Center for Perinatal Research at Nationwide Children's Hospital, Columbus, OH 43205, USA; Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Kennedy Center, Vanderbilt University, Nashville, TN 37232, USA.
Curr Biol. 2017 Apr 3;27(7):1048-1054. doi: 10.1016/j.cub.2017.02.036. Epub 2017 Mar 16.
Every year, 15 million preterm infants are born, and most spend their first weeks in neonatal intensive care units (NICUs) [1]. Although essential for the support and survival of these infants, NICU sensory environments are dramatically different from those in which full-term infants mature and thus likely impact the development of functional brain organization [2]. Yet the integrity of sensory systems determines effective perception and behavior [3, 4]. In neonates, touch is a cornerstone of interpersonal interactions and sensory-cognitive development [5-7]. NICU treatments used to improve neurodevelopmental outcomes rely heavily on touch [8]. However, we understand little of how brain maturation at birth (i.e., prematurity) and quality of early-life experiences (e.g., supportive versus painful touch) interact to shape the development of the somatosensory system [9]. Here, we identified the spatial, temporal, and amplitude characteristics of cortical responses to light touch that differentiate them from sham stimuli in full-term infants. We then utilized this data-driven analytical framework to show that the degree of prematurity at birth determines the extent to which brain responses to light touch (but not sham) are attenuated at the time of discharge from the hospital. Building on these results, we showed that, when controlling for prematurity and analgesics, supportive experiences (e.g., breastfeeding, skin-to-skin care) are associated with stronger brain responses, whereas painful experiences (e.g., skin punctures, tube insertions) are associated with reduced brain responses to the same touch stimuli. Our results shed crucial insights into the mechanisms through which common early perinatal experiences may shape the somatosensory scaffolding of later perceptual, cognitive, and social development.
每年有 1500 万早产儿出生，其中大多数在新生儿重症监护病房（NICU）度过最初的几周[1]。尽管 NICU 环境对这些婴儿的支持和生存至关重要，但与足月婴儿成熟的环境相比，NICU 环境在感官上有很大的不同，因此可能会影响功能性大脑组织的发育[2]。然而，感觉系统的完整性决定了有效的感知和行为[3,4]。在新生儿中，触觉是人际互动和感觉认知发展的基石[5-7]。用于改善神经发育结局的 NICU 治疗方法非常依赖于触觉[8]。然而，我们对出生时的大脑成熟度（即早产）和早期生活经历的质量（例如，支持性触摸与疼痛性触摸）如何相互作用来塑造感觉系统的发育知之甚少[9]。在这里，我们确定了皮质对光触的空间、时间和幅度特征，使它们与足月婴儿的假刺激区分开来。然后，我们利用这种数据驱动的分析框架表明，出生时的早产程度决定了大脑对光触的反应（而不是假刺激）在出院时被削弱的程度。基于这些结果，我们表明，在控制早产和止痛药的情况下，支持性体验（例如，母乳喂养、皮肤接触护理）与更强的大脑反应相关，而疼痛体验（例如，皮肤穿刺、管插入）与对相同触觉刺激的大脑反应减弱相关。我们的研究结果为常见的围产期早期体验如何塑造后期感知、认知和社会发展的感觉支架提供了重要的见解。
