23 results on '"Madeleine Verriotis"'
Search Results
2. Amygdalar Functional Connectivity Differences Associated With Reduced Pain Intensity in Pediatric Peripheral Neuropathic Pain
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Madeleine Verriotis, Clarissa Sorger, Judy Peters, Lizbeth J. Ayoub, Kiran K. Seunarine, Chris A. Clark, Suellen M. Walker, and Massieh Moayedi
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chronic pain ,neuropathic pain ,functional connectivity ,fMRI ,limbic ,brain ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
BackgroundThere is evidence of altered corticolimbic circuitry in adults with chronic pain, but relatively little is known of functional brain mechanisms in adolescents with neuropathic pain (NeuP). Pediatric NeuP is etiologically and phenotypically different from NeuP in adults, highlighting the need for pediatric-focused research. The amygdala is a key limbic region with important roles in the emotional-affective dimension of pain and in pain modulation.ObjectiveTo investigate amygdalar resting state functional connectivity (rsFC) in adolescents with NeuP.MethodsThis cross-sectional observational cohort study compared resting state functional MRI scans in adolescents aged 11–18 years with clinical features of chronic peripheral NeuP (n = 17), recruited from a tertiary clinic, relative to healthy adolescents (n = 17). We performed seed-to-voxel whole-brain rsFC analysis of the bilateral amygdalae. Next, we performed post hoc exploratory correlations with clinical variables to further explain rsFC differences.ResultsAdolescents with NeuP had stronger negative rsFC between right amygdala and right dorsolateral prefrontal cortex (dlPFC) and stronger positive rsFC between right amygdala and left angular gyrus (AG), compared to controls (PFDR
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- 2022
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3. Widespread nociceptive maps in the human neonatal somatosensory cortex
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Laura Jones, Madeleine Verriotis, Robert J Cooper, Maria Pureza Laudiano-Dray, Mohammed Rupawala, Judith Meek, Lorenzo Fabrizi, and Maria Fitzgerald
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infant ,pain ,brain ,somatotopy ,topography ,development ,Medicine ,Science ,Biology (General) ,QH301-705.5 - Abstract
Topographic cortical maps are essential for spatial localisation of sensory stimulation and generation of appropriate task-related motor responses. Somatosensation and nociception are finely mapped and aligned in the adult somatosensory (S1) cortex, but in infancy, when pain behaviour is disorganised and poorly directed, nociceptive maps may be less refined. We compared the topographic pattern of S1 activation following noxious (clinically required heel lance) and innocuous (touch) mechanical stimulation of the same skin region in newborn infants (n = 32) using multioptode functional near-infrared spectroscopy (fNIRS). Within S1 cortex, touch and lance of the heel elicit localised, partially overlapping increases in oxygenated haemoglobin concentration (Δ[HbO]), but while touch activation was restricted to the heel area, lance activation extended into cortical hand regions. The data reveals a widespread cortical nociceptive map in infant S1, consistent with their poorly directed pain behaviour.
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- 2022
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4. EEG, behavioural and physiological recordings following a painful procedure in human neonates
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Laura Jones, Maria Pureza Laudiano-Dray, Kimberley Whitehead, Madeleine Verriotis, Judith Meek, Maria Fitzgerald, and Lorenzo Fabrizi
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Science - Abstract
Abstract We present a dataset of cortical, behavioural, and physiological responses following a single, clinically required noxious stimulus in a neonatal sample. Cortical activity was recorded from 112 neonates (29–47 weeks gestational age at study) using a 20-channel electroencephalogram (EEG), which was time-locked to a heel lance. This data is linked to pain-related behaviour (facial expression), physiology (heart rate, oxygenation) and a composite clinical score (Premature Infant Pain Profile, PIPP). The dataset includes responses to non-noxious sham and auditory controls. The infants’ relevant medical and pain history was collected up to the day of the study and recorded in an extensive database of variables including clinical condition at birth, diagnoses, medications, previous painful procedures, injuries, and selected maternal information. This dataset can be used to investigate the cortical, physiological, and behavioural pain-related processing in human infants and to evaluate the impact of medical conditions and experiences upon the infant response to noxious stimuli. Furthermore, it provides information on the formation of individual pain phenotypes.
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- 2018
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5. The distribution of pain activity across the human neonatal brain is sex dependent.
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Madeleine Verriotis, Laura Jones, Kimberley Whitehead, Maria Laudiano-Dray, Ismini Panayotidis, Hemani Patel, Judith Meek, Lorenzo Fabrizi, and Maria Fitzgerald
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- 2018
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6. Age‐related effects on the anterior and posterior hippocampal volumes in 6–21 year olds: A model selection approach
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Lizbeth J. Ayoub, Junhao Zhu, Steven J. Lee, Nancy Mugisha, Kyle Patel, Emma G. Duerden, Jennifer Stinson, Madeleine Verriotis, Melanie Noel, Dehan Kong, Massieh Moayedi, and Mary Pat McAndrews
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Cognitive Neuroscience - Abstract
Although recent studies support significant differences in intrinsic structure, function, and connectivity along the longitudinal axis of the hippocampus, few studies have investigated the normative development of this dimension. In addition, factors known to influence hippocampal structure, such as sex or puberty, have yet to be characterized when assessing age-related effects on its subregions. This study addresses this gap by investigating the relationship of the anterior (antHC) and posterior (postHC) hippocampus volumes with age, and how these are moderated by sex or puberty, in structural magnetic resonance imaging scans from 183 typically developing participants aged 6-21 years. Based on previous literature, we first anticipated that non-linear models would best represent the relationship between age and the antHC and postHC volumes. We found that age-related effects are region-specific, such that the antHC volume remains stable with increasing age, while the postHC shows a cubic function characterized by overall volume increase with age but a slower rate during adolescence. Second, we hypothesized that models, which include biological sex or pubertal status would best describe these relationships. Contrary to expectation, models comprising either biological sex or pubertal status did not significantly improve model performance. Further longitudinal research is needed to evaluate their effects on the antHC and postHC development.
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- 2022
7. Author response: Widespread nociceptive maps in the human neonatal somatosensory cortex
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Laura Jones, Madeleine Verriotis, Robert J Cooper, Maria Pureza Laudiano-Dray, Mohammed Rupawala, Judith Meek, Lorenzo Fabrizi, and Maria Fitzgerald
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- 2021
8. Emergency Triage Assessment and Treatment Plus (ETAT+): adapting training to strengthen quality improvement and task-sharing in emergency paediatric care in Sierra Leone
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Christopher Hands, Sandra Hands, Madeleine Verriotis, James Bunn, Emma Bailey, Robert J Samuels, Kadiatu Sankoh, Ayeshatu Mustapha, Bhanu Williams, and Sebastian Taylor
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Health Policy ,Public Health, Environmental and Occupational Health ,Humans ,Articles ,Triage ,Child ,Hospitals, District ,Delivery of Health Care ,Quality Improvement ,Sierra Leone - Abstract
Background Over the past 25 years Sierra Leone has made progress in reducing maternal and child mortality, but the burden of preventable paediatric deaths remains high. Further progress towards achieving the Sustainable Development Goals will require greater strengthening of the health care system, including hospital care for perinatal and paediatric conditions. Emergency Triage Assessment and Treatment Plus (ETAT+) may offer a useful tool. Methods The five-day ETAT+ course was adapted as a six-month programme of in-situ training and mentoring integrated with patient flow and service delivery improvements in 14 regional and district government hospitals across the country. Nurses were trained to carry out the initial resuscitation and assessment of the sick paediatric patient, and to administer the first dose of medication per protocol. The course was for all clinical staff; most participants were nurses. Results The intervention was associated with an improvement in the quality of paediatric care and a reduction in mortality. In 2017 mortality decreased by 33.1%, from 14.5% at baseline to 9.7% after six months of the intervention. Mortality at the start of the 2018 intervention was 8.5% and reduced over six months to 6.5%. Care quality indicators showed improvement across the two intervention periods, with some evidence of sustained effect. Conclusions These results suggest that adapted ETAT+ training with in-situ mentoring alongside improved patient flow and service delivery supports improvements in the quality of paediatric care in Sierra Leonean hospitals. ETAT+ may provide an affordable framework for improving the quality of secondary paediatric care in Sierra Leone and a model of nurse-led resuscitation may allow for prompt and timely emergency paediatric care in Sierra Leonean hospitals where there are fewer physicians and other resources for care.
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- 2021
9. Widespread nociceptive maps in the human neonatal somatosensory cortex
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Robert J. Cooper, Maria Pureza Laudiano-Dray, Madeleine Verriotis, Maria Fitzgerald, Mohammed Rupawala, Judith Meek, Lorenzo Fabrizi, and Laura Jones
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Adult ,Nociception ,Brain Mapping ,Heel ,Sensory stimulation therapy ,General Immunology and Microbiology ,business.industry ,General Neuroscience ,Infant, Newborn ,Infant ,Pain ,Stimulation ,Somatosensory Cortex ,General Medicine ,Somatosensory system ,General Biochemistry, Genetics and Molecular Biology ,medicine.anatomical_structure ,Stimulus modality ,Touch ,Cortex (anatomy) ,medicine ,Humans ,business ,Neuroscience - Abstract
Topographic cortical maps are essential for spatial localisation of sensory stimulation and generation of appropriate task-related motor responses. Somatosensation and nociception are finely mapped and aligned in the adult somatosensory (S1) cortex, but in infancy, when pain behaviour is disorganised and poorly directed, nociceptive maps may be less refined. We compared the topographic pattern of S1 activation following noxious (clinically required heel lance) and innocuous (touch) mechanical stimulation of the same skin region in newborn infants (n=32) using multi-optode functional near-infrared spectroscopy (fNIRS). Signal to noise ratio and overall activation area did not differ with stimulus modality. Within S1 cortex, touch and lance of the heel elicit localised, partially overlapping increases in oxygenated haemoglobin (HbO), but while touch activation was restricted to the heel area, lance activation extended into cortical hand regions. The data reveals a widespread cortical nociceptive map in infant S1, consistent with their poorly directed pain behaviour.
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- 2021
10. Oxford Textbook of Pediatric Pain
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Madeleine Verriotis
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Our understanding of how pain in early life differs to that in maturity is continuing to increase and develop, using a mixture of approaches from basic science, clinical science, and implementation science. The new edition of the Oxford Textbook of Pediatric Pain brings together an international team of experts to provide an authoritative and comprehensive textbook on all aspects of pain in infants, children, and youth. Divided into nine sections, the textbook analyses pain as a multifactorial problem to give the reader a comprehensive understanding of this challenging subject. Evidence-based chapters look in depth at topics ranging from the long-term effects of the pain in children, to complementary therapy in paediatric pain. The text addresses the knowledge-to-practice gap through individual and organizational implementation, and facilitation strategies. Case examples and perspective boxes are provided to aid learning and illustrate the application of knowledge.
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- 2021
11. Phenotyping peripheral neuropathic pain in male and female adolescents: pain descriptors, somatosensory profiles, conditioned pain modulation, and child-parent reported disability
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Madeleine Verriotis, Suellen M. Walker, Judy Peters, and Clarissa Sorger
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Adult ,Male ,Pain Threshold ,Parents ,medicine.medical_specialty ,Adolescent ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Threshold of pain ,Medicine ,Humans ,Child ,business.industry ,Sensory loss ,medicine.disease ,Anesthesiology and Pain Medicine ,Complex regional pain syndrome ,Neurology ,Hyperalgesia ,Neuropathic pain ,Physical therapy ,Quality of Life ,Anxiety ,Neuralgia ,Pain catastrophizing ,Female ,Neurology (clinical) ,medicine.symptom ,business ,Psychosocial ,030217 neurology & neurosurgery ,Cohort study - Abstract
Neuropathic pain (NeuP) can be difficult to diagnose and manage in children. Data regarding prevalence and sex-dependent differences are limited, and more detailed phenotyping is needed. This observational cohort study recruited adolescents (10-17 years) with NeuP or complex regional pain syndrome (CRPS). After pain history and NeuP questionnaires, quantitative sensory testing was performed. Individual z-score plots were calculated with body-region control measures and matched to mechanism-related sensory profiles (sensory loss, thermal hyperalgesia, and mechanical hyperalgesia). Conditioned pain modulation was assessed with pressure pain threshold and a contralateral cold conditioning stimulus, and meaningful conditioned pain modulation defined as twice the standard error of measurement. Patients and parents completed validated questionnaires for child quality of life (QoL), pain catastrophizing, and self-reported anxiety/depression. Males (n = 23) and females (n = 43) with NeuP (n = 52) or CRPS (n = 14) reported moderate-severe pain with neuropathic sensory descriptors. Mixed patterns of sensory gain/loss at pain sites were not sex-dependent. Thermal hyperalgesia was common in both NeuP and CRPS, whereas sensory loss occurred only with NeuP and in a smaller proportion than adult cohorts. Conditioned pain modulation was inhibitory in 54%, facilitatory in 14%, and nonresponders had variable cold conditioning sensitivity. Males and females reported marked impairment of QoL, increased emotional distress, and pain catastrophising. Child-parent QoL scores correlated, but catastrophizing scores were discordant when parents or adolescents reported higher anxiety/depression. NeuP in adolescents is associated with significant pain, physical impairment, and psychosocial impairment. Quantifying alterations in somatosensory profiles, descending modulation, child and parent psychological function will inform individualized therapy and stratification for future clinical trials.
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- 2020
12. Nurse-led implementation of ETAT+ is associated with reduced mortality in a children's hospital in Freetown, Sierra Leone
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Hany Ragab, Christopher Hands, Madeleine Verriotis, Sandra Hands, and Ayeshatu Mustapha
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Male ,Nurses ,Disease ,Sierra leone ,Sierra Leone ,Secondary care ,03 medical and health sciences ,Nurse led ,0302 clinical medicine ,030225 pediatrics ,Intervention (counseling) ,medicine ,Outpatient clinic ,Humans ,030212 general & internal medicine ,Mortality ,Child ,Retrospective Studies ,business.industry ,medicine.disease ,Sick child ,Triage ,Quality Improvement ,Pediatrics, Perinatology and Child Health ,Female ,Medical emergency ,business ,Emergency Service, Hospital - Abstract
BACKGROUND In the wake of the Ebola virus disease (EVD) epidemic in Sierra Leone, secondary care facilities faced an increase in admissions with few members of medical staff available to assess and treat patients. This led to long waiting times in hospital outpatient departments. The study was undertaken in the outpatient department of Ola During Children's Hospital (the tertiary paediatric hospital for Sierra Leone) in the period immediately following the EVD epidemic of 2014-2015. AIMS This retrospective analysis of operational programme data aimed to assess whether a quality-improvement approach and task-sharing between medical and nursing staff improved the quality of triage and the timeliness of care. METHODS All staff working in the outpatient department were offered a 4-week training course, followed by on-the-job supervision and support for 6 months. Nurses who successfully completed the course were given responsibility for the initial assessment of sick patients and for prescribing and giving initial treatment. Data were collected at three points: before intervention and at 3 and 6 months after initiation of the intervention. All children presenting to the hospital for medical attention between 0800 and 1400 Monday to Friday were included. Triage assessment by the outpatient nurse was compared to that made by a clinically experienced observer, and the time taken for each child to be triaged, assessed and given initial treatment was recorded. RESULTS Between months 0 and 6 of the intervention, detection of emergency signs by the triage nurse improved from 30% to 100%, and detection of priority signs improved from 34% to 100%. For children presenting with emergency signs, the median time between triage and full assessment improved from 57 minutes before intervention to 17 minutes at 3 months and 5 minutes at 6 months (p
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- 2020
13. The Development of the Nociceptive System and Childhood Pain
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Clarissa Sorger, Suellen M. Walker, and Madeleine Verriotis
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Nociception ,business.industry ,Medicine ,business ,Neuroscience - Published
- 2020
14. The development of the nociceptive brain
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Maria Fitzgerald, Lorenzo Fabrizi, Madeleine Verriotis, and Pishan Chang
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Nociception ,medicine.diagnostic_test ,General Neuroscience ,Brain ,Sensory system ,Stimulation ,Neurophysiology ,Electroencephalography ,Somatosensory system ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Neural Pathways ,Connectome ,Noxious stimulus ,medicine ,Animals ,Humans ,Psychology ,Neuroscience ,030217 neurology & neurosurgery - Abstract
This review addresses the fundamental question of how we first experience pain, at the beginning of our lives. The brain is activated by peripheral tissue damaging stimulation from birth, but unlike other sensory systems, the pain system in healthy individuals cannot rely upon prolonged activity-dependent shaping through repeated noxious stimulation. Considering the importance of pain, remarkably little is known about when and how nociceptive cortical network activity characteristic of the mature adult brain develops. We begin this review by considering the underlying framework of connections in the infant brain. Since this developing brain connectome is necessary, if not sufficient, for pain experience, we discuss the structural and functional development of cortical and subcortical networks that contribute to this network. We then review specific information on the development of nociceptive processing in the infant brain, considering evidence from neurophysiological and hemodynamic measures separately, as the two are not always consistent. Finally we highlight areas that require further research and discuss how information gained from laboratory animal models will greatly increase our understanding in this area.
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- 2016
15. The feasibility and acceptability of research magnetic resonance imaging in adolescents with moderate–severe neuropathic pain
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Clarissa Sorger, Judy Peters, Madeleine Verriotis, Suellen M. Walker, Massieh Moayedi, Chris A. Clark, and Kiran K. Seunarine
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medicine.medical_specialty ,Pain ,02 engineering and technology ,Neuropathic pain ,Adolescents ,01 natural sciences ,Magnetic resonance imaging ,Neuroimaging ,Rating scale ,0103 physical sciences ,0202 electrical engineering, electronic engineering, information engineering ,Medicine ,010306 general physics ,Prospective cohort study ,Mri scan ,Children ,Pediatric ,medicine.diagnostic_test ,business.industry ,Quantitative sensory testing ,Consent rate ,Anesthesiology and Pain Medicine ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Physical therapy ,020201 artificial intelligence & image processing ,business ,Research Paper - Abstract
Supplemental Digital Content is Available in the Text., Introduction: Multimodal characterisation with questionnaires, Quantitative Sensory Testing (QST), and neuroimaging will improve understanding of neuropathic pain (NeuP) in adolescents. Magnetic resonance imaging (MRI) data in adolescents with NeuP are limited, and the perceived practical or ethical burden of scanning may represent a barrier to research. Objective: To determine the feasibility of MRI scanning in adolescents with moderate–severe NeuP, with respect to consent rate, postscan acceptability, and data quality. Methods: This prospective cohort study evaluating questionnaires and QST recruited adolescents aged 10 to 18 years with clinically diagnosed NeuP from a tertiary clinic. Eligible adolescents aged 11 years and older could additionally agree/decline an MRI scan. After the scan, families rated discomfort, perceived risk, and acceptability of current and future MRI scans (0–10 numerical rating scales). Head motion during scanning was compared with healthy controls to assess data quality. Results: Thirty-four families agreed to MRI (72% recruitment), and 21 adolescents with moderate–severe pain (average last week 6.7 ± 1.7; mean ± SD) and with neuropathic QST profiles were scanned. Three adolescents reported positional or noise-related discomfort during scanning. Perceived risk was low, and acceptability of the current scan was high for parents (range [median]: 7 to 10/10 [10]) and adolescents (8–10/10 [10]). Willingness to undergo a future research scan was high for parents (7–10/10 [10]) and adolescents (5–10/10 [10]) and did not differ from future scans for clinical purposes. Mean head motion during resting state functional MRI did not differ from control adolescents. Conclusion: Research MRI is feasible and acceptable for many adolescents with moderate–severe NeuP.
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- 2020
16. The distribution of pain activity across the human neonatal brain is sex dependent
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Madeleine, Verriotis, Laura, Jones, Kimberley, Whitehead, Maria, Laudiano-Dray, Ismini, Panayotidis, Hemani, Patel, Judith, Meek, Lorenzo, Fabrizi, and Maria, Fitzgerald
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Male ,Nociception ,Sex Characteristics ,Infant, Newborn ,Brain ,Pain ,Electroencephalography ,Gestational Age ,Pain Perception ,Article ,Touch Perception ,Neonatal ,Humans ,Female ,Sex ,EEG ,Evoked Potentials - Abstract
In adults, there are differences between male and female structural and functional brain connectivity, specifically for those regions involved in pain processing. This may partly explain the observed sex differences in pain sensitivity, tolerance, and inhibitory control, and in the development of chronic pain. However, it is not known if these differences exist from birth. Cortical activity in response to a painful stimulus can be observed in the human neonatal brain, but this nociceptive activity continues to develop in the postnatal period and is qualitatively different from that of adults, partly due to the considerable cortical maturation during this time. This research aimed to investigate the effects of sex and prematurity on the magnitude and spatial distribution pattern of the long-latency nociceptive event-related potential (nERP) using electroencephalography (EEG). We measured the cortical response time-locked to a clinically required heel lance in 81 neonates born between 29 and 42 weeks gestational age (median postnatal age 4 days). The results show that heel lance results in a spatially widespread nERP response in the majority of newborns. Importantly, a widespread pattern is significantly more likely to occur in females, irrespective of gestational age at birth. This effect is not observed for the short latency somatosensory waveform in the same infants, indicating that it is selective for the nociceptive component of the response. These results suggest the early onset of a greater anatomical and functional connectivity reported in the adult female brain, and indicate the presence of pain-related sex differences from birth., Highlights • Noxious stimulation causes widespread pain related potentials in the neonatal brain. • This widespread pain response is more likely to occur in female babies. • Brain responses to touch do not differ between male and female babies. • Sex differences in human brain pain pathways are present from birth.
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- 2017
17. A framework for three-dimensional navigation research
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Madeleine Verriotis, Robin Hayman, Aleksandar Jovalekic, Kathryn J. Jeffery, and University of Zurich
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Cognitive science ,Physiology ,Representation (systemics) ,Behavioural sciences ,1314 Physiology ,Space (commercial competition) ,142-005 142-005 ,Frame of reference ,330 Economics ,3206 Neuropsychology and Physiological Psychology ,Behavioral Neuroscience ,Neuropsychology and Physiological Psychology ,2802 Behavioral Neuroscience ,Core (graph theory) ,Comparative cognition ,Psychology ,Navigation research - Abstract
We have argued that the neurocognitive representation of large-scale, navigable three-dimensional space is anisotropic, having different properties in vertical versus horizontal dimensions. Three broad categories organize the experimental and theoretical issues raised by the commentators: (1) frames of reference, (2) comparative cognition, and (3) the role of experience. These categories contain the core of a research program to show how three-dimensional space is represented and used by humans and other animals.
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- 2017
18. Nociceptive Cortical Activity Is Dissociated from Nociceptive Behavior in Newborn Human Infants under Stress
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Laura, Jones, Lorenzo, Fabrizi, Maria, Laudiano-Dray, Kimberley, Whitehead, Judith, Meek, Madeleine, Verriotis, and Maria, Fitzgerald
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Male ,Nociception ,Hydrocortisone ,Infant, Newborn ,heart rate variability ,Brain ,Electroencephalography ,cortisol ,event related potential ,Article ,Facial Expression ,neonatal ,cortex ,Heart Rate ,Stress, Physiological ,Humans ,Female ,pain ,EEG ,Saliva ,Evoked Potentials ,development - Abstract
Summary Newborn infants display strong nociceptive behavior in response to tissue damaging stimuli, and this is accompanied by nociceptive activity generated in subcortical and cortical areas of the brain [1, 2]. In the absence of verbal report, these nociceptive responses are used as measures of pain sensation in newborn humans, as they are in animals [3, 4]. However, many infants are raised in a physiologically stressful environment, and little is known about the effect of background levels of stress upon their pain responses. In adults, acute physiological stress causes hyperalgesia [5, 6, 7], and increased background stress increases pain [8, 9, 10], but these data cannot necessarily be extrapolated to infants. Here we have simultaneously measured nociceptive behavior, brain activity, and levels of physiological stress in a sample of 56 newborn human infants aged 36–42 weeks. Salivary cortisol (hypothalamic pituitary axis), heart rate variability (sympathetic adrenal medullary system), EEG event-related potentials (nociceptive cortical activity), and facial expression (behavior) were acquired in individual infants following a clinically required heel lance. We show that infants with higher levels of stress exhibit larger amplitude cortical nociceptive responses, but this is not reflected in their behavior. Furthermore, while nociceptive behavior and cortical activity are normally correlated, this relationship is disrupted in infants with high levels of physiological stress. Brain activity evoked by noxious stimulation is therefore enhanced by stress, but this cannot be deduced from observation of pain behavior. This may be important in the prevention of adverse effects of early repetitive pain on brain development., Highlights • Infant pain behavior and nociceptive brain activity are generally correlated • Stress disrupts the relationship between infant pain brain activity and behavior • Stress is associated with increased nociceptive brain activity, but not behavior • Stress is an important factor when assessing infant pain experience, Jones et al. show that high physiological stress in infants, measured by cortisol and heart rate variability, is associated with greater cortical pain activity, but not with increased pain behavior. Stress disrupts the relationship between nociceptive brain activity and behavior and is an important extraneous factor when predicting infant pain.
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- 2017
19. Pediatric Erythromelalgia and SCN9A Mutations: Systematic Review and Single-Center Case Series
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Luke Arthur, Suellen M. Walker, Madeleine Verriotis, Richard F. Howard, Stephen G. Waxman, Kirsty Keen, Judy Peters, Sulayman D. Dib-Hajj, and Alison Kelly
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Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Pain ,Single Center ,03 medical and health sciences ,0302 clinical medicine ,Sodium channel blocker ,Erythromelalgia ,030225 pediatrics ,Genotype ,medicine ,Humans ,030212 general & internal medicine ,Child ,Retrospective Studies ,business.industry ,NAV1.7 Voltage-Gated Sodium Channel ,Publication bias ,medicine.disease ,Symptomatic relief ,Allodynia ,Mutation ,Pediatrics, Perinatology and Child Health ,Neuropathic pain ,Female ,Symptom Assessment ,medicine.symptom ,business - Abstract
Objectives To evaluate the clinical features of erythromelalgia in childhood associated with gain-of-function SCN9A mutations that increase activity of the Nav1.7 voltage-gated sodium channel, we conducted a systematic review of pediatric presentations of erythromelalgia related to SCN9A mutations, and compared pediatric clinical presentations of symptomatic erythromelalgia, with or without SCN9A mutations. Study design PubMed, Embase, and PsycINFO Databases were searched for reports of inherited erythromelalgia in childhood. Clinical features, management, and genotype were extracted. Case notes of pediatric patients with erythromelalgia from the Great Ormond Street Hospital Pain Service were reviewed for clinical features, patient-reported outcomes, and treatments. Children aged over 10 years were recruited for quantitative sensory testing. Results Twenty-eight publications described erythromelalgia associated with 15 different SCN9A gene variants in 25 children. Pain was severe and often refractory to multiple treatments, including nonspecific sodium channel blockers. Skin damage or other complications of cold immersion for symptomatic relief were common (60%). SCN9A mutations resulting in greater hyperpolarizing shifts in Nav1.7 sodium channels correlated with symptom onset at younger ages (P = .016). Variability in reporting, and potential publication bias toward severe cases, limit any estimations of overall prevalence. In our case series, symptoms were similar but comorbidities were more common in children with SCN9A mutations. Quantitative sensory testing revealed marked dynamic warm allodynia. Conclusions Inherited erythromelalgia in children is associated with difficult-to-manage pain and significant morbidity. Standardized reporting of outcome and management in larger series will strengthen identification of genotype-phenotype relationships. More effective long-term therapies are a significant unmet clinical need.
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- 2019
20. Encoding of mechanical nociception differs in the adult and infant brain
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Lorenzo, Fabrizi, Madeleine, Verriotis, Gemma, Williams, Amy, Lee, Judith, Meek, Sofia, Olhede, and Maria, Fitzgerald
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Adult ,Male ,Nociception ,Connectome ,Infant, Newborn ,Brain ,Humans ,Electroencephalography ,Female ,Middle Aged ,Nerve Net ,Article - Abstract
Newborn human infants display robust pain behaviour and specific cortical activity following noxious skin stimulation, but it is not known whether brain processing of nociceptive information differs in infants and adults. Imaging studies have emphasised the overlap between infant and adult brain connectome architecture, but electrophysiological analysis of infant brain nociceptive networks can provide further understanding of the functional postnatal development of pain perception. Here we hypothesise that the human infant brain encodes noxious information with different neuronal patterns compared to adults. To test this we compared EEG responses to the same time-locked noxious skin lance in infants aged 0–19 days (n = 18, clinically required) and adults aged 23–48 years (n = 21). Time-frequency analysis revealed that while some features of adult nociceptive network activity are present in infants at longer latencies, including beta-gamma oscillations, infants display a distinct, long latency, noxious evoked 18-fold energy increase in the fast delta band (2–4 Hz) that is absent in adults. The differences in activity between infants and adults have a widespread topographic distribution across the brain. These data support our hypothesis and indicate important postnatal changes in the encoding of mechanical pain in the human brain.
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- 2016
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21. Cortical activity evoked by inoculation needle prick in infants up to one-year old
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Madeleine, Verriotis, Lorenzo, Fabrizi, Amy, Lee, Sheryl, Ledwidge, Judith, Meek, and Maria, Fitzgerald
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Cerebral Cortex ,Male ,Event-related potential ,Infant ,Electroencephalography ,Procedural pain ,Postnatal development ,Cortical ,Needles ,MBPS ,Humans ,Female ,Immunization ,EEG ,Evoked Potentials ,Infants ,Pain Measurement ,Research Paper - Abstract
Supplemental Digital Content is Available in the Text. Inoculation elicits a clearly defined cortical electroencephalography response in preverbal infants that increases in amplitude between 1 to 2 and 12 months of age., 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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- 2015
22. Navigating in a three-dimensional world
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Kathryn J. Jeffery, Madeleine Verriotis, Robin Hayman, Aleksandar Jovalekic, and University of Zurich
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Horizontal and vertical ,Physiology ,Models, Neurological ,Spatial Behavior ,Space (commercial competition) ,142-005 142-005 ,Hippocampus ,3206 Neuropsychology and Physiological Psychology ,Behavioral Neuroscience ,Cognition ,Human–computer interaction ,Orientation ,2802 Behavioral Neuroscience ,Animals ,Humans ,Head direction cells ,Cognitive science ,Structure (mathematical logic) ,Neurons ,Plane (geometry) ,Representation (systemics) ,1314 Physiology ,Spatial cognition ,Horizontal plane ,330 Economics ,Neuropsychology and Physiological Psychology ,Space Perception ,Psychology ,Locomotion - Abstract
The study of spatial cognition has provided considerable insight into how animals (including humans) navigate on the horizontal plane. However, the real world is three-dimensional, having a complex topography including both horizontal and vertical features, which presents additional challenges for representation and navigation. The present article reviews the emerging behavioral and neurobiological literature on spatial cognition in non-horizontal environments. We suggest that three-dimensional spaces are represented in a quasi-planar fashion, with space in the plane of locomotion being computed separately and represented differently from space in the orthogonal axis – a representational structure we have termed “bicoded.” We argue that the mammalian spatial representation in surface-travelling animals comprises a mosaic of these locally planar fragments, rather than a fully integrated volumetric map. More generally, this may be true even for species that can move freely in all three dimensions, such as birds and fish. We outline the evidence supporting this view, together with the adaptive advantages of such a scheme.
- Published
- 2013
23. Anisotropic encoding of three-dimensional space by place cells and grid cells
- Author
-
Madeleine Verriotis, André A. Fenton, Aleksandar Jovalekic, Kathryn J. Jeffery, and Robin Hayman
- Subjects
Hippocampus ,Action Potentials ,Topology ,Three-dimensional space ,Parasubiculum ,03 medical and health sciences ,0302 clinical medicine ,Odometry ,Orientation (geometry) ,Orientation ,Path integration ,Animals ,Entorhinal Cortex ,030304 developmental biology ,Physics ,Neurons ,0303 health sciences ,Communication ,Brain Mapping ,business.industry ,General Neuroscience ,Grid ,Entorhinal cortex ,Electrodes, Implanted ,Rats ,Space Perception ,Anisotropy ,business ,Neuroscience ,030217 neurology & neurosurgery - Abstract
The subjective sense of space may result in part from the combined activity of place cells in the hippocampus and grid cells in posterior cortical regions such as the entorhinal cortex and pre- and parasubiculum. In horizontal planar environments, place cells provide focal positional information, whereas grid cells supply odometric (distance measuring) information. How these cells operate in three dimensions is unknown, even though the real world is three-dimensional. We investigated this issue in rats exploring two different kinds of apparatus: a climbing wall (the 'pegboard') and a helix. Place and grid cell firing fields had normal horizontal characteristics but were elongated vertically, with grid fields forming stripes. It seems that grid cell odometry (and by implication path integration) is impaired or absent in the vertical domain, at least when the rat itself remains horizontal. These findings suggest that the mammalian encoding of three-dimensional space is anisotropic.
- Published
- 2011
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