Search

Abstract Background Strong evidence suggests that maternal-infant skin-to-skin contact (SSC) is effective in reducing behavioural responses to pain. Given the multi-sensory benefits of SSC, it is highly likely that SSC provided during pain in early life may reduce pain-induced brain activity. The aim of this study is to examine the effect of SSC compared to 24% sucrose on pain-induced activity in the preterm infant brain during a medically required heel lance. Secondary objectives include determining (a) differences between behavioural pain response and noxious-related brain activity during heel lance and (b) rate of adverse events across groups. Methods We will randomly assign 126 babies (32 to 36 completed weeks gestational age) admitted to the neonatal intensive care unit, and their mothers within the first seven days of age to receive (i) SSC plus sterile water and (ii) 24% oral sucrose. Each baby will receive a medically indicated heel lance, following a no treatment baseline period. The primary outcome is noxious-related brain activity measured using an electroencephalogram (EEG) pain-specific event-related potential. Secondary outcomes include pain intensity measured using a bio-behavioural infant pain assessment tool (Premature Infant Pain Profile-Revised) and rate of adverse events. Discussion This will be the first clinical trial to compare the effect of SSC and 24% sucrose on pain-induced brain activity in the preterm infant brain during a clinical noxious stimulus, measured using EEG. Given the negative neurodevelopmental outcomes associated with unmanaged pain, it is imperative that preterm babies receive the most effective pain-reducing treatments to improve their health outcomes. Our findings will have important implications in informing optimal pain assessment and management in preterm infants. Trial registration ClinicalTrials.gov NCT03745963 . Registered on November 19, 2018.

Two techniques for analyzing human extracranial neurophysiological signals, namely the periodic/aperiodic parameterization of neural power spectra and the transient events framework of oscillatory activity, have recently emerged in the scientific literature. In this work, we integrate these two analysis perspectives to analyze extracranial neurophysiological signals as a series of transient rhythmic events disambiguated from the background aperiodic activity. We call this novel technique the periodic/aperiodic parametrization of transient oscillations (PAPTO). We demonstrate PAPTO by investigating resting-state sensorimotor magnetoencephalography recordings from the Cambridge Center for Ageing and Neuroscience cross-sectional study on healthy ageing (n = 600, ages 18–88). We show that PAPTO is more sensitive to neocortical transient beta rhythms compared to more conventional transient event detection algorithms and captures more variance in the resting-state occurrence rate of beta events across participants. The improved sensitivity of PAPTO reveals that the beta occurrence rate almost doubles over the adult lifespan which we discuss in terms of thalamocortical beta generation in the somatosensory cortex and the age-related decline of sensory perception.