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Cortical activity evoked by inoculation needle prick in infants up to one-year old.

Verriotis M, Fabrizi L, Lee A, Ledwidge S, Meek J, Fitzgerald M - Pain (2015)

Bottom Line: Pain behavior was scored using the Modified Behavioral Pain Scale.These components are the first recordings of brain activity in response to real-life needle pain in infants up to a year old.They provide new evidence of postnatal nociceptive processing and, combined with more traditional behavioral pain scores, offer a potentially more sensitive measure for testing the efficacy of analgesic protocols in this age group.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom bElizabeth Garrett Anderson Obstetric Wing, University College London Hospital, London, United Kingdom.

ABSTRACT
Inoculation is one of the first and most common experiences of procedural pain in infancy. However, little is known about how needle puncture pain is processed by the central nervous system in children. In this study, we describe for the first time the event-related activity in the infant brain during routine inoculation using electroencephalography. Fifteen healthy term-born infants aged 1 to 2 months (n = 12) or 12 months (n = 5) were studied in an outpatient clinic. Pain behavior was scored using the Modified Behavioral Pain Scale. A distinct inoculation event-related vertex potential, consisting of 2 late negative-positive complexes, was observable in single trials after needle contact with the skin. The amplitude of both negative-positive components was significantly greater in the 12-month group. Both inoculation event-related potential amplitude and behavioral pain scores increased with age but the 2 measures were not correlated with each other. These components are the first recordings of brain activity in response to real-life needle pain in infants up to a year old. They provide new evidence of postnatal nociceptive processing and, combined with more traditional behavioral pain scores, offer a potentially more sensitive measure for testing the efficacy of analgesic protocols in this age group.

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Related in: MedlinePlus

Column scatterplots showing the inoculation Modified Behavioral Pain Scale (MBPS) scores of 1- to 2-month-olds and 12-month-olds. Note the narrow range of scores in both groups. The median (solid horizontal line) and interquartile range (whiskers extending from the median) are indicated.
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Figure 8: Column scatterplots showing the inoculation Modified Behavioral Pain Scale (MBPS) scores of 1- to 2-month-olds and 12-month-olds. Note the narrow range of scores in both groups. The median (solid horizontal line) and interquartile range (whiskers extending from the median) are indicated.

Mentions: Both groups of infants exhibited little pain behavior before inoculation (median [Q1-Q3] MBPS scores = 2.0 [2.0-2.0] for 1- to 2-month-olds and 2.0 [1.0-2.0] for 12-month-olds) and responded strongly during the inoculation period (8.0 [7.5-8.0] and 9.0 [9.0-9.0], respectively). In line with the iERP amplitudes, the MBPS scores during the inoculation were significantly larger in the older infants (Wilcoxon–Mann–Whitney test; mean rank 15.0 vs 7.4 in 12-month vs 1-to 2-month-olds, respectively; Z = 2.93, P = 0.002; Fig. 8). However, examination of the relationship between cortical EEG responses and pain behavior revealed no correlation between the peak-to-peak amplitudes of either the first or second waveforms and the inoculation MBPS scores in 1- to 2-month-olds (Spearman rank order correlation coefficient; waveform 1: ρ = −0.15, P = 0.62 and waveform 2: ρ = −0.20, P = 0.52; n = 13). This relationship could not be explored in the 12-month-olds because all infants had identical scores (Fig. 8).


Cortical activity evoked by inoculation needle prick in infants up to one-year old.

Verriotis M, Fabrizi L, Lee A, Ledwidge S, Meek J, Fitzgerald M - Pain (2015)

Column scatterplots showing the inoculation Modified Behavioral Pain Scale (MBPS) scores of 1- to 2-month-olds and 12-month-olds. Note the narrow range of scores in both groups. The median (solid horizontal line) and interquartile range (whiskers extending from the median) are indicated.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4309489&req=5

Figure 8: Column scatterplots showing the inoculation Modified Behavioral Pain Scale (MBPS) scores of 1- to 2-month-olds and 12-month-olds. Note the narrow range of scores in both groups. The median (solid horizontal line) and interquartile range (whiskers extending from the median) are indicated.
Mentions: Both groups of infants exhibited little pain behavior before inoculation (median [Q1-Q3] MBPS scores = 2.0 [2.0-2.0] for 1- to 2-month-olds and 2.0 [1.0-2.0] for 12-month-olds) and responded strongly during the inoculation period (8.0 [7.5-8.0] and 9.0 [9.0-9.0], respectively). In line with the iERP amplitudes, the MBPS scores during the inoculation were significantly larger in the older infants (Wilcoxon–Mann–Whitney test; mean rank 15.0 vs 7.4 in 12-month vs 1-to 2-month-olds, respectively; Z = 2.93, P = 0.002; Fig. 8). However, examination of the relationship between cortical EEG responses and pain behavior revealed no correlation between the peak-to-peak amplitudes of either the first or second waveforms and the inoculation MBPS scores in 1- to 2-month-olds (Spearman rank order correlation coefficient; waveform 1: ρ = −0.15, P = 0.62 and waveform 2: ρ = −0.20, P = 0.52; n = 13). This relationship could not be explored in the 12-month-olds because all infants had identical scores (Fig. 8).

Bottom Line: Pain behavior was scored using the Modified Behavioral Pain Scale.These components are the first recordings of brain activity in response to real-life needle pain in infants up to a year old.They provide new evidence of postnatal nociceptive processing and, combined with more traditional behavioral pain scores, offer a potentially more sensitive measure for testing the efficacy of analgesic protocols in this age group.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom bElizabeth Garrett Anderson Obstetric Wing, University College London Hospital, London, United Kingdom.

ABSTRACT
Inoculation is one of the first and most common experiences of procedural pain in infancy. However, little is known about how needle puncture pain is processed by the central nervous system in children. In this study, we describe for the first time the event-related activity in the infant brain during routine inoculation using electroencephalography. Fifteen healthy term-born infants aged 1 to 2 months (n = 12) or 12 months (n = 5) were studied in an outpatient clinic. Pain behavior was scored using the Modified Behavioral Pain Scale. A distinct inoculation event-related vertex potential, consisting of 2 late negative-positive complexes, was observable in single trials after needle contact with the skin. The amplitude of both negative-positive components was significantly greater in the 12-month group. Both inoculation event-related potential amplitude and behavioral pain scores increased with age but the 2 measures were not correlated with each other. These components are the first recordings of brain activity in response to real-life needle pain in infants up to a year old. They provide new evidence of postnatal nociceptive processing and, combined with more traditional behavioral pain scores, offer a potentially more sensitive measure for testing the efficacy of analgesic protocols in this age group.

Show MeSH
Related in: MedlinePlus