Nociceptive Cortical Activity Is Dissociated from Nociceptive Behavior in Newborn Human Infants under Stress.
Nociceptive Cortical Activity Is Dissociated from Nociceptive Behavior in Newborn Human Infants under Stress.
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DOI：
10.1016/j.cub.2017.10.063
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发表时间：
2017-12-18
期刊：
影响因子：
--
通讯作者：
Fitzgerald M
中科院分区：
文献类型：
--
作者：
Jones L;Fabrizi L;Laudiano-Dray M;Whitehead K;Meek J;Verriotis M;Fitzgerald M
新生婴儿对组织损伤刺激表现出强烈的伤害性行为，并且伴随着大脑皮质下和皮质区域产生的伤害性活动。在没有口头报告的情况下，这些伤害性反应被用来衡量新生儿的疼痛感，就像动物一样。然而，许多婴儿是在生理压力环境中长大的，而人们对背景压力水平对其疼痛反应的影响知之甚少。在成人中，急性生理压力会导致痛觉过敏，而背景压力的增加会增加疼痛，但这些数据不一定能推断到婴儿身上。在这里，我们同时测量了 56 名 36-42 周新生婴儿的伤害感受行为、大脑活动和生理压力水平。在临床所需的足跟矛后，采集个体婴儿的唾液皮质醇（下丘脑垂体轴）、心率变异性（交感肾上腺髓质系统）、脑电图事件相关电位（伤害性皮层活动）和面部表情（行为）。我们发现，压力水平较高的婴儿表现出更大幅度的皮质伤害性反应，但这并没有反映在他们的行为中。此外，虽然伤害性行为和皮质活动通常是相关的，但这种关系在生理压力较高的婴儿中会被破坏。因此，有害刺激引起的大脑活动会因压力而增强，但这不能从疼痛行为的观察中推断出来。这对于预防早期重复性疼痛对大脑发育的不利影响可能很重要。婴儿疼痛行为和伤害性大脑活动通常相关 压力会破坏婴儿疼痛性大脑活动和行为之间的关系 压力与伤害性大脑活动增加有关，但与行为无关 压力是评估婴儿疼痛体验时的一个重要因素 Jones 等人。研究表明，通过皮质醇和心率变异性测量的婴儿的高生理压力与皮质疼痛活动的增加有关，但与疼痛行为的增加无关。压力会破坏伤害性大脑活动和行为之间的关系，并且是预测婴儿疼痛时的一个重要的无关因素。
Newborn infants display strong nociceptive behavior in response to tissue damaging stimuli, and this is accompanied by nociceptive activity generated in subcortical and cortical areas of the brain. In the absence of verbal report, these nociceptive responses are used as measures of pain sensation in newborn humans, as they are in animals. However, many infants are raised in a physiologically stressful environment, and little is known about the effect of background levels of stress upon their pain responses. In adults, acute physiological stress causes hyperalgesia, and increased background stress increases pain, but these data cannot necessarily be extrapolated to infants. Here we have simultaneously measured nociceptive behavior, brain activity, and levels of physiological stress in a sample of 56 newborn human infants aged 36–42 weeks. Salivary cortisol (hypothalamic pituitary axis), heart rate variability (sympathetic adrenal medullary system), EEG event-related potentials (nociceptive cortical activity), and facial expression (behavior) were acquired in individual infants following a clinically required heel lance. We show that infants with higher levels of stress exhibit larger amplitude cortical nociceptive responses, but this is not reflected in their behavior. Furthermore, while nociceptive behavior and cortical activity are normally correlated, this relationship is disrupted in infants with high levels of physiological stress. Brain activity evoked by noxious stimulation is therefore enhanced by stress, but this cannot be deduced from observation of pain behavior. This may be important in the prevention of adverse effects of early repetitive pain on brain development. Infant pain behavior and nociceptive brain activity are generally correlated Stress disrupts the relationship between infant pain brain activity and behavior Stress is associated with increased nociceptive brain activity, but not behavior Stress is an important factor when assessing infant pain experience Jones et al. show that high physiological stress in infants, measured by cortisol and heart rate variability, is associated with greater cortical pain activity, but not with increased pain behavior. Stress disrupts the relationship between nociceptive brain activity and behavior and is an important extraneous factor when predicting infant pain.
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影响因子：
2.2
作者：
GUNNAR, MR;HERTSGAARD, L;RIGATUSO, J
通讯作者：
RIGATUSO, J
影响因子：
7.4
作者：
Grunau, RE;Holsti, L;Yu, W
通讯作者：
Yu, W
影响因子：
9.2
作者：
Fabrizi, Lorenzo;Slater, Rebeccah;Worley, Alan;Meek, Judith;Boyd, Stewart;Olhede, Sofia;Fitzgerald, Maria
通讯作者：
Fitzgerald, Maria
影响因子：
4.6
作者：
Ramsay, D;Lewis, M
通讯作者：
Lewis, M
DOI：
10.1111/j.2517-6161.1977.tb01600.x
发表时间：
1977-01-01
期刊：
JOURNAL OF THE ROYAL STATISTICAL SOCIETY SERIES B-METHODOLOGICAL
影响因子：
--
作者：
DEMPSTER, AP;LAIRD, NM;RUBIN, DB
通讯作者：
RUBIN, DB