Authors
Emma G Duerden, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
Ruth E Grunau, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia V6H 3V4, Canada & BC Children's and Women's Hospitals, BC Children's Hospital Research Institute, Vancouver, British Columbia V6H 3N1, Canada
Ting Guo, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
Justin Foong, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
Alexander Pearson, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
Stephanie Au-Young, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada
Raphael Lavoie, Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Quebec H4H 1R3, Canada
M Mallar Chakravarty, Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Quebec H4H 1R3, Canada & Departments of Psychiatry and Biomedical Engineering, McGill University, Montreal, Quebec H3A 2B4, Canada
Vann Chau, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada & The University of Toronto, Toronto, Ontario M5S 1A1, Canada
Anne Synnes, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia V6H 3V4, Canada & BC Children's and Women's Hospitals, BC Children's Hospital Research Institute, Vancouver, British Columbia V6H 3N1, Canada
Steven P Miller, The University of Toronto, Toronto, Ontario M5S 1A1, Canada & Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario M5G 1X8, CanadaFollow
Publication Date
1-24-2018
Journal
The Journal of neuroscience : the official journal of the Society for Neuroscience
URL with Digital Object Identifier
10.1523/JNEUROSCI.0867-17.2017
Abstract
Very preterm human neonates are exposed to numerous invasive procedures as part of life-saving care. Evidence suggests that repetitive neonatal procedural pain precedes long-term alterations in brain development. However, to date the link between pain and brain development has limited temporal and anatomic specificity. We hypothesized that early exposure to painful stimuli during a period of rapid brain development, before pain modulatory systems reach maturity, will predict pronounced changes in thalamic development, and thereby cognitive and motor function. In a prospective cohort study, 155 very preterm neonates (82 males, 73 females) born 24-32 weeks' gestation underwent two MRIs at median postmenstrual ages 32 and 40 weeks that included structural, metabolic, and diffusion imaging. Detailed day-by-day clinical data were collected. Cognitive and motor abilities were assessed at 3 years, corrected age. The association of early (skin breaks, birth-Scan 1) and late pain (skin breaks, Scans 1-2) with thalamic volumes and
