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Craft AL, Camerota M, Loncar C, Carter BS, Check J, Helderman JB, Hofheimer JA, McGowan EC, Neal CR, O'Shea TM, Pastyrnak SL, Smith LM, Dansereau LM, DellaGrotta SA, Marsit C, Lester BM. Neonatal neurobehavior associated with developmental changes from age 2 to 3 in very preterm infants. Early Hum Dev 2024; 194:106039. [PMID: 38759420 PMCID: PMC11179958 DOI: 10.1016/j.earlhumdev.2024.106039] [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: 02/28/2024] [Revised: 05/13/2024] [Accepted: 05/13/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE Understand how high-risk infants' development changes over time. Examine whether NICU Network Neurobehavioral Scale (NNNS) profiles are associated with decrements in developmental outcomes between ages 2 and 3 years in infants born very preterm. STUDY DESIGN The Neonatal Outcomes for Very preterm Infants (NOVI) cohort is a multisite prospective study of 704 preterm infants born <30 weeks' gestation across nine university and VON affiliated NICUs. Data included infant neurobehavior measured by NNNS profiles at NICU discharge and the Bayley Scales of Infant and Toddler Development (BSID-III) at ages 2 and 3 years. Generalized estimating equations tested associations between NNNS profiles and BSID-III composite score changes between ages 2 and 3 years. RESULTS The final study sample included 433 infants with mean gestational age of 27 weeks at birth. Infants with dysregulated NNNS profiles were more likely to have decreases in BSID-III Cognitive (OR = 2.66) and Language scores (OR = 2.53) from age 2 to 3 years compared to infants with more well-regulated neurobehavioral NNNS profiles. Further, infants with more well-regulated NNNS profiles were more likely to have increases in BSID-III Cognitive scores (OR = 2.03), rather than no change, compared to infants with dysregulated NNNS profiles. CONCLUSIONS AND RELEVANCE Prior to NICU discharge, NNNS neurobehavioral profiles identified infants at increased risk for developing later language and cognitive challenges. Findings suggests that neonatal neurobehavior provides a unique, clinically significant contribution to the evaluation of very preterm infants to inform treatment planning for the most vulnerable.
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Affiliation(s)
- Alexandrea L Craft
- Women and Infants Hospital, Providence, RI, United States of America; Warren Alpert Medical School of Brown University, Providence, RI, United States of America.
| | - Marie Camerota
- Women and Infants Hospital, Providence, RI, United States of America; Warren Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Cynthia Loncar
- Women and Infants Hospital, Providence, RI, United States of America
| | - Brian S Carter
- Children's Mercy Hospital, Kansas City, MO, United States of America
| | - Jennifer Check
- Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | | | | | - Elisabeth C McGowan
- Women and Infants Hospital, Providence, RI, United States of America; Warren Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Charles R Neal
- University of Hawaii John A. Burns School of Medicine, Honolulu, HI, United States of America
| | - T Michael O'Shea
- UNC School of Medicine, Chapel Hill, NC, United States of America
| | - Steven L Pastyrnak
- Spectrum Health-Helen Devos Hospital, Grand Rapids, MI, United States of America
| | - Lynne M Smith
- Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Lynne M Dansereau
- Women and Infants Hospital, Providence, RI, United States of America
| | | | - Carmen Marsit
- Rollins School of Public Health of Emory University, Atlanta, GA, United States of America
| | - Barry M Lester
- Women and Infants Hospital, Providence, RI, United States of America; Warren Alpert Medical School of Brown University, Providence, RI, United States of America
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Bakker L, Jackson B, Miles A. The Impact of Physical and Environment Factors on Parental Presence for Oral Feeding in New Zealand Neonatal Intensive Care Units. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:166-182. [PMID: 38083855 DOI: 10.1177/19375867231216517] [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] [Indexed: 05/09/2024]
Abstract
AIM To identify physical environmental factors influencing family involvement in feeding in New Zealand neonatal units. BACKGROUND Infant oral feeding development is critical for both short-term feeding skills and longer term neurodevelopmental outcomes. The neonatal environment is well-known as challenging for neuroprotection due to negative sensory exposure. The impact of environmental factors on oral feeding in New Zealand (NZ) neonatal units is currently unexplored, and knowledge of this could allow for evidence-based unit design. METHODS Focused ethnography at five neonatal units, a national survey of NZ neonatal professionals (n = 102), and five focus groups were carried out. Current oral feeding practice, and beliefs, experiences, and opinions of unit staff and family about these practices were explored. Data were analyzed using qualitative content analysis. RESULTS Units were providing the best experience to families that they could with the resources they had available. Lack of physical space, lack of privacy, limited on-site accommodation for families, and lack of coordination between maternity and neonatal services were identified as impacting on family's comfort and sense of homeliness on the unit. Unit staff used furniture, screens, and external accommodation providers to support families where they could. CONCLUSIONS The physical design of neonatal units in New Zealand provides barriers to family's spending time privately developing oral feeding. Solutions are proposed to increase the size of bedspaces, provide single-family rooms, create greater on-site family accommodation options, combine maternity and neonatal healthcare, and improve family comfort and therefore connection with their infant.
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Affiliation(s)
- Lise Bakker
- Child Development Service, Palmerston North, New Zealand
- Te Whatu Ora Health New Zealand | Te Pae Hauora O Ruahine O Tararua Midcentral, New Zealand
| | - Bianca Jackson
- School of Psychology, The University of Auckland, New Zealand
| | - Anna Miles
- School of Psychology, The University of Auckland, New Zealand
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Nimmapirat P, Fiedler N, Suttiwan P, Sullivan MW, Ohman-Strickland P, Panuwet P, Barr DB, Prapamontol T, Naksen W. Predictors of executive function among 2 year olds from a Thai birth cohort. Infant Behav Dev 2024; 74:101916. [PMID: 38096613 PMCID: PMC10947867 DOI: 10.1016/j.infbeh.2023.101916] [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: 12/20/2022] [Revised: 09/05/2023] [Accepted: 12/06/2023] [Indexed: 01/31/2024]
Abstract
Executive function (EF) is a critical skill for academic achievement. Research on the psychosocial and environmental predictors of EF, particularly among Southeast Asian, agricultural, and low income/rural populations, is limited. Our longitudinal study explored the influence of agricultural environmental, psychosocial, and temperamental factors on children's emerging EF. Three-hundred and nine farm worker women were recruited during the first trimester of pregnancy. We evaluated the effects of prenatal insecticide exposure and psychosocial factors on "cool" (i.e., cognitive: A-not-B task, looking version) and "hot" EF (i.e., affective, response inhibition) measures of emerging EF. Maternal urine samples were collected monthly during pregnancy, composited, and analyzed for dialkylphosphate (DAP) metabolites of organophosphate insecticides. Psychosocial factors included socioeconomic status, maternal psychological factors, and quality of mother-child behavioral interactions. Backward stepwise regressions evaluated predictors of children's EF at 12 (N = 288), 18 (N = 277) and 24 (N = 280) months of age. We observed different predictive models for cool EF, as measured by A-not-B task, vs. hot EF, as measured by response inhibition tasks. Report of housing quality as a surrogate for income was a significant predictor of emerging EF. However, these variables had opposite effects for cool vs. hot EF. More financial resources predicted better cool EF performance but poorer hot EF performance. Qualitative findings indicate that homes with fewer resources were in tribal areas where children must remain close to an adult for safety reasons. This finding suggests that challenging physical environments (e.g., an elevated bamboo home with no electricity or running water), may contribute to development of higher levels of response inhibition through parental socialization methods that emphasize compliance. Children who tended to show more arousal and excitability, and joy reactivity as young infants in the laboratory setting had better cognitive performance. In contrast, maternal emotional availability was a significant predictor of hot EF. As expected, increased maternal exposure to pesticides during pregnancy was associated with worse cognitive performance but was not associated with inhibitory control. Identifying risk factors contributing to the differential developmental pathways of cool and hot EF will inform prevention strategies to promote healthy development in this and other unstudied rural, low income Southeast Asian farming communities.
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Affiliation(s)
- Pimjuta Nimmapirat
- Chulalongkorn University, Faculty of Psychology, LIFE Di Center, Bangkok, Thailand
| | - Nancy Fiedler
- Rutgers School of Public Health, Department of Environmental and Occupational Health and Justice, Piscataway, NJ, USA
| | - Panrapee Suttiwan
- Chulalongkorn University, Faculty of Psychology, LIFE Di Center, Bangkok, Thailand.
| | | | - Pamela Ohman-Strickland
- Rutgers School of Public Health, Department of Biostatistics and Epidemiology, Piscataway, NJ, USA
| | - Parinya Panuwet
- Emory University, Rollins School of Public Health, Gangarosa Department of Environmental Health, Atlanta, GA, USA
| | - Dana Boyd Barr
- Emory University, Rollins School of Public Health, Gangarosa Department of Environmental Health, Atlanta, GA, USA
| | - Tippawan Prapamontol
- Chiang Mai University, Research Institute for Health Sciences, Chiang Mai, Thailand
| | - Warangkana Naksen
- Chiang Mai University, Faculty of Public Health, Chiang Mai, Thailand
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Reynold de Seresin M, Roy A, Theveniaut C, Le Goff J, Chopin C, Rouger V, Roze JC, Flamant C, Muller JB. Assessing of executive functions in daily life in preterm children aged 3-4 years old from the "Behavior Rating Inventory of Executive Function-Preschool version" questionnaire. Front Pediatr 2023; 11:999100. [PMID: 37565238 PMCID: PMC10410931 DOI: 10.3389/fped.2023.999100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 06/26/2023] [Indexed: 08/12/2023] Open
Abstract
Background Executive functions (EFs) are a set of neuropsychological skills permitting solving problems in a new situation by regulating action, behavior, and emotional response. As cerebral maturation remains vulnerable in preterm children, a higher risk of developing cognitive disorders including EFs exist compared to term children. Aims The aim of this study was to estimate the incidence of preschool EF impairments through proxy reports in children born preterm before 34 weeks of gestational age using the Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P) version. Secondary aims were to report neonatal, child, or socioeconomic factors associated with EF disorders. Results Parents of 357 children born preterm aged 3-4 years old completed the BRIEF-P version. Impairment in EFs was clinically significant for 13.5% of preterm children (n = 47; 95% CI = 0.10-0.18) compared to 5.1% in term children. A low parental socioeconomic level was significantly associated with impaired parent-rated EF (19.1% vs. 5.3%, p = 0.003). Conclusions Proxy reports of EF impairment are about twice as frequent as in term children. EF difficulties are not related to neonatal or child severity factors in contrast with the parental socioeconomic level. Using a parent-rated questionnaire may be a useful and easy tool to identify early the daily life impact of EF disorders on clinical follow-up of preterm children.This study was recorded in the Clinical Trials Register under identifier NCT03700463.
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Affiliation(s)
- Magali Reynold de Seresin
- Pediatric and Neonatal Intensive Care Unit, Nantes University Hospital, Nantes, France
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
| | - Arnaud Roy
- Department of Psychology, Psychology Laboratory, University of Angers, Angers, France
- Reference Center for Learning Disabilities, Nantes University Hospital, Nantes, France
- Univ Angers, Nantes Université, LPPL, SFR CONFLUENCES, Angers, France
| | - Camille Theveniaut
- Pediatric and Neonatal Intensive Care Unit, Nantes University Hospital, Nantes, France
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
| | - Justine Le Goff
- Reference Center for Learning Disabilities, Nantes University Hospital, Nantes, France
| | - Coline Chopin
- Reference Center for Learning Disabilities, Nantes University Hospital, Nantes, France
| | - Valérie Rouger
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
| | - Jean-Christophe Roze
- Pediatric and Neonatal Intensive Care Unit, Nantes University Hospital, Nantes, France
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
- Epidemiologie Clinique, Centre d'Investigation Clinique (CIC004), Nantes University Hospital, Nantes, France
| | - Cyril Flamant
- Pediatric and Neonatal Intensive Care Unit, Nantes University Hospital, Nantes, France
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
- Epidemiologie Clinique, Centre d'Investigation Clinique (CIC004), Nantes University Hospital, Nantes, France
| | - Jean-Baptiste Muller
- Pediatric and Neonatal Intensive Care Unit, Nantes University Hospital, Nantes, France
- Réseau “Grandir Ensemble”, Nantes University Hospital, Nantes, France
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Campbell K, Malik L, Jones C, Ou Z, Presson A, Miller TA, Winter S, Glotzbach K. Abnormal infant neurobehavior and later neurodevelopmental delays in children with critical CHD. Cardiol Young 2023; 33:1102-1111. [PMID: 35833213 PMCID: PMC10704708 DOI: 10.1017/s1047951122002013] [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] [Indexed: 11/06/2022]
Abstract
Infants with critical CHD have abnormal neurobehavior assessed by the Neonatal ICU Network Neurobehavioral Scales. This retrospective cohort study hypothesized associations between abnormal infant neurobehavior in the first month of life and later neurodevelopmental outcomes at 1-2 years of age. Associations between abnormal infant attention (orienting to and tracking stimuli) on the Neonatal ICU Network Neurobehavioral Scales and later motor, cognitive, and language neurodevelopmental outcomes on the Bayley Scales of Infant Development-III at follow-up were examined with descriptive statistics and univariable and multivariable regression. Multiple imputation was used to account for missing outcome data. 189 infants with critical CHD were included, and 69% had abnormal neurobehavioral attention scores. 58 (31%) returned as toddlers for neurodevelopmental follow-up, of which 23% had motor delay. Abnormal infant attention had high sensitivity (92%, 95% CI 60-100%) but low specificity (36%, 95% CI 23-52%) for later motor delay. Higher infant attention scores were associated with higher later motor scores in univariable analysis (coefficient 3.49, 95% CI 0.52,6.46, p = 0.025), but not in multivariable analyses. Neither cognitive nor language scores were associated with infant attention scores. Lower birth weight and male sex were significantly associated with lower motor scores in multivariable analysis (p = 0.048, 0.007). Although impaired infant attention is interdependent with other clinical and demographic risk factors, it may be a sensitive clinical marker of risk for later motor delay. In children with critical CHD, impaired infant attention may be capturing early signs of abnormal visual-motor neurodevelopment.
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Affiliation(s)
- Kathleen Campbell
- Department of Pediatrics, Division of General Pediatrics, University of Utah, Salt Lake City, UT, USA
- Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lauren Malik
- Department of Pediatrics, Intermountain Primary Children’s Hospital, Salt Lake City, UT, USA
| | - Courtney Jones
- Department of Pediatrics, Intermountain Primary Children’s Hospital, Salt Lake City, UT, USA
| | - Zhining Ou
- Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, UT, USA
| | - Angela Presson
- Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, UT, USA
| | - Thomas A. Miller
- Department of Cardiovascular Services, Division of Pediatric Cardiology, Maine Medical Center, Portland, ME, USA
| | - Sarah Winter
- Department of Pediatrics, Division of General Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Kristi Glotzbach
- Department of Pediatrics, Division of Critical Care Medicine, University of Utah, Salt Lake City, UT, USA
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Fournier-Goodnight A, Holm HB. Early neurobehavioral outcomes in infants with suspected abusive head trauma: Performance across and relationship between measures. APPLIED NEUROPSYCHOLOGY. CHILD 2023:1-9. [PMID: 37116100 DOI: 10.1080/21622965.2023.2206030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Early neurobehavioral outcomes among infants with abusive head trauma (AHT) have not been well characterized. Though there are standardized measures for assessing infants, the ability of these measures to detect deficits may be limited. The Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale, Second Edition (NNNS-II) has been correlated with neurobehavioral outcomes as early as birth but has not been used with this clinical group. There is no strong evidence of the concurrent validity of this measure. The primary goal was to examine the concurrent validity of the NNNS-II in patients with suspected AHT by comparing it to the Mullen Scales of Early Learning, American Guidance Service (AGS) Edition (Mullen). A secondary goal was to characterize early neurobehavioral outcomes among infants with suspected AHT across two measures. This retrospective study included 11 infants who sustained a traumatic brain injury (TBI) around 40 days of age. The sample's performance was variable and ranged from average to below average across measures. Participants experienced the most difficulty with visuospatial processing, attentional abilities, physiologic regulation, and asymmetric reflexes, and data suggested the NNNS-II may be more sensitive to deficits. There was evidence of concurrent validity of the NNNS-II based on strong to moderate correlations with the Mullen. Use of the NNNS-II shortly after the injury is more likely to showcase deficits, which may increase the likelihood that patients receive early intervention. Establishing concurrent validity of the NNNS-II further contributes to the evidence base regarding its criterion related validity, which may promote its more regular use.
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Affiliation(s)
| | - Haley Bednarz Holm
- Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
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Anquetil M, Roche-Labarbe N, Rossi S. Tactile sensory processing as a precursor of executive attention: Toward early detection of attention impairments and neurodevelopmental disorders. WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2022:e1640. [PMID: 36574728 DOI: 10.1002/wcs.1640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 09/30/2022] [Accepted: 11/21/2022] [Indexed: 12/28/2022]
Abstract
Recent studies in developmental neuroscience tend to show the existence of neural attention networks from birth. Their construction is based on the first sensory experiences that allow us to learn the patterns of the world surrounding us and preserve our limited attentional resources. Touch is the first sensory modality to develop, although it is still little studied in developmental psychology in contrast to distal modalities such as audition or vision. Atypical tactile sensory processing at an early age could predict later attention dysfunction, both of them being part of the symptomatology of neurodevelopmental disorders (NDD). We review the state of knowledge on tactile sensory processing and its links with attention, executive attention (EA) in particular, and propose that abnormal tactile sensory processing at an early age could provide markers of EA dysfunctions, contributing to the early detection of NDD. This article is categorized under: Psychology > Attention.
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Impaired in vivo feto-placental development is associated with neonatal neurobehavioral outcomes. Pediatr Res 2022; 93:1276-1284. [PMID: 36335267 PMCID: PMC10147575 DOI: 10.1038/s41390-022-02340-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Fetal growth restriction (FGR) is a risk factor for neurodevelopmental problems, yet remains poorly understood. We sought to examine the relationship between intrauterine development and neonatal neurobehavior in pregnancies diagnosed with antenatal FGR. METHODS We recruited women with singleton pregnancies diagnosed with FGR and measured placental and fetal brain volumes using MRI. NICU Network Neurobehavioral Scale (NNNS) assessments were performed at term equivalent age. Associations between intrauterine volumes and neurobehavioral outcomes were assessed using generalized estimating equation models. RESULTS We enrolled 44 women diagnosed with FGR who underwent fetal MRI and 28 infants underwent NNNS assessments. Placental volumes were associated with increased self-regulation and decreased excitability; total brain, brainstem, cortical and subcortical gray matter (SCGM) volumes were positively associated with higher self-regulation; SCGM also was positively associated with higher quality of movement; increasing cerebellar volumes were positively associated with attention, decreased lethargy, non-optimal reflexes and need for special handling; brainstem volumes also were associated with decreased lethargy and non-optimal reflexes; cerebral and cortical white matter volumes were positively associated with hypotonicity. CONCLUSION Disrupted intrauterine growth in pregnancies complicated by antenatally diagnosed FGR is associated with altered neonatal neurobehavior. Further work to determine long-term neurodevelopmental impacts is warranted. IMPACT Fetal growth restriction is a risk factor for adverse neurodevelopment, but remains difficult to accurately identify. Intrauterine brain volumes are associated with infant neurobehavior. The antenatal diagnosis of fetal growth restriction is a risk factor for abnormal infant neurobehavior.
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Dumont V, Giovannella M, Zuba D, Clouard R, Durduran T, Guillois B, Roche-Labarbe N. Somatosensory prediction in the premature neonate brain. Dev Cogn Neurosci 2022; 57:101148. [PMID: 36027649 PMCID: PMC9428805 DOI: 10.1016/j.dcn.2022.101148] [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: 06/13/2022] [Revised: 07/11/2022] [Accepted: 08/18/2022] [Indexed: 11/18/2022] Open
Abstract
Sensory prediction (SP) is at the core of early cognitive development. Impaired SP may be a key to understanding the emergence of neurodevelopmental disorders, however there is little data on how and when this skill emerges. We set out to provide evidence of SP in the brain of premature neonates in the fundamental sensory modality: touch. Using Diffuse Correlation Spectroscopy, we measured blood flow changes in the somatosensory cortex of premature neonates presented with a vibrotactile stimulation-omission sequence. When ISI was fixed, participants presented a decrease in blood flow during stimulus omissions, starting when a stimulus should begin: the expectation of a certain stimulus onset induced deactivation of the somatosensory cortex. When ISI was jittered, we observed an increase in blood flow during omissions: the expectation of a likely but not certain stimulus onset induced activation of the somatosensory cortex. Our results reveal SP in the brain as early as four weeks before term, based on the temporal structure of a unimodal somatosensory stimulation, and show that SP produces opposite regulation of activity in the somatosensory cortex depending on how liable is stimulus onset. Future studies will investigate the predictive value of somatosensory prediction on neurodevelopment in this vulnerable population.
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Affiliation(s)
- Victoria Dumont
- Normandie Univ, UNICAEN, LPCN, 14000 Caen, France; Normandie Univ, UNICAEN, INSERM, COMETE, 14000 Caen, France.
| | - Martina Giovannella
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain
| | - Daniel Zuba
- Normandie Univ, UNICAEN, INSERM, COMETE, 14000 Caen, France; CHU, 14000 Caen, France
| | - Régis Clouard
- Normandie Univ, UNICAEN, ENSICAEN, CNRS, GREYC, 14000 Caen, France
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels (Barcelona), Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), 08015 Barcelona, Spain
| | - Bernard Guillois
- Normandie Univ, UNICAEN, LPCN, 14000 Caen, France; CHU, 14000 Caen, France
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Parikh AN, Triplett RL, Wu TJ, Arora J, Lukas K, Smyser TA, Miller JP, Luby JL, Rogers CE, Barch DM, Warner BB, Smyser CD. Neonatal Intensive Care Unit Network Neurobehavioral Scale Profiles in Full-Term Infants: Associations with Maternal Adversity, Medical Risk, and Neonatal Outcomes. J Pediatr 2022; 246:71-79.e3. [PMID: 35430247 PMCID: PMC10030163 DOI: 10.1016/j.jpeds.2022.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 03/01/2022] [Accepted: 04/08/2022] [Indexed: 01/30/2023]
Abstract
OBJECTIVES To examine healthy, full-term neonatal behavior using the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) in relation to measures of maternal adversity, maternal medical risk, and infant brain volumes. STUDY DESIGN This was a prospective, longitudinal, observational cohort study of pregnant mothers followed from the first trimester and their healthy, full-term infants. Infants underwent an NNNS assessment and high-quality magnetic resonance imaging 2-5 weeks after birth. A latent profile analysis of NNNS scores categorized infants into neurobehavioral profiles. Univariate and multivariate analyses compared differences in maternal factors (social advantage, psychosocial stress, and medical risk) and neonatal characteristics between profiles. RESULTS The latent profile analysis of NNNS summary scales of 296 infants generated 3 profiles: regulated (46.6%), hypotonic (16.6%), and fussy (36.8%). Infants with a hypotonic profile were more likely to be male (χ2 = 8.601; P = .014). Fussy infants had smaller head circumferences (F = 3.871; P = .022) and smaller total brain (F = 3.522; P = .031) and cerebral white matter (F = 3.986; P = .020) volumes compared with infants with a hypotonic profile. There were no differences between profiles in prenatal maternal health, social advantage, or psychosocial stress. CONCLUSIONS Three distinct neurobehavioral profiles were identified in healthy, full-term infants with hypotonic and fussy neurobehavioral features related to neonatal brain volumes and head circumference, but not prenatal exposure to socioeconomic or psychosocial adversity. Follow-up beyond the neonatal period will determine if identified profiles at birth are associated with subsequent clinical or developmental outcomes.
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Affiliation(s)
- Amisha N Parikh
- School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Regina L Triplett
- Department of Neurology, Washington University in St. Louis, St. Louis, MO.
| | - Tiffany J Wu
- School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Jyoti Arora
- Division of Biostatistics, Washington University in St. Louis, St. Louis, MO
| | - Karen Lukas
- Department of Neurology, Washington University in St. Louis, St. Louis, MO
| | - Tara A Smyser
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO
| | - J Philip Miller
- Division of Biostatistics, Washington University in St. Louis, St. Louis, MO
| | - Joan L Luby
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO; Department of Pediatrics, Washington University in St. Louis, St. Louis, MO
| | - Deanna M Barch
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO; Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO; Department of Radiology, Washington University in St. Louis, St. Louis, MO
| | - Barbara B Warner
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO
| | - Christopher D Smyser
- Department of Neurology, Washington University in St. Louis, St. Louis, MO; Department of Pediatrics, Washington University in St. Louis, St. Louis, MO; Department of Radiology, Washington University in St. Louis, St. Louis, MO
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