Comment on the Paper by van den Bosch et al. Entitled ‘Prematurity, Opioid Exposure and Neonatal Pain: Do They Affect the Developing Brain?': The Impact of Subtle Messaging

Neonatology ◽  
2015 ◽  
Vol 109 (2) ◽  
pp. 120-121 ◽  
Author(s):  
Liisa Holsti ◽  
Jill G. Zwicker ◽  
Ruth E. Grunau
Author(s):  
Damiano Menin ◽  
Marco Dondi

The study of the development of neonatal pain responses is of key importance, both for research and for clinical reasons, with particular regard to the population of preterm neonates, given the amount of painful procedures they are exposed to on a daily basis. The aim of this work was to systematize our knowledge about the development of pain responses in prematurely born neonates by focusing on some key methodological issues. Studies on the impact of age variables, namely gestational age (GA), postmenstrual age (PMA) and chronological age (CH), on pain responsivity in premature neonates were identified using Medline and Scopus. Studies (N = 42) were categorized based on terminological and methodological approaches towards age variables, and according to output variables considered (facial, nonfacial behavioral, physiological). Distinct multidimensional developmental patterns were found for each age-sampling strategy. Overall, each of the three age variables seems to affect pain responsivity, possibly differently across age windows. Targeted as well as integrated approaches, together with a renewed attention for methodological consistency, are needed to further our knowledge on this topic.


2002 ◽  
Vol 140 (6) ◽  
pp. 646-653 ◽  
Author(s):  
Pierre Gressens ◽  
Marta Rogido ◽  
Bénédicte Paindaveine ◽  
Augusto Sola

2017 ◽  
Vol 34 (3) ◽  
pp. 345-354 ◽  
Author(s):  
Maria Beatriz Martins LINHARES ◽  
Cláudia Maria GASPARDO

Abstract According to the World Health Organization and the International Association for the Study of Pain, pain is a relevant worldwide problem in the healthcare field. The present study aimed to describe the definition of pediatric pain and the main characteristics, and to examine the findings regarding the impact of pain on the development of the child. The best clinical practices in Neonatal Intensive Care Units should include developmental care and specifically implement pain management, aiming to protect the health and development of the infants. The efficacious non-pharmacological management of neonatal pain includes breastfeeding, skin-to-skin, non-nutritive sucking, facilitated-tucking and swaddling. Sweet solutions also have pain relief effects. Psychologists could actively participate in the implementation of non-pharmacological interventions and in the whole process to sensitize and train the professional teams, to alert parents to protection against pain and to support policymakers in the implementation of pain guidelines in the hospital.


Author(s):  
Vanja Slijepcevic Saftic ◽  
Gordana Buljan Flander ◽  
Ella Selak Bagarić

2013 ◽  
Vol 38 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Lisa Joanne DeGregorio ◽  
Sara McLean

Children in care, who have been maltreated, consistently demonstrate poorer educational outcomes than their peers. A number of reasons have been suggested for this such as a lack of stability and opportunities, as compared to their peers. One possible contributor to the poorer educational attainment of children in care is their underlying cognitive vulnerabilities. Cognitive deficits in maltreated children are thought to arise as a result of the impact of trauma on the developing brain. These cognitive deficits include difficulties with executive functioning. Executive functioning abilities include the ability to inhibit behaviour, plan ahead and switch from task to task and are critical for navigating the day to day requirements of educational settings. This article summarises what we know about the cognitive vulnerabilities of maltreated children in care and outlines the implications of these cognitive deficits for supporting maltreated children.


2021 ◽  
Vol 22 (15) ◽  
pp. 8218
Author(s):  
Tatyana Y. Postnikova ◽  
Alexandra V. Griflyuk ◽  
Dmitry V. Amakhin ◽  
Anna A. Kovalenko ◽  
Elena B. Soboleva ◽  
...  

Febrile seizures (FSs) in early life are significant risk factors of neurological disorders and cognitive impairment in later life. However, existing data about the impact of FSs on the developing brain are conflicting. We aimed to investigate morphological and functional changes in the hippocampus of young rats exposed to hyperthermia-induced seizures at postnatal day 10. We found that FSs led to a slight morphological disturbance. The cell numbers decreased by 10% in the CA1 and hilus but did not reduce in the CA3 or dentate gyrus areas. In contrast, functional impairments were robust. Long-term potentiation (LTP) in CA3-CA1 synapses was strongly reduced, which we attribute to the insufficient activity of N-methyl-D-aspartate receptors (NMDARs). Using whole-cell recordings, we found higher desensitization of NMDAR currents in the FS group. Since the desensitization of NMDARs depends on subunit composition, we analyzed NMDAR current decays and gene expression of subunits, which revealed no differences between control and FS rats. We suggest that an increased desensitization is due to insufficient activation of the glycine site of NMDARs, as the application of D-serine, the glycine site agonist, allows the restoration of LTP to a control value. Our results reveal a new molecular mechanism of FS impact on the developing brain.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Geraldine Favrais ◽  
Elie Saliba ◽  
Léa Savary ◽  
Sylvie Bodard ◽  
Zuhal Gulhan ◽  
...  

AbstractMelatonin has shown promising neuroprotective effects due to its anti-oxidant, anti-inflammatory and anti-apoptotic properties, making it a candidate drug for translation to humans in conditions that compromise the developing brain. Our study aimed to explore the impact of prenatal melatonin in an inflammatory/infectious context on GABAergic neurons and on oligodendrocytes (OLs), key cells involved in the encephalopathy of prematurity. An inflammatory/infectious agent (LPS, 300 μg/kg) was injected intraperitoneally (i.p.) to pregnant Wistar rats at gestational day 19 and 20. Melatonin (5 mg/kg) was injected i.p. following the same schedule. Immunostainings focusing on GABAergic neurons, OL lineage and myelination were performed on pup brain sections. Melatonin succeeded in preventing the LPS-induced decrease of GABAergic neurons within the retrospenial cortex, and sustainably promoted GABAergic neurons within the dentate gyrus in the inflammatory/infectious context. However, melatonin did not effectively prevent the LPS-induced alterations on OLs and myelination. Therefore, we demonstrated that melatonin partially prevented the deleterious effects of LPS according to the cell type. The timing of exposure related to the cell maturation stage is likely to be critical to achieve an efficient action of melatonin. Furthermore, it can be speculated that melatonin exerts a modest protective effect on extremely preterm infant brains.


2021 ◽  
Vol 12 ◽  
Author(s):  
Eeva-Leena Kataja ◽  
Ana João Rodrigues ◽  
Noora M. Scheinin ◽  
Saara Nolvi ◽  
Riikka Korja ◽  
...  

Synthetic glucocorticoids (sGC) are frequently administered to pregnant women at risk for preterm delivery to promote fetal lung maturation. Despite their undeniable beneficial effects in lung maturation, the impact of these hormones on developing brain is less clear. Recent human studies suggest that emotional and behavioral disorders are more common among sGC-exposed vs. non-exposed children, but the literature is sparse and controversial. We investigated if prenatal sGC exposure altered fear bias, a well-established infant attention phenotype, at 8-months. We used eye tracking and an overlap paradigm with control, neutral, happy, and fearful faces, and salient distractors, to evaluate infants’ attention disengagement from faces, and specifically from fearful vs. neutral and happy faces (i.e., a fear bias) in a sample (N = 363) of general population from the FinnBrain Birth Cohort Study. sGC exposed infants (N = 12) did not differ from non-exposed infants (N = 351) in their overall probability of disengagement in any single stimulus condition. However, in comparison with non-exposed infants, they did not show the age-typical fear bias and this association remained after controlling for confounding factors such as prematurity, gestational age at birth, birth weight, sex, and maternal postnatal depressive symptoms. Prenatal sGC exposure may alter emotional processing in infants. The atypical emotion processing in turn may be a predictor of emotional problems later in development. Future longitudinal studies are needed in order to evaluate the long-term consequences of sGC exposure for the developing brain.


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