Steven P. Miller, Brain Development in the Preterm Newborn: the Importance of the Everyday
The Research Institute Annual Scientific Retreat, Hospital for Sick Children (Sickkids), unites researchers, trainees, and staff, in the dissemination of research in the area of child health. Close to 900 staff, scientists, and trainees participated in the event this year. Topics included population-based approach to childhood diseases, research in pediatric drug development, and traumatic/acquired brain injury. (click here for full article and program list) Of particular interest was Dr. Steven P. Miller’s (Head, Division of Neurology and Senior Scientist, Neuroscience and Mental Health, Research Institute, The Hospital for Sick Children) presentation on traumatic/acquired brain injury, Brain Development in the Preterm Newborn: the Importance of the Everyday.
Preterm infants delivered at 24-32 weeks gestation in neonatal intensive care units (NICU), experience over 109 skin-breaking procedures (Brummelte et al., 2012). Infants’ exposure to routine, multiple, painful stressors while in the NICU occurs during a period of rapid brain development and vulnerability. Yet the relationship between early pain related stress and its potential influence on infants’ neurological health remains largely unknown. Dr. Miller, in partnership with Dr. Ruth Grunau and a team of researchers, are one of the first to investigate the ways in which routine painful procedures affect preterm infants’ brain development. The purpose of their recent study was to examine the impact of procedural pain on the early brain development of preterm newborns in NICUs (Brummelte et al., 2012) [link to article]. Procedural pain-related stress was defined as the number of skin-breaking events, such as a heel lance or intramuscular injection. Researchers conducted two brain-imaging scans of infants between the gestational ages of 24-32 weeks. The first scan was obtained shortly after birth and the second scan at term-equivalent age (around 40 weeks). Each scan provided a glimpse of the brain’s early structural and metabolic development. Two additional scans were conducted prospectively to test the hypothesis that greater procedural pain-related stress will be associated with impaired brain development. Results demonstrated a correlation between early neonatal pain and brain development in preterm newborns, after adjusting for multiple confounding factors such as infection, illness severity, and analgesic medication. These findings suggest that acute procedural pain may contribute to abnormal brain development and point to the need for pain management strategies to protect the developing brain.