scholarly journals Medullary Serotonergic Binding Deficits and Hippocampal Abnormalities in Sudden Infant Death Syndrome: One or Two Entities?

2021 ◽  
Vol 9 ◽  
Author(s):  
Robin L. Haynes ◽  
Hannah C. Kinney ◽  
Elisabeth A. Haas ◽  
Jhodie R. Duncan ◽  
Molly Riehs ◽  
...  
Keyword(s):  
Dentate Gyrus ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Molecular Layer ◽  
Granular Cell ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Prenatal Smoking ◽  
Reported Data ◽  
The Relationship

Sudden infant death syndrome (SIDS) is understood as a syndrome that presents with the common phenotype of sudden death but involves heterogenous biological causes. Many pathological findings have been consistently reported in SIDS, notably in areas of the brain known to play a role in autonomic control and arousal. Our laboratory has reported abnormalities in SIDS cases in medullary serotonin (5-HT) receptor 1A and within the dentate gyrus of the hippocampus. Unknown, however, is whether the medullary and hippocampal abnormalities coexist in the same SIDS cases, supporting a biological relationship of one abnormality with the other. In this study, we begin with an analysis of medullary 5-HT1A binding, as determined by receptor ligand autoradiography, in a combined cohort of published and unpublished SIDS (n = 86) and control (n = 22) cases. We report 5-HT1A binding abnormalities consistent with previously reported data, including lower age-adjusted mean binding in SIDS and age vs. diagnosis interactions. Utilizing this combined cohort of cases, we identified 41 SIDS cases with overlapping medullary 5-HT1A binding data and hippocampal assessment and statistically addressed the relationship between abnormalities at each site. Within this SIDS analytic cohort, we defined abnormal (low) medullary 5-HT1A binding as within the lowest quartile of binding adjusted for age and we examined three specific hippocampal findings previously identified as significantly more prevalent in SIDS compared to controls (granular cell bilamination, clusters of immature cells in the subgranular layer, and single ectopic cells in the molecular layer of the dentate gyrus). Our data did not find a strong statistical relationship between low medullary 5-HT1A binding and the presence of any of the hippocampal abnormalities examined. It did, however, identify a subset of SIDS (~25%) with both low medullary 5-HT1A binding and hippocampal abnormalities. The subset of SIDS cases with both low medullary 5-HT1A binding and single ectopic cells in the molecular layer was associated with prenatal smoking (p = 0.02), suggesting a role for the exposure in development of the two abnormalities. Overall, our data present novel information on the relationship between neuropathogical abnormalities in SIDS and support the heterogenous nature and overall complexity of SIDS pathogenesis.

Letters to the Editor

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 168-168
Author(s):  
Vincent J. M. Di Maio
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Forensic Pathology ◽  
Sudden Infant Death ◽  
Laboratory Medicine ◽  
Sudden Infant ◽  
Letters To The Editor ◽  
New Information ◽  
The Relationship

In the editorial by Little and Brooks,1 the authors refer to "new information" that two of the five deaths in the study by Steinschneider2 were in fact murders. This brings into question the conclusions of the Steinschneider study, the relationship between apnea and sudden infant death syndrome (if any) and, perhaps, the use of home monitors. All of this was not "new information" to the Forensic Pathology community. That the two deaths in the study by Steinschneider were probably homicide was stated in a chapter in Clinics in Laboratory Medicine, a letter to Pediatrics, and in the textbook Forensic Pathology.3

Sudden Infant Death Syndrome and Phenothiazines

PEDIATRICS ◽  
1983 ◽  
Vol 71 (6) ◽  
pp. 986-987
Author(s):  
A. N. STANTON
Keyword(s):  
Side Effects ◽  
Sudden Infant Death Syndrome ◽  
Temperature Rise ◽  
Temperature Regulation ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Standard Dosage ◽  
The Relationship ◽  
Anticholinergic Side Effects

To the Editor.— Kahn and Blum1 discuss the relationship between phenothiazines and the sudden infant death syndrome (SIDS) but do not mention the potentially important anticholinergic side effects of this group of drugs. Phenothiazines impair temperature regulation, including the ability to sweat, and are implicated in many reports of heatstroke2,3 and hypothermia. Any temperature rise tends to occur early in treatment4 and may bee provoked by standard dosage.5 Studies in mice given a single 1-mg/kg dose of chlorpromazine show that younger animals become hyperthermic, whereas older ones becomes hypothermic.6

Sudden Infant Death Syndrome in Relation to Weather and Optimetrically Measured Air Pollution in Taiwan

PEDIATRICS ◽  
1995 ◽  
Vol 96 (6) ◽  
pp. 1106-1110
Author(s):  
Harald H. Knöbel ◽  
Chien-Jen Chen ◽  
Kung-Yee Liang
Keyword(s):  
Air Pollution ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Live Births ◽  
Rate Ratios ◽  
Tract Infections ◽  
The Relationship

Objective. To examine the possible role of weather and air pollution in sudden infant death syndrome (SIDS) and suffocation. Methods. Poisson regression analysis was carried out to measure the association between daily rates of SIDS per 1000 live births and daily average values of visibility and temperature in Taiwan between 1981 and 1991. The optimetrical measure of air pollution was used to represent pollution over a whole area rather than at a point source. Results. Mortality from SIDS per 1000 live births was 3.3 times greater in the lowest category of visibility on the day of death than in the highest category; this rate ratio was 3.4 for the average visibility during the 9 days before death. Adjustment for population size, season, level of urbanization, incidence of deaths from respiratory tract infections, temperature, air pressure, sunshine, rainfall, relative humidity, and windspeed increased these rate ratios to 3.8 and 5.1, respectively. This suggests that the relationship between air pollution and SIDS is not biased by ecological confounders. For temperature the rate ratios were between 3.3 and 4.0. Conclusions. Our findings confirm the association of climatic temperature and air pollution with SIDS.

National Institutes of Health Consensus Development Conference on Infantile Apnea and Home Monitoring, Sept 29 to Oct 1, 1986

PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 292-299 ◽  
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Home Monitoring ◽  
Clinical Problem ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Breathing Patterns ◽  
The Public ◽  
Technical Advances ◽  
The Relationship

Apnea has long been recognized as a clinical problem in infants. Considerable investigative and clinical attention has been directed toward this condition. Although progress has been made and certain categories of apnea have been delineated, etiology remains unclear in many situations. Furthermore, the condition is common in certain populations, such as in infants born prematurely. Whether an apneic event occurs independently or in association with a pathophysiologic process such as sepsis or an environmental factor such as change in temperature, there is concern about possible effects of interrupted breathing. Measurement of normal and abnormal physiologic processes such as breathing patterns is facilitated by devices. Monitors have emerged in the laboratory and hospital and have contributed to the discovery of new knowledge and management of abnormalities. Monitoring in this paper refers to the use of electronic devices. Technical advances, especially in electronics, have resulted in many devices that seem to be accurate, useful, and safe. Others are of questionable value. Sudden infant death syndrome (SIDS) was recognized before this century but did not receive close attention until relatively recently. Public Law 93-270, The Sudden Infant Death Syndrome Act of 1974, gave the Public Health Service the mandate to stimulate research and administer counseling and information programs. In 1972, a paper reported that two of five infants with documented prolonged sleep apnea died of SIDS. A great deal of attention during the 1970s was directed toward the relationship between apnea and SIDS. As the 1970s and 1980s unfolded, the use of monitors in the home environment to detect apnea expanded.

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