Children's National Hospital, Prenatal Pediatrics Institute, 111 Michigan Ave., NW, Washington, DC, 20010, USA.
Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Clin Auton Res. 2021 Jun;31(3):415-424. doi: 10.1007/s10286-021-00793-7. Epub 2021 Mar 14.
The mature central autonomic network includes connectivity between autonomic nervous system brainstem centers and the cerebral cortex. The study objective was to evaluate the regional connectivity between the cerebral cortex and brainstem autonomic centers in term newborns by measuring coherence between high-density electroencephalography and heart rate variability as measured by electrocardiography.
Low-risk term newborns with birth gestational age of 39-40 weeks were prospectively enrolled and studied using time-synced electroencephalography and electrocardiography for up to 60 min before discharge from the birth hospital. The ccortical autonomicc nervous system association was analyzed using coherence between electroencephalography-delta power and heart rate variability. Heart rate variability measured the parasympathetic tone (root mean square of successive differences of heart rate) and sympathetic tone (standard deviation of heart rate).
One hundred and twenty-nine low-risk term infants were included. High coherence delta-root mean square of successive differences was found in central, bitemporal, and occipital brain regions, with less robust coherence delta-standard deviation in the central region and bitemporal areas.
Our findings describe a topography of ccortical autonomicc connectivity present at term in low-risk newborns, which was more robust to parasympathetic than sympathetic brainstem centers and was independent of newborn state.
成熟的中枢自主神经系统包括自主神经系统脑干中枢与大脑皮层之间的连通性。本研究旨在通过测量高密度脑电图与心电图测量的心率变异性之间的相干性,评估足月新生儿大脑皮层与脑干自主中心之间的区域连通性。
前瞻性纳入低危足月新生儿,在出生医院出院前,使用时间同步脑电图和心电图对其进行长达 60 分钟的监测。通过脑电图-δ 功率与心率变异性之间的相干性分析皮质自主神经系统的关联。心率变异性测量副交感神经张力(心率连续差值的均方根)和交感神经张力(心率标准差)。
共纳入 129 例低危足月婴儿。在中央、双颞和枕叶脑区发现高相干性δ-均方根差值,而在中央区和双颞区,相干性δ-标准差则较弱。
我们的研究结果描述了低危新生儿在足月时存在的皮质自主连通的地形图,这种连通性对副交感神经比交感神经脑干中枢更为稳健,且与新生儿状态无关。