Department of Child Health Care, Children's Hospital of Nanjing Medical University, Nanjing, P. R. China.
Dev Neurobiol. 2022 Sep;82(6):545-561. doi: 10.1002/dneu.22898. Epub 2022 Aug 19.
Although extensive and untreated pain that occurs during a critical developmental window may impair cognition later in life, environmental interventions early in life might promote cognition. However, the underlying mechanism is poorly understood. Our current study utilized a rat model of "repetitive needle pricks" from the day of birth (P0) to postnatal day 7 (P7) to mimic the painful experience of preterm neonates in the neonatal intensive care unit. Enriched environment (EE) during development period (from P15 to P70) was implemented as a nonpharmacological intervention approach. Electrophysiological recording, behavioral tests, and biochemical analysis were performed after the end of EE (between P71 and P80). The results showed neonatal repetitive pain resulted in a reduction in mechanical withdrawal thresholds by the von Frey test in P70 (p < .001). Furthermore, neonatal repetitive pain impaired spatial learning and memory (p < .05) and even led to dysfunction in fear memory (p < .01). In contrast, EE rescued neonatal pain-induced cognitive deficits and normalized hippocampal long-term potentiation in rats exposed to neonatal pain (p << .05). The beneficial effect of EE might be the improvements in hippocampal synaptic plasticity via upregulating neurotrophic factors and N-methyl-d-aspartate (NMDA) receptors in the hippocampus. Our findings provide evidence that early environmental intervention might be a safe strategy to overcome neurodevelopmental abnormalities in preterm infants who experienced multiple procedural painful events during the early critical period.
尽管在关键发育窗口期发生的广泛而未经治疗的疼痛可能会损害以后的认知能力,但生命早期的环境干预可能会促进认知能力。然而,其潜在机制尚不清楚。我们目前的研究使用了从出生日(P0)到出生后第 7 天(P7)的大鼠“重复针刺”模型,以模拟新生儿重症监护病房中早产儿的痛苦经历。在发育期间(P15 至 P70)实施丰富环境(EE)作为非药物干预方法。在 EE 结束后(P71 至 P80 之间)进行电生理记录、行为测试和生化分析。结果表明,新生儿重复疼痛导致 von Frey 测试在 P70 时机械退缩阈值降低(p < 0.001)。此外,新生儿重复疼痛损害了空间学习和记忆(p < 0.05),甚至导致恐惧记忆功能障碍(p < 0.01)。相比之下,EE 挽救了新生儿疼痛引起的认知缺陷,并使暴露于新生儿疼痛的大鼠海马长时程增强正常化(p << 0.05)。EE 的有益作用可能是通过上调神经生长因子和海马中的 N-甲基-D-天冬氨酸(NMDA)受体来改善海马突触可塑性。我们的研究结果为早期环境干预可能是克服在早期关键期经历多次程序性疼痛事件的早产儿神经发育异常的安全策略提供了证据。