Mueller Megan E, Graz Myriam Bickle, Truttmann Anita C, Schneider Juliane, Duerden Emma G
Applied Psychology, Faculty of Education, Western University, 1137 Western Rd, London, ON, N6G 1G7, Canada.
Department of Woman-Mother-Child, Clinic of Neonatology, University Hospital Center, University of Lausanne, Lausanne, Switzerland.
Brain Struct Funct. 2024 Dec;229(9):2369-2378. doi: 10.1007/s00429-024-02845-w. Epub 2024 Aug 6.
Very preterm birth (< 32 weeks' gestational age) is associated with later social and emotional impairments, which may result from enhanced vulnerability of the limbic system during this period of heightened vulnerability. Evidence suggests that early procedural pain may be a key moderator of early brain networks. In a prospective cohort study, neonates born very preterm (< 30 weeks' gestation) underwent MRI scanning at term-equivalent age (TEA) and clinical data were collected (mechanical ventilation, analgesics, sedatives). Procedural pain was operationalized as the number of skin breaking procedures. Amygdala volumes were automatically extracted. The Strengths and Difficulties questionnaire was used to assess social-emotional outcomes at 5 years of age (mean age 67.5 months). General linear models were employed to examine the association between neonatal amygdala volumes and social-emotional outcomes and the timing and amount of procedural pain exposure (early within the first weeks of life to TEA) as a moderator, adjusting for biological sex, gestational age, 5-year assessment age, days of mechanical ventilation and total cerebral volumes. A total of 42 preterm infants participated. Right amygdala volumes at TEA were associated with prosocial behaviour at age 5 (B = -0.010, p = 0.005). Procedural pain was found to moderate the relationship between right amygdala volumes in the neonatal period and conduct problems at 5 years, such that early skin breaking procedures experienced within the first few weeks of life strengthened the association between right amygdala volumes and conduct problems (B = 0.005, p = 0.047). Late skin breaking procedures, experienced near TEA, also strengthened the association between right amygdala volumes and conduct problems (B = 0.004, p = 0.048).
极早产（孕周<32周）与后期的社会和情感障碍有关，这可能是由于在此易损期边缘系统的易损性增强所致。有证据表明，早期程序性疼痛可能是早期脑网络的关键调节因素。在一项前瞻性队列研究中，极早产（孕周<30周）的新生儿在足月等效年龄（TEA）时接受了MRI扫描，并收集了临床数据（机械通气、镇痛药、镇静剂）。程序性疼痛通过皮肤破损操作的次数来衡量。杏仁核体积通过自动提取获得。使用长处和困难问卷来评估5岁（平均年龄67.5个月）时的社会情感结果。采用一般线性模型来检验新生儿杏仁核体积与社会情感结果之间的关联，以及作为调节因素的程序性疼痛暴露的时间和量（从生命最初几周到TEA的早期），并对生物性别、孕周、5岁评估年龄、机械通气天数和全脑体积进行了调整。共有42名早产儿参与。TEA时右侧杏仁核体积与5岁时的亲社会行为相关（B = -0.010，p = 0.005）。研究发现，程序性疼痛调节了新生儿期右侧杏仁核体积与5岁时行为问题之间的关系，即生命最初几周内经历的早期皮肤破损操作加强了右侧杏仁核体积与行为问题之间的关联（B = 0.005，p = 0.047）。接近TEA时经历的晚期皮肤破损操作也加强了右侧杏仁核体积与行为问题之间的关联（B = 0.004，p = 0.048）。
