditory association cortex. Our results support a longitudinal early brain macro and microstructural maturation of white and cortical grey matter in preterm infants. The music intervention led to an increased intracortical complexity in regions important for socio-emotional development, known to be impaired in preterm infants.
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Affiliation(s)
- Joana Sa de Almeida
- Division of Development and Growth, Department of Paediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
| | - Olivier Baud
- Division of Neonatal and Intensive Care, Department of Paediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Sebastien Fau
- Division of Neonatal and Intensive Care, Department of Paediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Francisca Barcos-Munoz
- Division of Neonatal and Intensive Care, Department of Paediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Sebastien Courvoisier
- Center of BioMedical Imaging (CIBM), University of Geneva, Geneva, Switzerland; Department of Radiology and Medical Informatics, Geneva, Switzerland
| | - Lara Lordier
- Division of Development and Growth, Department of Paediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
| | - François Lazeyras
- Center of BioMedical Imaging (CIBM), University of Geneva, Geneva, Switzerland; Department of Radiology and Medical Informatics, Geneva, Switzerland
| | - Petra S Hüppi
- Division of Development and Growth, Department of Paediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
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19
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Hadaya L, Dimitrakopoulou K, Vanes LD, Kanel D, Fenn-Moltu S, Gale-Grant O, Counsell SJ, Edwards AD, Saqi M, Batalle D, Nosarti C. Parsing brain-behavior heterogeneity in very preterm born children using integrated similarity networks. Transl Psychiatry 2023; 13:108. [PMID: 37012252 PMCID: PMC10070645 DOI: 10.1038/s41398-023-02401-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 04/05/2023] Open
Abstract
Very preterm birth (VPT; ≤32 weeks' gestation) is associated with altered brain development and cognitive and behavioral difficulties across the lifespan. However, heterogeneity in outcomes among individuals born VPT makes it challenging to identify those most vulnerable to neurodevelopmental sequelae. Here, we aimed to stratify VPT children into distinct behavioral subgroups and explore between-subgroup differences in neonatal brain structure and function. 198 VPT children (98 females) previously enrolled in the Evaluation of Preterm Imaging Study (EudraCT 2009-011602-42) underwent Magnetic Resonance Imaging at term-equivalent age and neuropsychological assessments at 4-7 years. Using an integrative clustering approach, we combined neonatal socio-demographic, clinical factors and childhood socio-emotional and executive function outcomes, to identify distinct subgroups of children based on their similarity profiles in a multidimensional space. We characterized resultant subgroups using domain-specific outcomes (temperament, psychopathology, IQ and cognitively stimulating home environment) and explored between-subgroup differences in neonatal brain volumes (voxel-wise Tensor-Based-Morphometry), functional connectivity (voxel-wise degree centrality) and structural connectivity (Tract-Based-Spatial-Statistics). Results showed two- and three-cluster data-driven solutions. The two-cluster solution comprised a 'resilient' subgroup (lower psychopathology and higher IQ, executive function and socio-emotional scores) and an 'at-risk' subgroup (poorer behavioral and cognitive outcomes). No neuroimaging differences between the resilient and at-risk subgroups were found. The three-cluster solution showed an additional third 'intermediate' subgroup, displaying behavioral and cognitive outcomes intermediate between the resilient and at-risk subgroups. The resilient subgroup had the most cognitively stimulating home environment and the at-risk subgroup showed the highest neonatal clinical risk, while the intermediate subgroup showed the lowest clinical, but the highest socio-demographic risk. Compared to the intermediate subgroup, the resilient subgroup displayed larger neonatal insular and orbitofrontal volumes and stronger orbitofrontal functional connectivity, while the at-risk group showed widespread white matter microstructural alterations. These findings suggest that risk stratification following VPT birth is feasible and could be used translationally to guide personalized interventions aimed at promoting children's resilience.
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Affiliation(s)
- Laila Hadaya
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Konstantina Dimitrakopoulou
- Translational Bioinformatics Platform, NIHR Biomedical Research Centre, Guy's and St. Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Lucy D Vanes
- Centre for Neuroimaging Sciences, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Dana Kanel
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Sunniva Fenn-Moltu
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Oliver Gale-Grant
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Serena J Counsell
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - A David Edwards
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Mansoor Saqi
- Translational Bioinformatics Platform, NIHR Biomedical Research Centre, Guy's and St. Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Dafnis Batalle
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Chiara Nosarti
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK.
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.
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20
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Baud O, Knoop M, Jacquens A, Possovre ML. [Oxytocin: a new target for neuroprotection?]. Biol Aujourdhui 2023; 216:145-153. [PMID: 36744980 DOI: 10.1051/jbio/2022012] [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: 04/27/2022] [Indexed: 02/07/2023]
Abstract
Every year, 30 million infants worldwide are delivered after intra-uterine growth restriction (IUGR) and 15 million are born preterm. These two conditions are the leading causes of ante-/perinatal stress and brain injury responsible for neurocognitive and behavioral disorders affecting more than 9 million children each year. Most pharmacological candidates to prevent perinatal brain damage have failed to demonstrate substantial benefits. In contrast, environment enrichment based on developmental care, skin-to-skin contact and vocal/music exposure appear to exert positive effects on brain structure and function. However, mechanisms underlying these effects remain unknown. There is strong evidence that an adverse environment during pregnancy and the neonatal period can influence hormonal responses of the newborn with long-lasting neurobehavioral consequences in infancy and adulthood. In particular, excessive cortisol release in response to perinatal stress associated with prematurity or IUGR is recognized to induce brain-programming effects and neuroinflammation, a key predictor of subsequent neurological impairments. These deleterious effects are known to be balanced by oxytocin (OT), a neuropeptide released by the hypothalamus, which plays a role during the perinatal period and in social behavior. In addition, preclinical studies suggest that OT is able to regulate the central inflammatory response to injury in the adult brain. Using a rodent model of IUGR associated with developing white matter damage, we recently reported that carbetocin, a brain permeable OT receptor (OTR) agonist, induced a significant reduction of activated microglia, the primary immune cells of the brain. Moreover, this reduced microglia reactivity was associated with long-term neuroprotection. These findings make OT a promising candidate for neonatal neuroprotection through neuroinflammation regulation. However, the mechanisms linking endogenous OT and central inflammation response to injury have not yet been established. Further studies are needed to assess the protective role of OT in the developing brain through modulation of microglial activation, a key feature of brain injury observed in infants born preterm or growth-restricted. They are expected to have several impacts in the near future not only for improving knowledge of microglial cell physiology and reactivity during brain development, but also to design clinical trials testing interventions associated with endogenous OT release as a relevant strategy to alleviate neuroinflammation in neonates.
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Affiliation(s)
- Olivier Baud
- Laboratoire du développement, Université de Genève, Genève, Suisse - Inserm U1141, Université Paris Cité, 75019 Paris, France - Service de Soins Intensifs Pédiatriques et Néonatologie, Hôpitaux Universitaires de Genève, 30 boulevard de Cluse, 1205 Genève, Suisse
| | - Marit Knoop
- Laboratoire du développement, Université de Genève, Genève, Suisse
| | - Alice Jacquens
- Laboratoire du développement, Université de Genève, Genève, Suisse - Inserm U1141, Université Paris Cité, 75019 Paris, France
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21
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Wang T, Huang X, Wang J. Asthma's effect on brain connectivity and cognitive decline. Front Neurol 2023; 13:1065942. [PMID: 36818725 PMCID: PMC9936195 DOI: 10.3389/fneur.2022.1065942] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/29/2022] [Indexed: 02/05/2023] Open
Abstract
Objective To investigate the changes in dynamic voxel mirror homotopy connection (dVMHC) between cerebral hemispheres in patients with asthma. Methods Our study was designed using a case-control method. A total of 31 subjects with BA and 31 healthy subjects with matching basic information were examined using rsfMRI. We also calculated and obtained the dVMHC value between the cerebral cortexes. Results Compared with the normal control group, the dVMHC of the lingual gyrus (Ling) and the calcarine sulcus (CAL), which represented the visual network (VN), increased significantly in the asthma group, while the dVMHC of the medial superior frontal gyrus (MSFG), the anterior/middle/posterior cingulate gyrus (A/M/PCG), and the supplementary motor area (SMA) of the sensorimotor network decreased significantly in the asthma group. Conclusion This study showed that the ability of emotion regulation and the efficiency of visual and cognitive information processing in patients with BA was lower than in those in the HC group. The dVMHC analysis can be used to sensitively evaluate oxygen saturation, visual function changes, and attention bias caused by emotional disorders in patients with asthma, as well as to predict airway hyperresponsiveness, inflammatory progression, and dyspnea.
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Affiliation(s)
- Tao Wang
- Medical College of Nanchang University, Nanchang, China,The Second Department of Respiratory Disease, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Xin Huang
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Jun Wang
- The Second Department of Respiratory Disease, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China,*Correspondence: Jun Wang ✉
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22
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Pino O, Di Pietro S, Poli D. Effect of Musical Stimulation on Placental Programming and Neurodevelopment Outcome of Preterm Infants: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2718. [PMID: 36768104 PMCID: PMC9915377 DOI: 10.3390/ijerph20032718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The fetal environment is modulated by the placenta, which integrates and transduces information from the maternal environment to the fetal developmental program and adapts rapidly to changes through epigenetic mechanisms that respond to internal (hereditary) and external (environmental and social) signals. Consequently, the fetus corrects the trajectory of own development. During the last trimester of gestation, plasticity shapes the fetal brain, and prematurity can alter the typical developmental trajectories. In this period, prevention through activity-inducing (e.g., music stimulation) interventions are currently tested. The purpose of this review is to describe the potentialities of music exposure on fetus, and on preterm newborns in the Neonatal Intensive Care Unit evaluating its influence on neurobehavioral development. METHODS Databases were searched from 2010 to 2022 for studies investigating mechanisms of placental epigenetic regulation and effects of music exposure on the fetus and pre-term neonates. RESULTS In this case, 28 selected papers were distributed into three research lines: studies on placental epigenetic regulation (13 papers), experimental studies of music stimulation on fetus or newborns (6 papers), and clinical studies on premature babies (9 papers). Placental epigenetic changes of the genes involved in the cortisol and serotonin response resulted associated with different neurobehavioral phenotypes in newborns. Prenatal music stimulation had positive effects on fetus, newborn, and pregnant mother while post-natal exposure affected the neurodevelopment of the preterm infants and parental interaction. CONCLUSIONS The results testify the relevance of environmental stimuli for brain development during the pre- and perinatal periods and the beneficial effects of musical stimulation that can handle the fetal programming and the main neurobehavioral disorders.
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Affiliation(s)
- Olimpia Pino
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Sofia Di Pietro
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Diana Poli
- INAIL Research, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene Via Fontana Candida 1, 00078 Monte Porzio Catone, Italy
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23
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Papatzikis E, Agapaki M, Selvan RN, Pandey V, Zeba F. Quality standards and recommendations for research in music and neuroplasticity. Ann N Y Acad Sci 2023; 1520:20-33. [PMID: 36478395 DOI: 10.1111/nyas.14944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Research on how music influences brain plasticity has gained momentum in recent years. Considering, however, the nonuniform methodological standards implemented, the findings end up being nonreplicable and less generalizable. To address the need for a standardized baseline of research quality, we gathered all the studies in the music and neuroplasticity field in 2019 and appraised their methodological rigor systematically and critically. The aim was to provide a preliminary and, at the minimum, acceptable quality threshold-and, ipso facto, suggested recommendations-whereupon further discussion and development may take place. Quality appraisal was performed on 89 articles by three independent raters, following a standardized scoring system. The raters' scoring was cross-referenced following an inter-rater reliability measure, and further studied by performing multiple ratings comparisons and matrix analyses. The results for methodological quality were at a quite good level (quantitative articles: mean = 0.737, SD = 0.084; qualitative articles: mean = 0.677, SD = 0.144), following a moderate but statistically significant level of agreement between the raters (W = 0.44, χ2 = 117.249, p = 0.020). We conclude that the standards for implementation and reporting are of high quality; however, certain improvements are needed to reach the stringent levels presumed for such an influential interdisciplinary scientific field.
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Affiliation(s)
- Efthymios Papatzikis
- Department of Early Childhood Education and Care, Oslo Metropolitan University, Oslo, Norway
| | - Maria Agapaki
- Department of Early Childhood Education and Care, Oslo Metropolitan University, Oslo, Norway
| | - Rosari Naveena Selvan
- Institute for Physics 3 - Biophysics and Bernstein Center for Computational Neuroscience (BCCN), University of Göttingen, Göttingen, Germany.,Department of Psychology, University of Münster, Münster, Germany
| | | | - Fathima Zeba
- School of Humanities and Social Sciences, Manipal Academy of Higher Education Dubai, Dubai, United Arab Emirates
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24
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Guittard C, Novo A, Eutrope J, Gower C, Barbe C, Bednarek N, Rolland AC, Caillies S, Loron G. Protocol for a prospective multicenter longitudinal randomized controlled trial (CALIN) of sensory-tonic stimulation to foster parent child interactions and social cognition in very premature infants. Front Pediatr 2023; 10:913396. [PMID: 36727004 PMCID: PMC9885178 DOI: 10.3389/fped.2022.913396] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/15/2022] [Indexed: 01/17/2023] Open
Abstract
Introduction Premature birth is associated with long-term somatic and neurological disorders, including cognitive, social and behavioral impairments. Moreover, the mothers of infants born preterm exhibit a higher prevalence of anxiety and depressive symptoms after birth. Early rehabilitation, developmental care, and parenting support have already been shown to have a positive impact on neurological outcome. However, no randomized controlled study has so far assessed the effects on parenting and long-term neurological outcomes of proprioceptive stimulation to trigger positive brain plasticity in very preterm babies. The CALIN project will therefore investigate the impact of sensory-tonic stimulation (STS) of extremely preterm infants by their parents on child parent interactions, infants' morphological and functional brain development and subsequent cognition (including social cognition), and parents' anxiety and depressive symptoms in the postpartum period. Methods and analysis Infants born between 25 and 32 weeks of gestation will be randomly assigned to the "STS + Kangaroo care" or "Kangaroo care" group. The primary endpoint, child and parent interactions, will be rated at 12 months corrected age using the Coding Interactive Behavior system. Secondary endpoints include: 1/functional and anatomical brain maturation sequentially assessed during neonatal hospitalization using electroencephalogram (EEG), amplitude-integrated EEG (aEEG), cranial ultrasound and MRI performed at term-corrected age, 2/social and cognitive outcomes assessed at 15 months, 2, 4 and 6 years, and 3/parents' anxiety and depressive symptoms assessed at 7 ± 1 weeks after birth, using dedicated questionnaires. Ethics and dissemination This study was approved by the French Ethics Committee for the Protection of Persons on 18 October 2021. It is registered with the French National Agency for the Safety of Medicines and Health Products (ANSM; no. 2020-A00382-37). The registry number on ClinicalTrials.gov is NCT04380051.
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Affiliation(s)
| | - Alexandre Novo
- CHU Nantes, Département de Psychiatrie, Les Apsyades, Nantes, France
| | - Julien Eutrope
- Université de Reims Champagne-Ardenne, C2S, CHU Reims, Service de Pédopsychiatrie, Reims, France
| | - Corinne Gower
- CHU Reims, Unité d’Aide Méthodologique, Reims, France
| | - Coralie Barbe
- Université de Reims Champagne-Ardenne, Research on Health University Department, C2S, Reims, France
| | - Nathalie Bednarek
- Université de Reims Champagne-Ardenne, CReSTIC, CHU Reims, Service de Médecine Néonatale et de Réanimation Pédiatrique, Reims, France
| | - Anne-Catherine Rolland
- Université de Reims Champagne-Ardenne, C2S, CHU Reims, Service de Pédopsychiatrie, Reims, France
| | | | - Gauthier Loron
- Université de Reims Champagne-Ardenne, CReSTIC, CHU Reims, Service de Médecine Néonatale et de Réanimation Pédiatrique, Reims, France
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25
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Ratridewi I, Amalia K, Huwae TECJ, Putera MA, Sulistijono E. Systemic Candidosis Diagnostic Test with Candida Score and Monocyte Count in Premature Infants with Late-Onset Sepsis: Research in Low Resources Country. RUSSIAN JOURNAL OF INFECTION AND IMMUNITY 2023. [DOI: 10.15789/2220-7619-scd-2012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Abstract
Introduction: Candida is the cause of most systemic fungal infections that plays a role in the pathophysiology of sepsis in newborns, especially in premature infants with late-onset sepsis. The candida score can be used to assess the occurrence of systemic candidosis where a candida score 2.5 can accurately identify patients who are at high risk for candidiasis infection. Monocytes also play an important role in preventing candida invasion.
Materials and methods: This study used a cross sectional research design. Data was collected from premature infants with late-onset sepsis being suspected of systemic candidosis in neonatology inpatient ward. It was submitted from the period of November-December 2021. It takes a minimum of 31 samples to meet the criteria to process and analyze the data. The data obtained were processed and analyzed using the Receiver Operating Characteristic (ROC) method to obtain the Area Under Curve (AUC) value. Based on the AUC curve, the search for the most optimal intersection is carried out to obtain the sensitivity and specificity values.
Results: Of the 31 research subjects, the number of subjects with positive PCR results was 27 (76.93%) while negative were 4 respondents (12.9%). The mean value of PCR density in the positive group of subjects was 76.93 and the range was 40.23 122.78. Meanwhile, in the group of subjects who were negative, the PCR density value was 0. The results of the candida score diagnostic test showed that the sensitivity obtained was 81%. Higher sensitivity and specificity 70% were found in the combined examination of candida scores and monocyte counts according to cut-off compared with separate examinations.
Conclusions: The combined examination of candida score and monocyte count can be used as a diagnostic test for systemic candidosis in premature infants with late-onset sepsis, and could be used to consider the initiation of empirical antifungal therapy, either prophylactically or therapeutically, especially in limited laboratory facilities in Indonesia.
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26
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Wang W, Yu Q, Liang W, Xu F, Li Z, Tang Y, Liu S. Altered cortical microstructure in preterm infants at term-equivalent age relative to term-born neonates. Cereb Cortex 2023; 33:651-662. [PMID: 35259759 DOI: 10.1093/cercor/bhac091] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/11/2022] [Accepted: 02/08/2022] [Indexed: 02/03/2023] Open
Abstract
Preterm (PT) birth is a potential factor for abnormal brain development. Although various alterations of cortical structure and functional connectivity in preterm infants have been reported, the underlying microstructural foundation is still undetected thoroughly in PT infants relative to full-term (FT) neonates. To detect the very early cortical microstructural alteration noninvasively with advanced neurite orientation dispersion and density imaging (NODDI) on a whole-brain basis, we used multi-shell diffusion MRI of healthy newborns selected from the Developing Human Connectome Project. 73 PT infants and 69 FT neonates scanned at term-equivalent age were included in this study. By extracting the core voxels of gray matter (GM) using GM-based spatial statistics (GBSS), we found that comparing to FT neonates, infants born preterm showed extensive lower neurite density in both primary and higher-order association cortices (FWE corrected, P < 0.025). Higher orientation dispersion was only found in very preterm subgroup in the orbitofrontal cortex, fronto-insular cortex, entorhinal cortex, a portion of posterior cingular gyrus, and medial parieto-occipital cortex. This study provided new insights into exploring structural MR for functional and behavioral variations in preterm population, and these findings may have marked clinical importance, particularly in the guidance of ameliorating the development of premature brain.
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Affiliation(s)
- Wenjun Wang
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Mental Disorders, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, 250012, China
| | - Qiaowen Yu
- Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China
| | - Wenjia Liang
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Mental Disorders, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, 250012, China
| | - Feifei Xu
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Mental Disorders, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, 250012, China
| | - Zhuoran Li
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China
| | - Yuchun Tang
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Mental Disorders, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, 250012, China
| | - Shuwei Liu
- Department of Anatomy and Neurobiology, Research Center for Sectional and Imaging Anatomy, Shandong Key Laboratory of Mental Disorders, Shandong Key Laboratory of Digital Human and Clinical Anatomy, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong, 250012, China
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27
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Vogelsang M, Vogelsang L, Diamond S, Sinha P. Prenatal auditory experience and its sequelae. Dev Sci 2023; 26:e13278. [PMID: 35583318 PMCID: PMC11164537 DOI: 10.1111/desc.13278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 12/15/2022]
Abstract
Towards the end of the second trimester of gestation, a human fetus is able to register environmental sounds. This in utero auditory experience is characterized by comprising strongly low-pass-filtered versions of sounds from the external world. Here, we present computational tests of the hypothesis that this early exposure to severely degraded auditory inputs serves an adaptive purpose-it may induce the neural development of extended temporal integration. Such integration can facilitate the detection of information carried by low-frequency variations in the auditory signal, including emotional or other prosodic content. To test this prediction, we characterized the impact of several training regimens, biomimetic and otherwise, on a computational model system trained and tested on the task of emotion recognition. We find that training with an auditory trajectory recapitulating that of a neurotypical infant in the pre-to-postnatal period results in temporally extended receptive field structures and yields the best subsequent accuracy and generalization performance on the task of emotion recognition. This strongly suggests that the progression from low-pass-filtered to full-frequency inputs is likely to be an adaptive feature of our development, conferring significant benefits to later auditory processing abilities relying on temporally extended analyses. Additionally, this finding can help explain some of the auditory impairments associated with preterm births, suggests guidelines for the design of auditory environments in neonatal care units, and points to enhanced training procedures for computational models.
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Affiliation(s)
- Marin Vogelsang
- School of Computer and Communication Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Lukas Vogelsang
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Sidney Diamond
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Pawan Sinha
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
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28
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Ai M, Loui P, Morris TP, Chaddock-Heyman L, Hillman CH, McAuley E, Kramer AF. Musical Experience Relates to Insula-Based Functional Connectivity in Older Adults. Brain Sci 2022; 12:1577. [PMID: 36421901 PMCID: PMC9688373 DOI: 10.3390/brainsci12111577] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
Engaging in musical activities throughout the lifespan may protect against age-related cognitive decline and modify structural and functional connectivity in the brain. Prior research suggests that musical experience modulates brain regions that integrate different modalities of sensory information, such as the insula. Most of this research has been performed in individuals classified as professional musicians; however, general musical experiences across the lifespan may also confer beneficial effects on brain health in older adults. The current study investigated whether general musical experience, characterized using the Goldsmith Music Sophistication Index (Gold-MSI), was associated with functional connectivity in older adults (age = 65.7 ± 4.4, n = 69). We tested whether Gold-MSI was associated with individual differences in the functional connectivity of three a priori hypothesis-defined seed regions in the insula (i.e., dorsal anterior, ventral anterior, and posterior insula). We found that older adults with more musical experience showed greater functional connectivity between the dorsal anterior insula and the precentral and postcentral gyrus, and between the ventral anterior insula and diverse brain regions, including the insula and prefrontal cortex, and decreased functional connectivity between the ventral anterior insula and thalamus (voxel p < 0.01, cluster FWE p < 0.05). Follow-up correlation analyses showed that the singing ability subscale score was key in driving the association between functional connectivity differences and musical experience. Overall, our findings suggest that musical experience, even among non-professional musicians, is related to functional brain reorganization in older adults.
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Affiliation(s)
- Meishan Ai
- Department of Psychology, Northeastern University, Boston, MA 02115, USA
| | - Psyche Loui
- Department of Psychology, Northeastern University, Boston, MA 02115, USA
- Department of Music, Northeastern University, Boston, MA 02115, USA
| | - Timothy P. Morris
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, MA 02115, USA
| | - Laura Chaddock-Heyman
- Department of Psychology, Northeastern University, Boston, MA 02115, USA
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Charles H. Hillman
- Department of Psychology, Northeastern University, Boston, MA 02115, USA
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, MA 02115, USA
| | - Edward McAuley
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Arthur F. Kramer
- Department of Psychology, Northeastern University, Boston, MA 02115, USA
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
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29
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Siffredi V, Liverani MC, Freitas LGA, Tadros D, Farouj Y, Borradori Tolsa C, Van De Ville D, Hüppi PS, Ha-Vinh Leuchter R. Large-scale brain network dynamics in very preterm children and relationship with socio-emotional outcomes: an exploratory study. Pediatr Res 2022:10.1038/s41390-022-02342-y. [PMID: 36329223 DOI: 10.1038/s41390-022-02342-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/30/2022] [Accepted: 09/24/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Children born very preterm (VPT; <32 weeks' gestation) are at high risk of neurodevelopmental and behavioural difficulties associated with atypical brain maturation, including socio-emotional difficulties. The analysis of large-scale brain network dynamics during rest allows us to investigate brain functional connectivity and its association with behavioural outcomes. METHODS Dynamic functional connectivity was extracted by using the innovation-driven co-activation patterns framework in VPT and full-term children aged 6-9 to explore changes in spatial organisation, laterality and temporal dynamics of spontaneous large-scale brain activity (VPT, n = 28; full-term, n = 12). Multivariate analysis was used to explore potential biomarkers for socio-emotional difficulties in VPT children. RESULTS The spatial organisation of the 13 retrieved functional networks was comparable across groups. Dynamic features and lateralisation of network brain activity were also comparable for all brain networks. Multivariate analysis unveiled group differences in associations between dynamical functional connectivity parameters with socio-emotional abilities. CONCLUSION In this exploratory study, the group differences observed might reflect reduced degrees of maturation of functional architecture in the VPT group in regard to socio-emotional abilities. Dynamic features of functional connectivity could represent relevant neuroimaging markers and inform on potential mechanisms through which preterm birth leads to neurodevelopmental and behavioural disorders. IMPACT Spatial organisation of the retrieved resting-state networks was comparable between school-aged very preterm and full-term children. Dynamic features and lateralisation of network brain activity were also comparable across groups. Multivariate pattern analysis revealed different patterns of association between dynamical functional connectivity parameters and socio-emotional abilities in the very preterm and full-term groups. Findings suggest a reduced degree of maturation of the functional architecture in the very preterm group in association with socio-emotional abilities.
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Affiliation(s)
- Vanessa Siffredi
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland. .,Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne, Écublens, Switzerland. .,Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Maria Chiara Liverani
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.,SensoriMotor, Affective and Social Development Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Lorena G A Freitas
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.,Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne, Écublens, Switzerland.,Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - D Tadros
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.,Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne, Écublens, Switzerland.,Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Y Farouj
- Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne, Écublens, Switzerland.,Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Cristina Borradori Tolsa
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Dimitri Van De Ville
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.,Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne, Écublens, Switzerland.,Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Petra Susan Hüppi
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Russia Ha-Vinh Leuchter
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
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30
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Yrjölä P, Myers MM, Welch MG, Stevenson NJ, Tokariev A, Vanhatalo S. Facilitating early parent-infant emotional connection improves cortical networks in preterm infants. Sci Transl Med 2022; 14:eabq4786. [PMID: 36170448 DOI: 10.1126/scitranslmed.abq4786] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Exposure to environmental adversities during early brain development, such as preterm birth, can affect early brain organization. Here, we studied whether development of cortical activity networks in preterm infants may be improved by a multimodal environmental enrichment via bedside facilitation of mother-infant emotional connection. We examined functional cortico-cortical connectivity at term age using high-density electroencephalography recordings in infants participating in a randomized controlled trial of Family Nurture Intervention (FNI). Our results identify several large-scale, frequency-specific network effects of FNI, most extensively in the alpha frequency in fronto-central cortical regions. The connectivity strength in this network was correlated to later neurocognitive performance, and it was comparable to healthy term-born infants rather than the infants receiving standard care. These findings suggest that preterm neurodevelopmental care can be improved by a biologically driven environmental enrichment, such as early facilitation of direct human connection.
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Affiliation(s)
- Pauliina Yrjölä
- BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, Children's Hospital and HUS Imaging, Helsinki University Central Hospital, 00029 HUS, Helsinki, Finland.,Department of Physiology, University of Helsinki, 00014 University of Helsinki, Helsinki, Finland
| | - Michael M Myers
- Departments of Psychiatry and Pediatrics, Columbia University Medical Center, New York, NY 10032, USA
| | - Martha G Welch
- Departments of Psychiatry and Pediatrics, Columbia University Medical Center, New York, NY 10032, USA
| | - Nathan J Stevenson
- Brain Modelling Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia
| | - Anton Tokariev
- BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, Children's Hospital and HUS Imaging, Helsinki University Central Hospital, 00029 HUS, Helsinki, Finland.,Department of Physiology, University of Helsinki, 00014 University of Helsinki, Helsinki, Finland
| | - Sampsa Vanhatalo
- BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, Children's Hospital and HUS Imaging, Helsinki University Central Hospital, 00029 HUS, Helsinki, Finland.,Department of Physiology, University of Helsinki, 00014 University of Helsinki, Helsinki, Finland
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31
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Sensory-based interventions in the NICU: systematic review of effects on preterm brain development. Pediatr Res 2022; 92:47-60. [PMID: 34508227 DOI: 10.1038/s41390-021-01718-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 07/12/2021] [Accepted: 08/17/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Infants born preterm are known to be at risk for abnormal brain development and adverse neurobehavioral outcomes. To improve early neurodevelopment, several non-pharmacological interventions have been developed and implemented in the neonatal intensive care unit (NICU). Sensory-based interventions seem to improve short-term neurodevelopmental outcomes in the inherently stressful NICU environment. However, how this type of intervention affects brain development in the preterm population remains unclear. METHODS A systematic review of the literature was conducted for published studies in the past 20 years reporting the effects of early, non-pharmacological, sensory-based interventions on the neonatal brain after preterm birth. RESULTS Twelve randomized controlled trials (RCT) reporting short-term effects of auditory, tactile, and multisensory interventions were included after the screening of 1202 articles. Large heterogeneity was identified among studies in relation to both types of intervention and outcomes. Three areas of focus for sensory interventions were identified: auditory-based, tactile-based, and multisensory interventions. CONCLUSIONS Diversity in interventions and outcome measures challenges the possibility to perform an integrative synthesis of results and to translate these for evidence-based clinical practice. This review identifies gaps in the literature and methodological challenges for the implementation of RCTs of sensory interventions in the NICU. IMPACT This paper represents the first systematic review to investigate the effect of non-pharmacological, sensory-based interventions in the NICU on neonatal brain development. Although reviewed RCTs present evidence on the impact of such interventions on the neonatal brain following preterm birth, it is not yet possible to formulate clear guidelines for clinical practice. This review integrates existing literature on the effect of sensory-based interventions on the brain after preterm birth and identifies methodological challenges for the conduction of high-quality RCTs.
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32
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Chajes JR, Stern JA, Kelsey CM, Grossmann T. Examining the Role of Socioeconomic Status and Maternal Sensitivity in Predicting Functional Brain Network Connectivity in 5-Month-Old Infants. Front Neurosci 2022; 16:892482. [PMID: 35757535 PMCID: PMC9226752 DOI: 10.3389/fnins.2022.892482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/03/2022] [Indexed: 11/13/2022] Open
Abstract
Infancy is a sensitive period of human brain development that is plastically shaped by environmental factors. Both proximal factors, such as sensitive parenting, and distal factors, such as socioeconomic status (SES), are known predictors of individual differences in structural and functional brain systems across the lifespan, yet it is unclear how these familial and contextual factors work together to shape functional brain development during infancy, particularly during the first months of life. In the current study, we examined pre-registered hypotheses regarding the interplay between these factors to assess how maternal sensitivity, within the broader context of socioeconomic variation, relates to the development of functional connectivity in long-range cortical brain networks. Specifically, we measured resting-state functional connectivity in three cortical brain networks (fronto-parietal network, default mode network, homologous-interhemispheric connectivity) using functional near-infrared spectroscopy (fNIRS), and examined the associations between maternal sensitivity, SES, and functional connectivity in a sample of 5-month-old infants and their mothers (N = 50 dyads). Results showed that all three networks were detectable during a passive viewing task, and that maternal sensitivity was positively associated with functional connectivity in the default mode network, such that infants with more sensitive mothers exhibited enhanced functional connectivity in this network. Contrary to hypotheses, we did not observe any associations of SES with functional connectivity in the brain networks assessed in this study. This suggests that at 5 months of age, maternal sensitivity is an important proximal environmental factor associated with individual differences in functional connectivity in a long-range cortical brain network implicated in a host of emotional and social-cognitive brain processes.
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Affiliation(s)
- Johanna R Chajes
- Department of Psychology, University of Virginia, Charlottesville, VA, United States
| | - Jessica A Stern
- Department of Psychology, University of Virginia, Charlottesville, VA, United States
| | - Caroline M Kelsey
- Department of Psychology, University of Virginia, Charlottesville, VA, United States.,Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Tobias Grossmann
- Department of Psychology, University of Virginia, Charlottesville, VA, United States
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33
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Luhmann HJ, Kanold PO, Molnár Z, Vanhatalo S. Early brain activity: Translations between bedside and laboratory. Prog Neurobiol 2022; 213:102268. [PMID: 35364141 PMCID: PMC9923767 DOI: 10.1016/j.pneurobio.2022.102268] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/01/2022] [Accepted: 03/25/2022] [Indexed: 01/29/2023]
Abstract
Neural activity is both a driver of brain development and a readout of developmental processes. Changes in neuronal activity are therefore both the cause and consequence of neurodevelopmental compromises. Here, we review the assessment of neuronal activities in both preclinical models and clinical situations. We focus on issues that require urgent translational research, the challenges and bottlenecks preventing translation of biomedical research into new clinical diagnostics or treatments, and possibilities to overcome these barriers. The key questions are (i) what can be measured in clinical settings versus animal experiments, (ii) how do measurements relate to particular stages of development, and (iii) how can we balance practical and ethical realities with methodological compromises in measurements and treatments.
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Affiliation(s)
- Heiko J. Luhmann
- Institute of Physiology, University Medical Center of the Johannes Gutenberg University Mainz, Duesbergweg 6, Mainz, Germany.,Correspondence:, , ,
| | - Patrick O. Kanold
- Department of Biomedical Engineering and Kavli Neuroscience Discovery Institute, Johns Hopkins University, School of Medicine, 720 Rutland Avenue / Miller 379, Baltimore, MD 21205, USA.,Correspondence:, , ,
| | - Zoltán Molnár
- Department of Physiology, Anatomy and Genetics, Sherrington Building, University of Oxford, Parks Road, Oxford OX1 3PT, UK.
| | - Sampsa Vanhatalo
- BABA Center, Departments of Physiology and Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital, Helsinki, Finland.
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34
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Vo Van P, Alison M, Morel B, Beck J, Bednarek N, Hertz-Pannier L, Loron G. Advanced Brain Imaging in Preterm Infants: A Narrative Review of Microstructural and Connectomic Disruption. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030356. [PMID: 35327728 PMCID: PMC8947160 DOI: 10.3390/children9030356] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/21/2022] [Accepted: 03/02/2022] [Indexed: 11/16/2022]
Abstract
Preterm birth disrupts the in utero environment, preventing the brain from fully developing, thereby causing later cognitive and behavioral disorders. Such cerebral alteration occurs beneath an anatomical scale, and is therefore undetectable by conventional imagery. Prematurity impairs the microstructure and thus the histological process responsible for the maturation, including the myelination. Cerebral MRI diffusion tensor imaging sequences, based on water’s motion into the brain, allows a representation of this maturation process. Similarly, the brain’s connections become disorganized. The connectome gathers structural and anatomical white matter fibers, as well as functional networks referring to remote brain regions connected one over another. Structural and functional connectivity is illustrated by tractography and functional MRI, respectively. Their organizations consist of core nodes connected by edges. This basic distribution is already established in the fetal brain. It evolves greatly over time but is compromised by prematurity. Finally, cerebral plasticity is nurtured by a lifetime experience at microstructural and macrostructural scales. A preterm birth causes a negative and early disruption, though it can be partly mitigated by positive stimuli based on developmental neonatal care.
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Affiliation(s)
- Philippe Vo Van
- Department of Neonatology, Hospices Civils de Lyon, Femme Mère Enfant Hospital, 59 Boulevard Pinel, 69500 Bron, France
- Correspondence:
| | - Marianne Alison
- Service d’Imagerie Pédiatrique, Hôpital Robert Debré, APHP, 75019 Paris, France;
- U1141 Neurodiderot, Équipe 5 inDev, Inserm, CEA, Université de Paris, 75019 Paris, France;
| | - Baptiste Morel
- Pediatric Radiology Department, Clocheville Hospital, CHRU of Tours, 37000 Tours, France;
- UMR 1253, iB-Rain, Université de Tours, Inserm, 37000 Tours, France
| | - Jonathan Beck
- Department of Neonatology, Reims University Hospital Alix de Champagne, 51100 Reims, France; (J.B.); (N.B.); (G.L.)
- CReSTIC EA 3804, Université de Reims Champagne Ardenne, 51100 Reims, France
| | - Nathalie Bednarek
- Department of Neonatology, Reims University Hospital Alix de Champagne, 51100 Reims, France; (J.B.); (N.B.); (G.L.)
- CReSTIC EA 3804, Université de Reims Champagne Ardenne, 51100 Reims, France
| | - Lucie Hertz-Pannier
- U1141 Neurodiderot, Équipe 5 inDev, Inserm, CEA, Université de Paris, 75019 Paris, France;
- NeuroSpin, CEA-Saclay, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - Gauthier Loron
- Department of Neonatology, Reims University Hospital Alix de Champagne, 51100 Reims, France; (J.B.); (N.B.); (G.L.)
- CReSTIC EA 3804, Université de Reims Champagne Ardenne, 51100 Reims, France
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35
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Boissel L, Guilé JM, Viaux-Savelon S, Mariana C, Corde P, Wallois F, Benarous X. A narrative review of the effect of parent-child shared reading in preterm infants. Front Pediatr 2022; 10:860391. [PMID: 36172394 PMCID: PMC9510730 DOI: 10.3389/fped.2022.860391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
The benefits of book-reading interventions on language development in full-term infants have been well investigated. Because children born preterm face a greater risk of cognitive, language and emotional impairments, this narrative review examines the theoretical evidence, empirical findings, and practical challenges for introducing such intervention to this population. The effect of shared book interventions on typically developing infants is mediated by three components: a linguistic aspect (i.e., exposure to enriched linguistic input), an interactive aspect (i.e., eliciting more synchronous and contingent communication), and a parental aspect (i.e., reducing parental stress and increasing sense of control). Parental shared book reading in a neonatal intensive care unit (NICU) was found to be feasible and well accepted. It provides concrete support for positive parenting in a highly stressful context. Preliminary evidence supports a positive effect of shared reading sessions in physiological parameters of preterm infants in NICU. One study showed that parental shared book reading in an NICU is associated with lower decline in language development during the first 24 months compared to a historical control group. Findings from a community-based birth cohort confirm the positive effect of this intervention on cognitive development with a 2-year-follow up. More structured clinical trials are now needed to confirm these preliminary findings. Questions remain about possible moderators of these interventions, in particular cultural features.
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Affiliation(s)
- Laure Boissel
- Department of Child and Adolescent Psychopathology, Amiens University Hospital, Amiens, France.,INSERM Unit U1105 Research Group for Analysis of the Multimodal Cerebral Function, University of Picardy Jules Verne, Amiens, France
| | - Jean-Marc Guilé
- Department of Child and Adolescent Psychopathology, Amiens University Hospital, Amiens, France.,INSERM Unit U1105 Research Group for Analysis of the Multimodal Cerebral Function, University of Picardy Jules Verne, Amiens, France.,Pôle de psychiatrie de l'enfant et de l'adolescent, Etablissement Publique de Santé Mentale de la Somme, Amiens, France
| | - Sylvie Viaux-Savelon
- Hospices civils de Lyon, Hôpital de la Croix Rousse, Université Lyon 1, Lyon, France
| | - Charlotte Mariana
- Department of Child and Adolescent Psychopathology, Amiens University Hospital, Amiens, France
| | - Pascal Corde
- Department of Child and Adolescent Psychopathology, Amiens University Hospital, Amiens, France
| | - Fabrice Wallois
- INSERM Unit U1105 Research Group for Analysis of the Multimodal Cerebral Function, University of Picardy Jules Verne, Amiens, France.,Department of Pediatric Neurophysiology, Amiens University Hospital, Amiens, France
| | - Xavier Benarous
- Department of Child and Adolescent Psychopathology, Amiens University Hospital, Amiens, France.,INSERM Unit U1105 Research Group for Analysis of the Multimodal Cerebral Function, University of Picardy Jules Verne, Amiens, France
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36
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Mohan A, Gokulakrishnan G, El‐Saie A, Brickley A, Hagan J, Pammi M. Music therapy for preterm neonates in the neonatal intensive care unit: An overview of systematic reviews. Acta Paediatr 2021; 110:3180-3200. [PMID: 34346112 DOI: 10.1111/apa.16055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 01/08/2023]
Abstract
AIM To summarise the quantity and quality of evidence for using music therapy for preterm infants in the neonatal intensive care unit (NICU). METHODS We performed an overview of evidence for the effectiveness and safety of MT for preterm infants in the NICU. We performed a random-effects meta-analysis of data from studies that fit the definition of MT. RESULTS We identified 12 eligible systematic reviews and the methodological quality by AMSTAR-2 ranged from moderate to critically low. We identified 14 eligible randomised trials and 7 observational studies where the intervention fits the definition of MT. Meta-analysis of the RCTs showed that MT significantly decreases heart rate, mean difference (MD) (95% CI), -3.21 [-5.22, -1.19], respiratory rate, MD -2.93 [-5.65, -0.22], and maternal anxiety, MD -17.50 [-20.10, -14.90], and increases feeding volume, MD 29.59 [12.79, 46.38]. Long-term neurodevelopmental or safety outcomes were not reported. GRADE assessment of outcomes ranged from low to very low, downgraded for high risk of bias in the included studies, inconsistency and imprecision. CONCLUSION Low to very low certainty evidence suggests that MT in preterm infants improves short-term physiological parameters, feeding and maternal anxiety but safety and long-term outcomes were not reported.
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Affiliation(s)
| | - Ganga Gokulakrishnan
- Section of Neonatology Department of Pediatrics Baylor College of Medicine and Texas Children’s Hospital Houston TX USA
| | - Ahmed El‐Saie
- Section of Neonatology Department of Pediatrics Baylor College of Medicine and Texas Children’s Hospital Houston TX USA
| | - Alix Brickley
- Children’s Hospital Colorado in the Ponzio Creative Arts Therapy Program Denver CO USA
| | - Joseph Hagan
- Section of Neonatology Department of Pediatrics Baylor College of Medicine and Texas Children’s Hospital Houston TX USA
| | - Mohan Pammi
- Section of Neonatology Department of Pediatrics Baylor College of Medicine and Texas Children’s Hospital Houston TX USA
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37
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Papatzikis E, Elhalik M, Inocencio SAM, Agapaki M, Selvan RN, Muhammed FS, Haroon NA, Dash SK, Sofologi M, Bezoni A. Key Challenges and Future Directions When Running Auditory Brainstem Response (ABR) Research Protocols with Newborns: A Music and Language EEG Feasibility Study. Brain Sci 2021; 11:brainsci11121562. [PMID: 34942864 PMCID: PMC8699561 DOI: 10.3390/brainsci11121562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/25/2022] Open
Abstract
Although many musical intervention studies exist in the wider framework of neuroscience and psychology, the preliminary importance of feasibility studies is rarely discussed. Adding to this fact the limited research existing on the therapeutic and restorative potential of music exposure during early developmental periods, pushed us to concentrate on investigating newborns’ perception of music and its impact on the brain. Here, we explore the feasibility of a randomized controlled trial (RCT) approach when measuring and comparing the neurophysiological perception of music versus language on the brainstem of newborns using auditory brainstem response (ABR). Twenty-five healthy full-term infants were recruited, eight of which were measured within their first 10 days postpartum. The evaluation of the study’s feasibility appealed to five main objectives that essentially answer the question: Can our protocol work? Each objective proposes questions based on Orsmond and Cohn’s guiding framework, designed to assess, and assist feasibility in understanding barriers toward a study’s success. Our results justify that newborns are well capable of undergoing the study and given meticulous considerations and improvements on the intervention resources. The procedure’s communication and technical obstacles are resoluble. Moreover, assimilation of external factors to adapt, such as the culture variation and the ABR protocol implementation are necessary. The study was well received in the selected region (Middle East), and the recording procedure showed potential outcomes for a comprehensive RCT.
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Affiliation(s)
- Efthymios Papatzikis
- Department of Early Childhood Education and Care, Oslo Metropolitan University, 0167 Oslo, Norway
- Correspondence:
| | - Mahmoud Elhalik
- Neonatal Intensive Care Unit, Latifa Women and Children’s Hospital, Dubai 9115, United Arab Emirates; (M.E.); (F.S.M.); (N.A.H.); (S.K.D.)
| | | | | | - Rosari Naveena Selvan
- Institute for Physics 3—Biophysics and Bernstein Center for Computational Neuroscience, University of Göttingen, 37073 Göttingen, Germany;
- Department of Psychology, University of Münster, 48149 Münster, Germany
| | - Faseela Shejeed Muhammed
- Neonatal Intensive Care Unit, Latifa Women and Children’s Hospital, Dubai 9115, United Arab Emirates; (M.E.); (F.S.M.); (N.A.H.); (S.K.D.)
| | - Nazreen Abdulla Haroon
- Neonatal Intensive Care Unit, Latifa Women and Children’s Hospital, Dubai 9115, United Arab Emirates; (M.E.); (F.S.M.); (N.A.H.); (S.K.D.)
| | - Swarup Kumar Dash
- Neonatal Intensive Care Unit, Latifa Women and Children’s Hospital, Dubai 9115, United Arab Emirates; (M.E.); (F.S.M.); (N.A.H.); (S.K.D.)
| | - Maria Sofologi
- Psychology Laboratory, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece;
- Institute of Humanities and Social Sciences, University Research Centre of Ioannina, 45110 Ioannina, Greece
| | - Antonia Bezoni
- Department of Midwifery, Røyken Health Station, 3440 Røyken, Norway;
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38
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Ren H, Zou L, Wang L, Lu C, Yuan Y, Dai C, Chen W. Evaluation of the Short-Term Music Therapy on Brain Functions of Preterm Infants Using Functional Near-Infrared Spectroscopy. Front Neurol 2021; 12:649340. [PMID: 34650500 PMCID: PMC8505667 DOI: 10.3389/fneur.2021.649340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 08/19/2021] [Indexed: 11/23/2022] Open
Abstract
Music contains substantial contents that humans can perceive and thus has the capability to evoke positive emotions. Even though neonatal intensive care units (NICUs) can provide preterm infants a developmental environment, they still cannot fully simulate the environment in the womb. The reduced maternal care would increase stress levels in premature infants. Fortunately, music intervention has been proved that it can improve the NICU environment, such as stabilize the heart rate and the respiratory rate, reduce the incidence of apnea, and improve feeding. However, the effects of music therapy on the brain development of preterm infants need to be further investigated. In this paper, we evaluated the influence of short-term music therapy on the brain functions of preterm infants measured by functional near-infrared spectroscopy (fNIRS). We began by investigating how premature babies perceive structural information of music by calculating the correlations between music features and fNIRS signals. Then, the influences of short-term music therapy on brain functions were evaluated by comparing the resting-state functional connectivity before and after the short-term music therapy. The results show that distinct brain regions are responsible for processing corresponding musical features, indicating that preterm infants have the capability to process the complex musical content. However, the results of network analysis show that short-term music intervention is insufficient to cause the changes in cerebral functional connectivity. Therefore, long-term music therapy may be required to achieve the deserved effects on brain functional connectivity.
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Affiliation(s)
- Haoran Ren
- School of Information Science and Technology, The Center for Intelligent Medical Electronics, Fudan University, Shanghai, China
| | - Liangyan Zou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Laishuan Wang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Chunmei Lu
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Yafei Yuan
- School of Information Science and Technology, The Center for Intelligent Medical Electronics, Fudan University, Shanghai, China
| | - Chenyun Dai
- School of Information Science and Technology, The Center for Intelligent Medical Electronics, Fudan University, Shanghai, China
| | - Wei Chen
- School of Information Science and Technology, The Center for Intelligent Medical Electronics, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention, Shanghai, China
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39
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Provasi J, Blanc L, Carchon I. The Importance of Rhythmic Stimulation for Preterm Infants in the NICU. CHILDREN (BASEL, SWITZERLAND) 2021; 8:660. [PMID: 34438551 PMCID: PMC8393990 DOI: 10.3390/children8080660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/22/2021] [Accepted: 07/27/2021] [Indexed: 11/18/2022]
Abstract
The fetal environment provides the fetus with multiple potential sources of rhythmic stimulation that are not present in the NICU. Maternal breathing, heartbeats, walking, dancing, running, speaking, singing, etc., all bathe the fetus in an environment of varied rhythmic stimuli: vestibular, somatosensory, tactile, and auditory. In contrast, the NICU environment does not offer the same proportion of rhythmic stimulation. After analyzing the lack of rhythmic stimulation in the NICU, this review highlights the different proposals for vestibular and/or auditory rhythmic stimulation offered to preterm infants alone and with their parents. The focus is on the beneficial effects of auditory and vestibular stimulation involving both partners of the mother-infant dyad. A preliminary study on the influence of a skin-to-skin lullaby on the stability of maternal behavior and on the tonic emotional manifestations of the preterm infant is presented as an example. The review concludes with the importance of introducing rhythmic stimulations in the NICU.
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Affiliation(s)
- Joëlle Provasi
- Cognitions Humaine et Artificielle -EPHE-PSL, CHArt Laboratory, 93322 Aubervilliers, France;
| | - Loreline Blanc
- Psychomotor Therapist, DE ISRP, 92100 Boulogne-Billancourt, France;
| | - Isabelle Carchon
- Cognitions Humaine et Artificielle -EPHE-PSL, CHArt Laboratory, 93322 Aubervilliers, France;
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40
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Kelsey CM, Farris K, Grossmann T. Variability in Infants' Functional Brain Network Connectivity Is Associated With Differences in Affect and Behavior. Front Psychiatry 2021; 12:685754. [PMID: 34177669 PMCID: PMC8220897 DOI: 10.3389/fpsyt.2021.685754] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
Variability in functional brain network connectivity has been linked to individual differences in cognitive, affective, and behavioral traits in adults. However, little is known about the developmental origins of such brain-behavior correlations. The current study examined functional brain network connectivity and its link to behavioral temperament in typically developing newborn and 1-month-old infants (M [age] = 25 days; N = 75) using functional near-infrared spectroscopy (fNIRS). Specifically, we measured long-range connectivity between cortical regions approximating fronto-parietal, default mode, and homologous-interhemispheric networks. Our results show that connectivity in these functional brain networks varies across infants and maps onto individual differences in behavioral temperament. Specifically, connectivity in the fronto-parietal network was positively associated with regulation and orienting behaviors, whereas connectivity in the default mode network showed the opposite effect on these behaviors. Our analysis also revealed a significant positive association between the homologous-interhemispheric network and infants' negative affect. The current results suggest that variability in long-range intra-hemispheric and cross-hemispheric functional connectivity between frontal, parietal, and temporal cortex is associated with individual differences in affect and behavior. These findings shed new light on the brain origins of individual differences in early-emerging behavioral traits and thus represent a viable novel approach for investigating developmental trajectories in typical and atypical neurodevelopment.
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Affiliation(s)
- Caroline M. Kelsey
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States
- Department of Psychology, University of Virginia, Charlottesville, VA, United States
| | - Katrina Farris
- Department of Psychology, University of Virginia, Charlottesville, VA, United States
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Tobias Grossmann
- Department of Psychology, University of Virginia, Charlottesville, VA, United States
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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Menke BM, Hass J, Diener C, Pöschl J. Family-centered music therapy-Empowering premature infants and their primary caregivers through music: Results of a pilot study. PLoS One 2021; 16:e0250071. [PMID: 33989286 PMCID: PMC8121291 DOI: 10.1371/journal.pone.0250071] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 03/30/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In Neonatal Intensive Care Units (NICUs) premature infants are exposed to various acoustic, environmental and emotional stressors which have a negative impact on their development and the mental health of their parents. Family-centred music therapy bears the potential to positively influence these stressors. The few existing studies indicate that interactive live-improvised music therapy interventions both reduce parental stress factors and support preterm infants' development. METHODS The present randomized controlled longitudinal study (RCT) with very low and extremely low birth weight infants (born <30+0 weeks of gestation) and their parents analyzed the influence of music therapy on both the physiological development of premature infants and parental stress factors. In addition, possible interrelations between infant development and parental stress were explored. 65 parent-infant-pairs were enrolled in the study. The treatment group received music therapy twice a week from the 21st day of life till discharge from hospital. The control group received treatment as usual. RESULTS Compared to the control group, infants in the treatment group showed a 11.1 days shortening of caffeine therapy, 12.1 days shortening of nasogastric/ orogastric tube feed and 15.5 days shortening of hospitalization, on average. While these differences were not statistically significant, a factor-analytical compound measure of all three therapy durations was. From pre-to-post-intervention, parents showed a significant reduction in stress factors. However, there were no differences between control and treatment group. A regression analysis showed links between parental stress factors and physiological development of the infants. CONCLUSION This pilot study suggests that a live-improvised interactive music therapy intervention for extremely and very preterm infants and their parents may have a beneficial effect on the therapy duration needed for premature infants before discharge from hospital is possible. The study identified components of the original physiological variables of the infants as appropriate endpoints and suggested a slight change in study design to capture possible effects of music therapy on infants' development as well. Further studies should assess both short-term and long-term effects on premature infants as well as on maternal and paternal health outcomes, to determine whether a family-centered music therapy, actually experienced as an added value to developmental care, should be part of routine care at the NICU.
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Affiliation(s)
- Barbara M. Menke
- Department of Neonatology, University Children’s Hospital, Heidelberg, Germany
- Institute for Applied Research, SRH University Heidelberg, Heidelberg, Germany
| | - Joachim Hass
- Institute for Applied Research, SRH University Heidelberg, Heidelberg, Germany
- Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Carsten Diener
- Institute for Applied Research, SRH University Heidelberg, Heidelberg, Germany
| | - Johannes Pöschl
- Department of Neonatology, University Children’s Hospital, Heidelberg, Germany
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Dubois J, Alison M, Counsell SJ, Hertz‐Pannier L, Hüppi PS, Benders MJ. MRI of the Neonatal Brain: A Review of Methodological Challenges and Neuroscientific Advances. J Magn Reson Imaging 2021; 53:1318-1343. [PMID: 32420684 PMCID: PMC8247362 DOI: 10.1002/jmri.27192] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 01/04/2023] Open
Abstract
In recent years, exploration of the developing brain has become a major focus for researchers and clinicians in an attempt to understand what allows children to acquire amazing and unique abilities, as well as the impact of early disruptions (eg, prematurity, neonatal insults) that can lead to a wide range of neurodevelopmental disorders. Noninvasive neuroimaging methods such as MRI are essential to establish links between the brain and behavioral changes in newborns and infants. In this review article, we aim to highlight recent and representative studies using the various techniques available: anatomical MRI, quantitative MRI (relaxometry, diffusion MRI), multiparametric approaches, and functional MRI. Today, protocols use 1.5 or 3T MRI scanners, and specialized methodologies have been put in place for data acquisition and processing to address the methodological challenges specific to this population, such as sensitivity to motion. MR sequences must be adapted to the brains of newborns and infants to obtain relevant good soft-tissue contrast, given the small size of the cerebral structures and the incomplete maturation of tissues. The use of age-specific image postprocessing tools is also essential, as signal and contrast differ from the adult brain. Appropriate methodologies then make it possible to explore multiple neurodevelopmental mechanisms in a precise way, and assess changes with age or differences between groups of subjects, particularly through large-scale projects. Although MRI measurements only indirectly reflect the complex series of dynamic processes observed throughout development at the molecular and cellular levels, this technique can provide information on brain morphology, structural connectivity, microstructural properties of gray and white matter, and on the functional architecture. Finally, MRI measures related to clinical, behavioral, and electrophysiological markers have a key role to play from a diagnostic and prognostic perspective in the implementation of early interventions to avoid long-term disabilities in children. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Jessica Dubois
- University of ParisNeuroDiderot, INSERM,ParisFrance
- UNIACT, NeuroSpin, CEA; Paris‐Saclay UniversityGif‐sur‐YvetteFrance
| | - Marianne Alison
- University of ParisNeuroDiderot, INSERM,ParisFrance
- Department of Pediatric RadiologyAPHP, Robert‐Debré HospitalParisFrance
| | - Serena J. Counsell
- Centre for the Developing BrainSchool of Biomedical Engineering & Imaging Sciences, King's College LondonLondonUK
| | - Lucie Hertz‐Pannier
- University of ParisNeuroDiderot, INSERM,ParisFrance
- UNIACT, NeuroSpin, CEA; Paris‐Saclay UniversityGif‐sur‐YvetteFrance
| | - Petra S. Hüppi
- Division of Development and Growth, Department of Woman, Child and AdolescentUniversity Hospitals of GenevaGenevaSwitzerland
| | - Manon J.N.L. Benders
- Department of NeonatologyUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
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Vitale FM, Chirico G, Lentini C. Sensory Stimulation in the NICU Environment: Devices, Systems, and Procedures to Protect and Stimulate Premature Babies. CHILDREN-BASEL 2021; 8:children8050334. [PMID: 33923031 PMCID: PMC8146433 DOI: 10.3390/children8050334] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/13/2021] [Accepted: 04/22/2021] [Indexed: 01/30/2023]
Abstract
Prematurity deprives infants of the prenatal sensory stimulation essential to their correct development; in addition, the stressful environment of the NICU impacts negatively on their growth. The purpose of this review was to investigate the effects of NICU noise pollution on preterm infants and parents. We focused on the systems and projects used to control and modulate sounds, as well as on those special devices and innovative systems used to deliver maternal sounds and vibrations to this population. The results showed beneficial effects on the preterm infants in different areas such as physiological, autonomic, and neurobehavioral development. Although most of these studies highlight positive reactions, there is also a general acknowledgement of the current limits: small and heterogeneous groups, lack of structured variable measurements, systematic control groups, longitudinal studies, and normative values. The mother's presence is always preferred, but the use of music therapy and the devices analyzed, although not able to replace her presence, aim to soften her absence through familiar and protective stimuli, which is a very powerful aid during the COVID-19 pandemic.
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Affiliation(s)
- Francesco Massimo Vitale
- Psicologia Magistrale (LM-51), Clinical and Rehabilitation Psychology, Università Niccolò Cusano, 00166 Roma, Italy
- Correspondence: (F.M.V.); (G.C.)
| | - Gaetano Chirico
- Neonatology and Neonatal Intensive Care Unit, Children Hospital, ASST Spedali Civili, 25123 Brescia, Italy
- Correspondence: (F.M.V.); (G.C.)
| | - Carmen Lentini
- Neonatal Pathology/NICU, Ospedale Civile Padova—AOPD, 35128 Padova, Italy;
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Ettenberger M, Bieleninik Ł, Epstein S, Elefant C. Defining Attachment and Bonding: Overlaps, Differences and Implications for Music Therapy Clinical Practice and Research in the Neonatal Intensive Care Unit (NICU). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1733. [PMID: 33579015 PMCID: PMC7916808 DOI: 10.3390/ijerph18041733] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 01/19/2023]
Abstract
Preterm birth and the subsequent hospitalization in the Neonatal Intensive Care Unit (NICU) is a challenging life event for parents and babies. Stress, anxiety, and depressive symptoms, limitations in holding or touching the baby, and medical complications during the NICU stay can negatively affect parental mental health. This can threaten the developing parent-infant relationship and might adversely impact child development. Music therapy in the NICU is an internationally growing field of clinical practice and research and is increasingly applied to promote relationship building between parents and babies. The two most commonly used concepts describing the early parent-infant relationship are 'attachment' and 'bonding'. While frequently used interchangeably in the literature, they are actually not the same and describe distinctive processes of the early relationship formation. Thus, it is important to discuss the overlaps and differences between attachment and bonding and the implications for music therapy clinical practice and research. Whereas providing examples and possible scenarios for music therapists working on either bonding or attachment, the distinction between both concepts is relevant for many health care professionals concerned with early parenting interventions in the NICU. This will hopefully lead to a more precise use of theory, and ultimately, to a more informed clinical practice and research.
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Affiliation(s)
- Mark Ettenberger
- Department of Music Therapy, University Hospital Fundación Santa Fe de Bogotá, Bogotá 110111, Colombia
- SONO—Centro de Musicoterapia, Bogotá 110221, Colombia
| | - Łucja Bieleninik
- Institute of Psychology, University of Gdansk, 80-309 Gdansk, Poland;
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, 5029 Bergen, Norway
| | - Shulamit Epstein
- School for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (S.E.); (C.E.)
| | - Cochavit Elefant
- School for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (S.E.); (C.E.)
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45
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Haslbeck FB, Bucher HU, Bassler D, Hagmann C, Natalucci G. Creative Music Therapy and Neurodevelopmental Outcomes in Pre-term Infants at 2 Years: A Randomized Controlled Pilot Trial. Front Pediatr 2021; 9:660393. [PMID: 34222141 PMCID: PMC8249730 DOI: 10.3389/fped.2021.660393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
Impaired neurodevelopment is increasingly recognized as a major health issue in children born prematurely. Creative music therapy (CMT) intends to prevent and or reduce neurobehavioral deficits in pre-term infants using musical stimulation and socio-emotional co-regulation. We conducted a randomized, clinical pilot CMT trial to test feasibility and to examine long-term neurodevelopmental outcomes in pre-term infants (NCT02434224: https://clinicaltrials.gov/ct2/show/NCT02434224). Eighty-two pre-term infants were randomized either to CMT or standard care. A specially trained music therapist provided family-integrating CMT via infant-directed singing during hospitalization. Fifty-six infants underwent follow-up at 2 years of corrected age. No significant beneficial nor adverse effects of CMT were identified in routine clinical neurodevelopmental measures (Bayley-III Scales of Infant and Toddler Development and the standardized neurological examination). Longer term follow-up (5 years) and larger future studies are recommended to elucidate possible long-term effects of music in relation to more sensitive outcomes including executive function, detailed language processing and social-emotional development.
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Affiliation(s)
| | - Hans Ulrich Bucher
- Department of Neonatology, Newborn Research Zurich, University Hospital Zurich, Zurich, Switzerland
| | - Dirk Bassler
- Department of Neonatology, Newborn Research Zurich, University Hospital Zurich, Zurich, Switzerland
| | - Cornelia Hagmann
- Department of Neonatology and Pediatric Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Giancarlo Natalucci
- Department of Neonatology, Newborn Research Zurich, University Hospital Zurich, Zurich, Switzerland.,Larsson-Rosenquist Foundation Centre for Neurodevelopment, Growth and Nutrition of the Newborn, University Hospital Zurich, Zurich, Switzerland
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46
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Akiyama A, Tsai JD, W Y Tam E, Kamino D, Hahn C, Go CY, Chau V, Whyte H, Wilson D, McNair C, Papaioannou V, Hugh SC, Papsin BC, Nishijima S, Yamazaki T, Miller SP, Ochi A. The Effect of Music and White Noise on Electroencephalographic (EEG) Functional Connectivity in Neonates in the Neonatal Intensive Care Unit. J Child Neurol 2021; 36:38-47. [PMID: 32838628 DOI: 10.1177/0883073820947894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The purpose of this study is to investigate whether listening to music and white noise affects functional connectivity on scalp electroencephalography (EEG) in neonates in the neonatal intensive care unit.Nine neonates of ≥34 weeks' gestational age, who were already undergoing clinical continuous EEG monitoring in the neonatal intensive care unit, listened to lullaby-like music and white noise for 1 hour each separated by a 2-hour interval of no intervention. EEG segments during periods of music, white noise, and no intervention were band-pass filtered as delta (0.5-4 Hz), theta (4-8 Hz), lower alpha (8-10 Hz), upper alpha (10-13 Hz), beta (13-30 Hz), and gamma (30-45 Hz). Synchronization likelihood was used as a measure of connectivity between any 2 electrodes.In theta, lower alpha, and upper alpha frequency bands, the synchronization likelihood values yielded statistical significance with sound (music, white noise and no intervention) and with edge (between any 2 electrodes) factors. In theta, lower alpha, and upper alpha frequency bands, statistical significance was obtained between music and white noise (t = 3.12, 3.32, and 3.68, respectively; P < .017), and between white noise and no intervention (t = 4.51, 3.09, and 2.95, respectively, P < .017). However, there was no difference between music and no intervention.Although limited by a small sample size and the 1-time only auditory intervention, these preliminary results demonstrate the feasibility of EEG connectivity analyses even at bedside in neonates on continuous EEG monitoring in the neonatal intensive care unit. They also point to the possibility of detecting significant changes in functional connectivity related to the theta and alpha bands using auditory interventions.
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Affiliation(s)
- Akiyoshi Akiyama
- Department of Paediatrics (Neurology), The 7979Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.,Department of Bioscience and Bioinformatics, 12924Kyushu Institute of Technology, Fukuoka, Japan
| | - Jeng-Dau Tsai
- Department of Paediatrics (Neurology), The 7979Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Chung Shan Medical University Hospital and Chung Shan Medical University, Taichung, Taiwan
| | - Emily W Y Tam
- Department of Paediatrics (Neurology), The 7979Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Daphne Kamino
- Department of Paediatrics (Neurology), The 7979Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Cecil Hahn
- Department of Paediatrics (Neurology), The 7979Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Cristina Y Go
- Department of Paediatrics (Neurology), The 7979Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Vann Chau
- Department of Paediatrics (Neurology), The 7979Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Hilary Whyte
- Department of Paediatrics (Neonatology), 7979The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Diane Wilson
- Department of Paediatrics (Neonatology), 7979The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Carol McNair
- Department of Paediatrics (Neonatology), 7979The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Vicky Papaioannou
- Department of Otolaryngology, The 7979Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Communication Disorders, The 7979Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sarah C Hugh
- Department of Surgery (Otolaryngology), Joseph Brant Hospital and McMaster University, Burlington, Ontario, Canada
| | - Blake C Papsin
- Department of Otolaryngology, The 7979Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sakura Nishijima
- Department of Paediatrics (Neurology), The 7979Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.,Department of Bioscience and Bioinformatics, 12924Kyushu Institute of Technology, Fukuoka, Japan
| | - Toshimasa Yamazaki
- Department of Bioscience and Bioinformatics, 12924Kyushu Institute of Technology, Fukuoka, Japan
| | - Steven P Miller
- Department of Paediatrics (Neurology), The 7979Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Ayako Ochi
- Department of Paediatrics (Neurology), The 7979Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
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Sa de Almeida J, Meskaldji DE, Loukas S, Lordier L, Gui L, Lazeyras F, Hüppi PS. Preterm birth leads to impaired rich-club organization and fronto-paralimbic/limbic structural connectivity in newborns. Neuroimage 2020; 225:117440. [PMID: 33039621 DOI: 10.1016/j.neuroimage.2020.117440] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/08/2020] [Accepted: 10/05/2020] [Indexed: 02/06/2023] Open
Abstract
Prematurity disrupts brain development during a critical period of brain growth and organization and is known to be associated with an increased risk of neurodevelopmental impairments. Investigating whole-brain structural connectivity alterations accompanying preterm birth may provide a better comprehension of the neurobiological mechanisms related to the later neurocognitive deficits observed in this population. Using a connectome approach, we aimed to study the impact of prematurity on neonatal whole-brain structural network organization at term-equivalent age. In this cohort study, twenty-four very preterm infants at term-equivalent age (VPT-TEA) and fourteen full-term (FT) newborns underwent a brain MRI exam at term age, comprising T2-weighted imaging and diffusion MRI, used to reconstruct brain connectomes by applying probabilistic constrained spherical deconvolution whole-brain tractography. The topological properties of brain networks were quantified through a graph-theoretical approach. Furthermore, edge-wise connectivity strength was compared between groups. Overall, VPT-TEA infants' brain networks evidenced increased segregation and decreased integration capacity, revealed by an increased clustering coefficient, increased modularity, increased characteristic path length, decreased global efficiency and diminished rich-club coefficient. Furthermore, in comparison to FT, VPT-TEA infants had decreased connectivity strength in various cortico-cortical, cortico-subcortical and intra-subcortical networks, the majority of them being intra-hemispheric fronto-paralimbic and fronto-limbic. Inter-hemispheric connectivity was also decreased in VPT-TEA infants, namely through connections linking to the left precuneus or left dorsal cingulate gyrus - two regions that were found to be hubs in FT but not in VPT-TEA infants. Moreover, posterior regions from Default-Mode-Network (DMN), namely precuneus and posterior cingulate gyrus, had decreased structural connectivity in VPT-TEA group. Our finding that VPT-TEA infants' brain networks displayed increased modularity, weakened rich-club connectivity and diminished global efficiency compared to FT infants suggests a delayed transition from a local architecture, focused on short-range connections, to a more distributed architecture with efficient long-range connections in those infants. The disruption of connectivity in fronto-paralimbic/limbic and posterior DMN regions might underlie the behavioral and social cognition difficulties previously reported in the preterm population.
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Affiliation(s)
- Joana Sa de Almeida
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - Djalel-Eddine Meskaldji
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland; Institute of Mathematics, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Serafeim Loukas
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland; Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Lara Lordier
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - Laura Gui
- Department of Radiology and Medical Informatics, Center of BioMedical Imaging (CIBM), University of Geneva, Geneva, Switzerland
| | - François Lazeyras
- Department of Radiology and Medical Informatics, Center of BioMedical Imaging (CIBM), University of Geneva, Geneva, Switzerland
| | - Petra S Hüppi
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.
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Filippa M, Lordier L, De Almeida JS, Monaci MG, Adam-Darque A, Grandjean D, Kuhn P, Hüppi PS. Early vocal contact and music in the NICU: new insights into preventive interventions. Pediatr Res 2020; 87:249-264. [PMID: 31266053 DOI: 10.1038/s41390-019-0490-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 06/14/2019] [Indexed: 12/11/2022]
Abstract
It is now clearly established that the environment and the sensory stimuli, particularly during the perinatal period, have an impact on infant's development. During the last trimester of gestation, activity-dependent plasticity shapes the fetal brain, and prematurity has been shown to alter the typical developmental trajectories. In this delicate period, preventive interventions aiming at modulating these developmental trajectories through activity-inducing interventions are currently underway to be tested. The purpose of this review paper is to describe the potentialities of early vocal contact and music on the preterm infant's brain development, and their potential beneficial effect on early development. Scientific evidence supports a behavioral orientation of the newborn to organized sounds, such as those of voice and music, and recent neuroimaging studies further confirm full cerebral processing of music as multisensory stimuli. However, the impact of long-term effects of music exposure and early vocal contact on preterm infants' long-term neurodevelopment needs be further investigated. To conclude, it is necessary to establish the neuroscientific bases of the early perception and the long-term effects of music and early vocal contact on the premature newborns' development. Scientific projects are currently on the way to fill this gap in knowledge.
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Affiliation(s)
- Manuela Filippa
- Department of Women, Infants and Adolescents, Division of Development and Growth, University Children Hospital, University of Geneva, Geneva, Switzerland. .,University of Valle d'Aosta, Aosta, Italy. .,Neuroscience of Emotion and Affective Dynamics, Swiss Center for Affective Sciences, and Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
| | - Lara Lordier
- Department of Women, Infants and Adolescents, Division of Development and Growth, University Children Hospital, University of Geneva, Geneva, Switzerland
| | - Joana Sa De Almeida
- Department of Women, Infants and Adolescents, Division of Development and Growth, University Children Hospital, University of Geneva, Geneva, Switzerland
| | | | - Alexandra Adam-Darque
- Laboratory of Cognitive Neurorehabilitation, Department of Clinical Neuroscience, Division of Neurorehabilitation, University Hospital of Geneva and University of Geneva, Geneva, Switzerland
| | - Didier Grandjean
- Neuroscience of Emotion and Affective Dynamics, Swiss Center for Affective Sciences, and Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Pierre Kuhn
- Service de Médecine et réanimation du nouveau-né, Hôpital de Hautepierre, CHU Strasbourg, Strasbourg, France
| | - Petra S Hüppi
- Department of Women, Infants and Adolescents, Division of Development and Growth, University Children Hospital, University of Geneva, Geneva, Switzerland
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49
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van Dokkum NH, Jaschke AC, Ravensbergen AG, Reijneveld SA, Hakvoort L, de Kroon MLA, Bos AF. Feasibility of Live-Performed Music Therapy for Extremely and Very Preterm Infants in a Tertiary NICU. Front Pediatr 2020; 8:581372. [PMID: 33178653 PMCID: PMC7596259 DOI: 10.3389/fped.2020.581372] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/08/2020] [Indexed: 01/06/2023] Open
Abstract
Objective: We aimed to investigate the feasibility of live-performed music therapy for extremely and very preterm infants admitted to the neonatal intensive care unit (NICU), and their parents, starting the 1st-2nd week after birth. They may benefit from live-performed music therapy as comforting non-pharmacological intervention. Study Design: We included infants born before 30 weeks' gestation in a single center NICU study. Live-performed music therapy was provided three times per week, tailored to the infant's medical condition. Parents were actively involved. Feasibility was determined as a combination of participation, drop-out, overstimulation (based on COMFORT-Neo scores), and evaluations of the intervention by parents and nurses (using a questionnaire on perceived effects on the parent, their infant and the NICU sound environment). Results: We included 18 infants (90% participation rate), with a gestational age of median 27 weeks (IQR 26-28 weeks), 61% males. One infant (5.6%) dropped-out. Differences of COMFORT-Neo scores during and after sessions compared with before sessions were non-significant; overstimulation by music therapy did not occur. Parents reported high satisfaction (highest score possible of 7) with the interventions and reported improvements in both infant and their own respiratory rates. Nurses also reported high satisfaction with the intervention and perceived a quieter NICU sound environment during and after sessions. Conclusion: Live-performed music therapy for extremely and very preterm infants is feasible and well-tolerated, and is experienced as an added value to developmental care. Future studies should assess both short-term and long-term effects, to determine whether this intervention should be part of routine care at the NICU and whether it is most beneficial to start shortly after birth.
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Affiliation(s)
- Nienke H van Dokkum
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Artur C Jaschke
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Music Therapy, ArtEZ University of the Arts, Enschede, Netherlands
| | - Anne-Greet Ravensbergen
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Music Therapy, ArtEZ University of the Arts, Enschede, Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Laurien Hakvoort
- Department of Music Therapy, ArtEZ University of the Arts, Enschede, Netherlands
| | - Marlou L A de Kroon
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Arend F Bos
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Sa de Almeida J, Lordier L, Zollinger B, Kunz N, Bastiani M, Gui L, Adam-Darque A, Borradori-Tolsa C, Lazeyras F, Hüppi PS. Music enhances structural maturation of emotional processing neural pathways in very preterm infants. Neuroimage 2019; 207:116391. [PMID: 31765804 DOI: 10.1016/j.neuroimage.2019.116391] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/18/2019] [Accepted: 11/21/2019] [Indexed: 11/26/2022] Open
Abstract
Prematurity disrupts brain maturation by exposing the developing brain to different noxious stimuli present in the neonatal intensive care unit (NICU) and depriving it from meaningful sensory inputs during a critical period of brain development, leading to later neurodevelopmental impairments. Musicotherapy in the NICU environment has been proposed to promote sensory stimulation, relevant for activity-dependent brain plasticity, but its impact on brain structural maturation is unknown. Neuroimaging studies have demonstrated that music listening triggers neural substrates implied in socio-emotional processing and, thus, it might influence networks formed early in development and known to be affected by prematurity. Using multi-modal MRI, we aimed to evaluate the impact of a specially composed music intervention during NICU stay on preterm infant's brain structure maturation. 30 preterm newborns (out of which 15 were exposed to music during NICU stay and 15 without music intervention) and 15 full-term newborns underwent an MRI examination at term-equivalent age, comprising diffusion tensor imaging (DTI), used to evaluate white matter maturation using both region-of-interest and seed-based tractography approaches, as well as a T2-weighted image, used to perform amygdala volumetric analysis. Overall, WM microstructural maturity measured through DTI metrics was reduced in preterm infants receiving the standard-of-care in comparison to full-term newborns, whereas preterm infants exposed to the music intervention demonstrated significantly improved white matter maturation in acoustic radiations, external capsule/claustrum/extreme capsule and uncinate fasciculus, as well as larger amygdala volumes, in comparison to preterm infants with standard-of-care. These results suggest a structural maturational effect of the proposed music intervention on premature infants' auditory and emotional processing neural pathways during a key period of brain development.
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Affiliation(s)
- Joana Sa de Almeida
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - Lara Lordier
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Nicolas Kunz
- Center of BioMedical Imaging (CIBM), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Matteo Bastiani
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, UK; NIHR Biomedical Research Centre, University of Nottingham, UK; Wellcome Centre for Integrative Neuroimaging (WIN) - Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, UK
| | - Laura Gui
- Department of Radiology and Medical Informatics, Center of BioMedical Imaging (CIBM), University of Geneva, Geneva, Switzerland
| | - Alexandra Adam-Darque
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - Cristina Borradori-Tolsa
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - François Lazeyras
- Department of Radiology and Medical Informatics, Center of BioMedical Imaging (CIBM), University of Geneva, Geneva, Switzerland
| | - Petra S Hüppi
- Division of Development and Growth, Department of Woman, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.
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