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de Groot ER, Dudink J, Austin T. Sleep as a driver of pre- and postnatal brain development. Pediatr Res 2024:10.1038/s41390-024-03371-5. [PMID: 38956219 DOI: 10.1038/s41390-024-03371-5] [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: 04/10/2024] [Revised: 06/11/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024]
Abstract
In 1966, Howard Roffwarg proposed the ontogenic sleep hypothesis, relating neural plasticity and development to rapid eye movement (REM) sleep, a hypothesis that current fetal and neonatal sleep research is still exploring. Recently, technological advances have enabled researchers to automatically quantify neonatal sleep architecture, which has caused a resurgence of research in this field as attempts are made to further elucidate the important role of sleep in pre- and postnatal brain development. This article will review our current understanding of the role of sleep as a driver of brain development and identify possible areas for future research. IMPACT: The evidence to date suggests that Roffwarg's ontogenesis hypothesis of sleep and brain development is correct. A better understanding of the relationship between sleep and the development of functional connectivity is needed. Reliable, non-invasive tools to assess sleep in the NICU and at home need to be tested in a real-world environment and the best way to promote healthy sleep needs to be understood before clinical trials promoting and optimizing sleep quality in neonates could be undertaken.
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Affiliation(s)
- Eline R de Groot
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
- Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Topun Austin
- NeoLab, Evelyn Perinatal Imaging Centre, The Rosie Hospital, Cambridge University Hospitals, Cambridge, UK.
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Di Fiore JM, Liu G, Loparo KA, Bearer CF. The effect of early postnatal auditory stimulation on outcomes in preterm infants. Pediatr Res 2024:10.1038/s41390-024-03329-7. [PMID: 38909158 DOI: 10.1038/s41390-024-03329-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/18/2024] [Indexed: 06/24/2024]
Abstract
Preterm infants are deprived of in utero sensory stimulation during the third trimester, an important period of central nervous system development. As a result, maturational trajectories are often reduced in infants born preterm. One such system affected is the brain including the auditory and respiratory control pathways. During normal pregnancy the intrauterine environment attenuates external auditory stimuli while exposing the fetus to filtered maternal voice, intra-abdominal sounds, and external stimuli. In contrast, during the third trimester of development, preterm infants are exposed to a vastly different soundscape including non-attenuated auditory sounds and a lack of womb related stimuli, both of which may affect postnatal brain maturation. Therefore, fostering a nurturing postnatal auditory environment during hospitalization may have a significant impact on related outcomes of preterm infants. Studies using a range of postnatal auditory stimulations have suggested that exposure to sounds or lack thereof can have a significant impact on outcomes. However, studies are inconsistent with sound levels, duration of exposure to auditory stimuli, and the gestational age at which infants are exposed. IMPACT: Auditory stimulation can provide a low cost and low risk intervention to stabilize respiration, improve neuronal maturation and reduce long-term sequelae in preterm infants. The potential benefits of auditory stimulation are dependent on the type of sound, the duration of exposure and age at time of exposure. Future studies should focus on the optimal type and duration of sound exposure and postnatal developmental window to improve outcomes.
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Affiliation(s)
- Juliann M Di Fiore
- Dept of Pediatrics, Case Western Reserve University, Cleveland, OH, 44016, USA
- Division of Neonatology, Rainbow Babies and Children's Hospital, Cleveland, OH, 44016, USA
| | - Gloria Liu
- Dept of Pediatrics, Case Western Reserve University, Cleveland, OH, 44016, USA
| | - Kenneth A Loparo
- ISSACS: Institute for Smart, Secure and Connected Systems, Case Western Reserve University, Cleveland, OH, USA
| | - Cynthia F Bearer
- Dept of Pediatrics, Case Western Reserve University, Cleveland, OH, 44016, USA.
- Division of Neonatology, Rainbow Babies and Children's Hospital, Cleveland, OH, 44016, USA.
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Schmidt Mellado G, Pillay K, Adams E, Alarcon A, Andritsou F, Cobo MM, Evans Fry R, Fitzgibbon S, Moultrie F, Baxter L, Slater R. The impact of premature extrauterine exposure on infants' stimulus-evoked brain activity across multiple sensory systems. Neuroimage Clin 2021; 33:102914. [PMID: 34915328 PMCID: PMC8683775 DOI: 10.1016/j.nicl.2021.102914] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/10/2021] [Accepted: 12/09/2021] [Indexed: 11/03/2022]
Abstract
Prematurity can result in widespread neurodevelopmental impairment, with the impact of premature extrauterine exposure on brain function detectable in infancy. A range of neurodynamic and haemodynamic functional brain measures have previously been employed to study the neurodevelopmental impact of prematurity, with methodological and analytical heterogeneity across studies obscuring how multiple sensory systems are affected. Here, we outline a standardised template analysis approach to measure evoked response magnitudes for visual, tactile, and noxious stimulation in individual infants (n = 15) using EEG. By applying these templates longitudinally to an independent cohort of very preterm infants (n = 10), we observe that the evoked response template magnitudes are significantly associated with age-related maturation. Finally, in a cross-sectional study we show that the visual and tactile response template magnitudes differ between a cohort of infants who are age-matched at the time of study but who differ according to whether they are born during the very preterm or late preterm period (n = 10 and 8 respectively). These findings demonstrate the significant impact of premature extrauterine exposure on brain function and suggest that prematurity can accelerate maturation of the visual and tactile sensory system in infants born very prematurely. This study highlights the value of using a standardised multi-modal evoked-activity analysis approach to assess premature neurodevelopment, and will likely complement resting-state EEG and behavioural assessments in the study of the functional impact of developmental care interventions.
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Affiliation(s)
| | - Kirubin Pillay
- Department of Paediatrics, University of Oxford, Oxford, UK
| | - Eleri Adams
- Newborn Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Ana Alarcon
- Newborn Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Department of Neonatology, Hospital Sant Joan de Deu, Institut de Recerca Sant Joan de Deu, Universitat de Barcelona, Barcelona, Spain
| | | | - Maria M Cobo
- Department of Paediatrics, University of Oxford, Oxford, UK; Universidad San Francisco de Quito USFQ, Colegio de Ciencias Biologicas y Ambientales, Quito, Ecuador
| | - Ria Evans Fry
- Department of Paediatrics, University of Oxford, Oxford, UK
| | - Sean Fitzgibbon
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Fiona Moultrie
- Department of Paediatrics, University of Oxford, Oxford, UK
| | - Luke Baxter
- Department of Paediatrics, University of Oxford, Oxford, UK.
| | - Rebeccah Slater
- Department of Paediatrics, University of Oxford, Oxford, UK.
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Bone conducted responses in the neonatal rat auditory cortex. Sci Rep 2021; 11:16777. [PMID: 34408208 PMCID: PMC8373948 DOI: 10.1038/s41598-021-96188-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/22/2021] [Indexed: 12/14/2022] Open
Abstract
Rats are born deaf and start hearing at the end of the second postnatal week, when the ear canals open and low-intensity sounds start to evoke responses in the auditory cortex. Here, using μECoG electrode arrays and intracortical silicon probe recordings, we found that bone-conducted (BC) sounds evoked biphasic responses in the auditory cortex starting from postnatal day (P) 8. The initial phase of these responses, generated by thalamocortical input, was followed by intracortical propagation within supragranular layers. BC-evoked responses co-localized with the responses evoked by electrical stimulation of the cochlea and the deepest layers of the inferior colliculus prior to onset of low-threshold hearing (P13), as well as with the responses evoked by high-frequency (30 kHz) low-intensity (70 dB) air-conducted sounds after that. Thus, BC signals reach high-frequency processing regions of the auditory cortex well before the onset of low-threshold hearing, reflecting early integrity of the auditory system.
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Didoné DD, Oliveira LS, Durante AS, de Almeida K, Garcia MV, Riesgo RDS, Sleifer P. Cortical auditory-evoked potential as a biomarker of central auditory maturation in term and preterm infants during the first 3 months. Clinics (Sao Paulo) 2021; 76:e2944. [PMID: 34669874 PMCID: PMC8491591 DOI: 10.6061/clinics/2021/e2944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/19/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To analyze central auditory maturation in term and preterm infants during the first 3 months of life by comparing the latency and amplitude of cortical auditory-evoked potential at different frequencies. METHODS In this study, 17 term and 18 preterm infants were examined; all had tested positive on the neonatal hearing screening test. Cortical auditory potential was investigated during the first and third months of life. The response of the cortical auditory-evoked potential was investigated at frequencies of 500, 1000, 2000, and 4000 Hz. The latency and amplitude of the cortical response were automatically detected and manually analyzed by three researchers with experience in electrophysiology. The results were compared using analysis of variance and the Bonferroni test. A significance level of 5% was used for all analyses. RESULTS Latency values of cortical auditory-evoked potential in the first month of birth were significantly higher than those in the third month, and latency values of the preterm group were higher than those of the term group, regardless of the frequency and time of evaluation. In general, the latency of the cortical auditory-evoked potential was higher at high frequencies. Amplitude values in the third month of life were significantly higher than those in the first month for term and preterm infants. CONCLUSION Central auditory maturation was observed in both groups but with different results between those born at term and preterm, with latencies of cortical auditory-evoked potential higher for the preterm group and at high frequencies.
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Affiliation(s)
- Dayane Domeneghini Didoné
- Programa de Pos-Graduacao em Saude da Crianca e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, BR
- Corresponding author. E-mail:
| | | | | | - Kátia de Almeida
- Faculdade de Ciencias Medicas, Santa Casa de Sao Paulo, (FCMSCSP), Sao Paulo, SP, BR
| | | | - Rudimar dos Santos Riesgo
- Programa de Pos-Graduacao em Saude da Crianca e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, BR
| | - Pricila Sleifer
- Departamento de Saude e Comunicacao Humana, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, BR
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