Evaluation of auditory perception development in neonates by quantitative electroencephalography and auditory event-related potentials

Music Intervention for Pain Control in the Pediatric Population: A Systematic Review and Meta-Analysis

Music intervention (MI) has been applied as an effective adjunctive treatment for pain control in various clinical settings. However, no meta-analysis has yet been published on the analgesic effects of MI in infants and children. We performed a systematic review of PubMed, EMBASE, Web of Science, and Cochrane Library databases to identify randomized controlled trials (RCTs) with the keywords "pain" AND "music therapy" from inception to January 2022. Primary outcomes were pain intensity and vital signs. Standardized mean difference (SMD) values and the corresponding 95% confidence intervals (CIs) were computed using a random effect model. Subgroup analyses with age groups, types of pain, and music styles were conducted. A total of 38 RCTs involving 5601 participants met the selection criteria. MI significantly decreased the pain levels (SMD = -0.57, p < 0.001), both in the newborn group (p = 0.007) and in the infant/children group (p < 0.001). MI significantly reduced heart rate (SMD = -0.50, p < 0.001) and respiratory rate (SMD = -0.60, p = 0.002) and increased peripheral capillary oxygen saturation (SMD = 0.44, p < 0.001). In subgroup analyses of types of pain, MI had significant effects on prick pain (p = 0.003), chronic and procedural pain (p < 0.001), and postoperative pain (p = 0.018). As for music styles, significant analgesic effects were observed for classical music (p < 0.001), kids' music (p < 0.001), and pop music (p = 0.001), but not for world music (p = 0.196), special composition (p = 0.092), and multiple music combinations (p = 0.420). In conclusion, our analysis provides supportive evidence about the efficacy of MI, especially classical, kids', and pop music, in controlling prick, procedural, and postoperative pain in the pediatric population.

Mismatch response in preterm and asphyxic neonates: a functional electrophysiological investigation of attention and habituation

BACKGROUND AND AIM

There is a lack of diagnostic tools for early risk stratification of cognitive outcome in infants born preterm and infants with asphyxia. Using auditory event-related potentials and mismatch response, we aimed to assess possible differences in early attention and learning, as a marker for brain maturation to subsequently improve the allocation of early neurodevelopmental support.

STUDY DESIGN AND METHODS

This cross-sectional study included 22 very preterm infants (gestational age (GA) < 32 weeks), eight term infants with asphyxia and 35 healthy term infants. An auditory oddball-paradigm with three consecutive stimulation blocks, separated by a two-minute break, was used as a cognitive discrimination task to assess attention and habituation.

RESULTS

The peak-to-peak analysis in the group comparisons showed no significant differences for the first stimulation block. In term healthy infants and term infants after asphyxia, no significant differences were found in amplitudes between block one and three. Preterm infants showed significantly (p = .007) lower amplitudes in the third block for F7 congruent to a positive habituation. The amplitude of the grouped electrodes correlated positively with GA for frontal (R = .271, p= .029) and parietal electrodes (R =.275, p = .027).

CONCLUSION

We found no differences in the auditory attention paradigm between preterm or term asphyxic and control infants when they were evaluated at term corrected age. Most infants did not show any electrophysiologically measurable learning effect indicating habituation or dishabituation. The small sample size of this study is a clear limitation. Therefore, the results must be evaluated with caution, especially regarding their potential predictive value for future cognitive development of infants with a developmental risk. However, our study underlines the possibility of an electrophysiological evaluation as a feasible tool to assess very early cognition in infants.

Clinical Application of Combined EEG-qEEG Functional Neuroimaging in the Practice of Pediatric Neuroscience: A Personal Perspective

This brief article is an overview of my personal experience over the past almost 10 years of the clinical use of EEG and quantitative EEG (qEEG) functional neuroimaging in a busy pediatric neurology practice. The concomitant use of surface EEG and functional electromagnetic EEG neuroimaging/qEEG in clinical practice provides significant additional clinical and neurophysiologic information. The qEEG is a noninvasive, inexpensive, portable technique with high temporal resolution (milliseconds) and improving spatial resolution (down to 3 mm³) and is an appropriate and validated tool for investigation of abnormal brain dynamics and connectivity of neuronal networks in clinical disorders of the brain. This article describes the daily applicability and utility of this modality in assisting diagnosis and clinical management of patients with a wide variety of presenting symptoms, including headaches, tics, autism spectrum disorder, inattention, sleep dysregulation, anxiety, and depression. The ease of data acquisition and analysis in clinical practices, coupled with skilled interpretation and clinical application, makes this tool one of the most valuable clinical tools to complement a thorough history and examination process.

[Effect of blood glucose on quantitative electroencephalography parameters in preterm infants]

OBJECTIVE

To study the value of quantitative electroencephalography (qEEG) in evaluating the effect of blood glucose on the brain function of preterm infants.

METHODS

The preterm infants who were admitted to the Department of Neonatology, The Third Xiangya Hospital of Central South University, from January to December 2019 were enrolled. According to the level of blood glucose, they were divided into group 1 (blood glucose <4.95 mmol/L), group 2 (blood glucose 4.95 to <6.60 mmol/L), group 3 (blood glucose 6.60 to <8.55 mmol/L), and group 4 (blood glucose ≥8.55 mmol/L). The changes in qEEG parameters were compared between groups, and a correlation analysis was performed for blood glucose and qEEG parameters.

RESULTS

A total of 39 preterm infants were enrolled (84 blood glucose measurements). Compared with group 4, the other three groups had significant increases in the total spectral power of each brain region and the absolute power of each frequency band in the frontal and occipital regions (P<0.05). The total spectral power, δ/θ ratio, and (δ+θ)/(α+β) ratio of each brain region were negatively correlated with blood glucose level, while the relative power of θ frequency band was positively correlated with blood glucose level (P<0.05).

CONCLUSIONS

With the change in blood glucose, there are significant changes in the total spectral power of each brain region, the power of each frequency band, and the frequency spectrum composition on qEEG in preterm infants. qEEG may therefore become an important tool to monitor the effect of abnormal blood glucose on brain function in preterm infants.