The developing human pain connectome and brain dynamics of infant pain: sex differences, pain history and skin-to-skin care

许多婴儿在出生时需要新生儿护理，要么是因为他们早产，要么是因为他们身体不适。一些最早产和身体不适的婴儿可能会在医院呆上几个月，在那里他们会接受无数的临床手术，其中许多都是组织断裂，可能会很痛苦。尽管努力减少手术和处理的数量，但对这些脆弱的个体来说，负担是相当大的，特别是当它们发生在大脑发育的关键阶段，不同大脑区域之间形成连接时。发育中的大脑需要感觉刺激才能正常发育，但如果这种刺激被夸大或应用在不适当的发育阶段，可能会造成永久性的伤害。事实上，反复早期接触痛苦的程序与大脑的持久不利变化有关。这个项目的目的是了解疼痛是如何在人类婴儿的大脑中处理的。我们将绘制处理疼痛所必需的大脑回路的结构和功能发育图，并调查住院期间重复的组织损伤程序如何影响这些回路。我们将确定这些回路在男性和女性身上的发育是否不同。此外，由于疼痛的体验高度依赖于大脑中已经发生的事情和我们周围发生的事情，我们将探索正在进行的大脑活动如何影响对痛苦刺激的反应，以及我们如何通过非药物干预来操纵这些过程，例如护理者的皮肤到皮肤护理，以减少经历的疼痛。这项研究项目将提供我们需要的知识，以减轻婴儿疼痛，减少新生儿重症监护程序的任何长期不良影响。

Many infants need neonatal care at birth, either because they have been born prematurely or because they are unwell. Some of the most premature and unwell babies can spend months in hospital where they undergo numerous clinical procedures, many of which are tissue breaking and likely to be painful. Despite efforts to reduce the number of procedures and handling, the burden to these vulnerable individuals is considerable, particularly as they occur at a critical phase of brain development, when connections are forming between different brain regions. The developing brain requires sensory stimulation to develop normally, but if this stimulation is exaggerated or applied at inappropriate developmental stages, it can cause permanent harm. Indeed, repeated early exposure to painful procedures is associated with lasting adverse changes to the brain. The aim of this project is to understand how pain is processed in the human infant brain. We will map the structural and functional development of the brain circuits that are necessary to process pain and investigate how these are affected by the repeated tissue-damaging procedures of hospital stay. We will establish whether these circuits develop differently in males and females. Moreover, as the experience of pain is highly dependent upon what is already going on in the brain and what happens around us, we will explore how ongoing brain activity influences the response to a painful stimulus and how we can manipulate these processes with non-pharmacological interventions, such as caregiver skin-to-skin care, to reduce the pain experienced. This research project will provide the knowledge we need to alleviate infant pain and reduce any long-term adverse effects of neonatal intensive care procedures.