Pain in biologically immature neonates induces numerous physiologic, endocrine, and behavioral changes that potentially have anegative imapce on long term neuro-developemental functioning. Medical care of infants born at very low gestational age involves systematic repeated exposure to noxious procedures, which induce stress and pain. Knowledge of the developmental course of pain reactivity in VLGA (<30 weeks) infants is urgently needed. We propose to study the neonatal development of early multidimensional pain responses of VLGA infants.
The specific aims are to 1) determine the immediate and subsequent effects of pharmacologic treatment on pain responses and developmental outcomes; 2) distinguish pain from stress in VLGA infants; 3) examine the role of neurologic lesion in the early development of altered pain response in infants with SNI; 4) examine whether early postnatal pain experience may result in ongoing hyperarousal; and 5) examine the effect of early and prolonged pain experience on subsequent neurobehavioral development during infancy. Biobehavioral pain and stress responses will be studied in VLGA infants randomized to either sedation or analgesia treatment groups, an in those not requiring sedation or analgesia. Pain responses will be measured on days 5 and 14, and at 32 weeks PCA. A multivariate approach to examining behavioral (facial and body actions) and physiological (spectral analysis of heart rate, oxygen saturation, cortisol) responses to pain and stress events will be used. Neurodevelopmental functioning will be assessed in follow-up at 3, 6, 8, and 18 months CCA. The results of these studies will have both theoretical importance and significant implications for clinical management of pain in VLGA infants.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD039783-03
Application #
6653894
Study Section
Special Emphasis Panel (ZRG1-IFCN-4 (01))
Program Officer
Ilekis, John V
Project Start
2001-07-01
Project End
2006-06-30
Budget Start
2003-07-01
Budget End
2004-06-30
Support Year
3
Fiscal Year
2003
Total Cost
$135,000
Indirect Cost
Name
University of British Columbia
Department
Type
DUNS #
251949962
City
Vancouver
State
BC
Country
Canada
Zip Code
V6 1-Z3
Duerden, Emma G; Grunau, Ruth E; Guo, Ting et al. (2018) Early Procedural Pain Is Associated with Regionally-Specific Alterations in Thalamic Development in Preterm Neonates. J Neurosci 38:878-886
Podrebarac, Samantha K; Duerden, Emma G; Chau, Vann et al. (2017) Antenatal exposure to antidepressants is associated with altered brain development in very preterm-born neonates. Neuroscience 342:252-262
Chau, C M Y; Cepeda, I L; Devlin, A M et al. (2017) The Val66Met brain-derived neurotrophic factor gene variant interacts with early pain exposure to predict cortisol dysregulation in 7-year-old children born very preterm: Implications for cognition. Neuroscience 342:188-199
Tremblay, Sophie; Ranger, Manon; Chau, Cecil M Y et al. (2017) Repeated exposure to sucrose for procedural pain in mouse pups leads to long-term widespread brain alterations. Pain 158:1586-1598
Valeri, Beatriz O; Ranger, Manon; Chau, Cecil M Y et al. (2016) Neonatal Invasive Procedures Predict Pain Intensity at School Age in Children Born Very Preterm. Clin J Pain 32:1086-1093
Duerden, Emma G; Guo, Ting; Dodbiba, Lorin et al. (2016) Midazolam dose correlates with abnormal hippocampal growth and neurodevelopmental outcome in preterm infants. Ann Neurol 79:548-59
Zwicker, Jill G; Miller, Steven P; Grunau, Ruth E et al. (2016) Smaller Cerebellar Growth and Poorer Neurodevelopmental Outcomes in Very Preterm Infants Exposed to Neonatal Morphine. J Pediatr 172:81-87.e2
Linden, Mark A; Cepeda, Ivan L; Synnes, Anne et al. (2015) Stress in parents of children born very preterm is predicted by child externalising behaviour and parent coping at age 7?years. Arch Dis Child 100:554-8
Moiseev, Alexander; Doesburg, Sam M; Grunau, Ruth E et al. (2015) Minimum variance beamformer weights revisited. Neuroimage 120:201-13
Ranger, Manon; Zwicker, Jill G; Chau, Cecil M Y et al. (2015) Neonatal Pain and Infection Relate to Smaller Cerebellum in Very Preterm Children at School Age. J Pediatr 167:292-8.e1

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