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Erschienen in: Clinical Autonomic Research 4/2015

01.08.2015 | Research Article

Altered autonomic control in preterm newborns with impaired neurological outcomes

verfasst von: Gerard Thiriez, Clémence Mougey, Danièle Vermeylen, Vanessa Wermenbol, Jean-Pol Lanquart, Jian Sheng Lin, Patricia Franco

Erschienen in: Clinical Autonomic Research | Ausgabe 4/2015

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Abstract

Purpose

Very preterm newborns are at high risk of neurological injury. The objective of this work was to study the impact of neurological aggression on the autonomic nervous system.

Methods

We studied polysomnography recordings, at term corrected gestational age, for 38 preterm infants born at less than 28 weeks or weighing less than 1 kg. These infants were seen by a neuropediatrician, average age at follow up was 54.4 months. We created two groups: one with children who did not have any neurological disorder, including cerebral palsy (CP), language or mental retardation, visual or hearing disability, and attention disorder; the second group contained children with at least one of these impairments. From the polysomnography recordings, using coarse-graining spectral analysis, we compared heart rate variability indices between preterm infants with normal and abnormal neurological outcomes.

Results

Twenty infants had an impaired neurological outcome. Regarding the clinical characteristics, there were more babies born from smoking mothers (p = 0.025), with early-onset neonatal sepsis (p = 0.04), and abnormal results on cerebral magnetic resonance imaging (p = 0.014) in the group with impaired neurological outcomes. Spectral parameters were significantly different between active and quiet sleep. Total powers, harmonic and non-harmonic powers, high frequency and low frequency powers were higher in active sleep compared with those in quiet sleep. Preterm babies with impaired neurological development, in particular those with CP, had lower total power and non-harmonic power especially in active sleep than those with normal neurological outcome.

Conclusion

These findings suggest that, in very preterm infants, perinatal neurological injuries could be associated with abnormal maturation of the autonomic nervous system.
Literatur
1.
Zurück zum Zitat Anders TF, Emde R, Parmelee A (1971) A manual of standardized terminology, techniques and criteria for scoring of states of sleep and wakefulness in newborn infants. Brain Information Service, Los Angeles Anders TF, Emde R, Parmelee A (1971) A manual of standardized terminology, techniques and criteria for scoring of states of sleep and wakefulness in newborn infants. Brain Information Service, Los Angeles
2.
Zurück zum Zitat Beuchee A, Carrault G, Bansard JY, Boutaric E, Betremieux P, Pladys P (2009) Uncorrelated randomness of the heart rate is associated with sepsis in sick premature infants. Neonatology 96:109–114PubMedCentralCrossRefPubMed Beuchee A, Carrault G, Bansard JY, Boutaric E, Betremieux P, Pladys P (2009) Uncorrelated randomness of the heart rate is associated with sepsis in sick premature infants. Neonatology 96:109–114PubMedCentralCrossRefPubMed
3.
Zurück zum Zitat Clairambault J, Curzi-Dascalova L, Kauffmann F, Medigue C, Leffler C (1992) Heart rate variability in normal sleeping full-term and preterm neonates. Early Hum Dev 28:169–183CrossRefPubMed Clairambault J, Curzi-Dascalova L, Kauffmann F, Medigue C, Leffler C (1992) Heart rate variability in normal sleeping full-term and preterm neonates. Early Hum Dev 28:169–183CrossRefPubMed
4.
Zurück zum Zitat Cohen G, Roux JC, Grailhe R, Malcolm G, Changeux JP, Lagercrantz H (2005) Perinatal exposure to nicotine causes deficits associated with a loss of nicotinic receptor function. Proc Natl Acad Sci USA 102:3817–3821PubMedCentralCrossRefPubMed Cohen G, Roux JC, Grailhe R, Malcolm G, Changeux JP, Lagercrantz H (2005) Perinatal exposure to nicotine causes deficits associated with a loss of nicotinic receptor function. Proc Natl Acad Sci USA 102:3817–3821PubMedCentralCrossRefPubMed
5.
Zurück zum Zitat Curzi-Dascalova L (1992) Physiological correlates of sleep development in premature and full-term neonates. Neurophysiol Clin 22:151–166CrossRefPubMed Curzi-Dascalova L (1992) Physiological correlates of sleep development in premature and full-term neonates. Neurophysiol Clin 22:151–166CrossRefPubMed
6.
Zurück zum Zitat Curzi-Dascalova L, Mirmiran M (1996) Manuel des techniques d’enregistrement et d’analyse des stades de sommeil et de veille chez le pre\0301mature\0301 et le nouveau-ne\0301 a\0300 terme = Manual of methods for recording and analyzing sleep-wakefulness states in preterm and full-term infant. INSERM, Paris Curzi-Dascalova L, Mirmiran M (1996) Manuel des techniques d’enregistrement et d’analyse des stades de sommeil et de veille chez le pre\0301mature\0301 et le nouveau-ne\0301 a\0300 terme = Manual of methods for recording and analyzing sleep-wakefulness states in preterm and full-term infant. INSERM, Paris
7.
Zurück zum Zitat Davidson S, Reina N, Shefi O, Hai-Tov U, Akselrod S (1997) Spectral analysis of heart rate fluctuations and optimum thermal management for low birth weight infants. Med Biol Eng Comput 35:619–625CrossRefPubMed Davidson S, Reina N, Shefi O, Hai-Tov U, Akselrod S (1997) Spectral analysis of heart rate fluctuations and optimum thermal management for low birth weight infants. Med Biol Eng Comput 35:619–625CrossRefPubMed
8.
Zurück zum Zitat Doussard-Roosevelt JA, McClenny BD, Porges SW (2001) Neonatal cardiac vagal tone and school-age developmental outcome in very low birth weight infants. Dev Psychobiol 38:56–66CrossRefPubMed Doussard-Roosevelt JA, McClenny BD, Porges SW (2001) Neonatal cardiac vagal tone and school-age developmental outcome in very low birth weight infants. Dev Psychobiol 38:56–66CrossRefPubMed
9.
Zurück zum Zitat Feldman R, Eidelman AI (2003) Skin-to-skin contact (Kangaroo Care) accelerates autonomic and neurobehavioural maturation in preterm infants. Dev Med Child Neurol 45:274–281CrossRefPubMed Feldman R, Eidelman AI (2003) Skin-to-skin contact (Kangaroo Care) accelerates autonomic and neurobehavioural maturation in preterm infants. Dev Med Child Neurol 45:274–281CrossRefPubMed
10.
Zurück zum Zitat Fox NA, Porges SW (1985) The relation between neonatal heart period patterns and developmental outcome. Child Dev 56:28–37CrossRefPubMed Fox NA, Porges SW (1985) The relation between neonatal heart period patterns and developmental outcome. Child Dev 56:28–37CrossRefPubMed
11.
Zurück zum Zitat Franco P, Chabanski S, Szliwowski H, Dramaix M, Kahn A (2000) Influence of maternal smoking on autonomic nervous system in healthy infants. Pediatr Res 47:215–220CrossRefPubMed Franco P, Chabanski S, Szliwowski H, Dramaix M, Kahn A (2000) Influence of maternal smoking on autonomic nervous system in healthy infants. Pediatr Res 47:215–220CrossRefPubMed
12.
Zurück zum Zitat Franco P, Szliwowski H, Dramaix M, Kahn A (1998) Polysomnographic study of the autonomic nervous system in potential victims of sudden infant death syndrome. Clin Auton Res 8:243–249CrossRefPubMed Franco P, Szliwowski H, Dramaix M, Kahn A (1998) Polysomnographic study of the autonomic nervous system in potential victims of sudden infant death syndrome. Clin Auton Res 8:243–249CrossRefPubMed
13.
Zurück zum Zitat Gerhardt U, Hans U, Hohage H (1999) Influence of smoking on baroreceptor function: 24 h measurements. J Hypertens 17:941–946CrossRefPubMed Gerhardt U, Hans U, Hohage H (1999) Influence of smoking on baroreceptor function: 24 h measurements. J Hypertens 17:941–946CrossRefPubMed
14.
Zurück zum Zitat Goto K, Mirmiran M, Adams MM, Longford RV, Baldwin RB, Boeddiker MA, Ariagno RL (1999) More awakenings and heart rate variability during supine sleep in preterm infants. Pediatrics 103:603–609CrossRefPubMed Goto K, Mirmiran M, Adams MM, Longford RV, Baldwin RB, Boeddiker MA, Ariagno RL (1999) More awakenings and heart rate variability during supine sleep in preterm infants. Pediatrics 103:603–609CrossRefPubMed
15.
Zurück zum Zitat Gould JB, Lee AF, James O, Sander L, Teager H, Fineberg N (1977) The sleep state characteristics of apnea during infancy. Pediatrics 59:182–194PubMed Gould JB, Lee AF, James O, Sander L, Teager H, Fineberg N (1977) The sleep state characteristics of apnea during infancy. Pediatrics 59:182–194PubMed
16.
Zurück zum Zitat Hanna BD, Nelson MN, White-Traut RC, Silvestri JM, Vasan U, Rey PM, Patel MK, Comiskey E (2000) Heart rate variability in preterm brain-injured and very-low-birth-weight infants. Biol Neonate 77:147–155CrossRefPubMed Hanna BD, Nelson MN, White-Traut RC, Silvestri JM, Vasan U, Rey PM, Patel MK, Comiskey E (2000) Heart rate variability in preterm brain-injured and very-low-birth-weight infants. Biol Neonate 77:147–155CrossRefPubMed
17.
Zurück zum Zitat Kinney HC, O’Donnell TJ, Kriger P, White WF (1993) Early developmental changes in [3H]nicotine binding in the human brainstem. Neuroscience 55:1127–1138CrossRefPubMed Kinney HC, O’Donnell TJ, Kriger P, White WF (1993) Early developmental changes in [3H]nicotine binding in the human brainstem. Neuroscience 55:1127–1138CrossRefPubMed
18.
Zurück zum Zitat Larroque B, Ancel PY, Marret S, Marchand L, Andre M, Arnaud C, Pierrat V, Roze JC, Messer J, Thiriez G, Burguet A, Picaud JC, Breart G, Kaminski M (2008) Neurodevelopmental disabilities and special care of 5-year-old children born before 33 weeks of gestation (the EPIPAGE study): a longitudinal cohort study. Lancet 371:813–820CrossRefPubMed Larroque B, Ancel PY, Marret S, Marchand L, Andre M, Arnaud C, Pierrat V, Roze JC, Messer J, Thiriez G, Burguet A, Picaud JC, Breart G, Kaminski M (2008) Neurodevelopmental disabilities and special care of 5-year-old children born before 33 weeks of gestation (the EPIPAGE study): a longitudinal cohort study. Lancet 371:813–820CrossRefPubMed
19.
Zurück zum Zitat Larroque B, Breart G, Kaminski M, Dehan M, Andre M, Burguet A, Grandjean H, Ledesert B, Leveque C, Maillard F, Matis J, Roze JC, Truffert P (2004) Survival of very preterm infants: epipage, a population based cohort study. Arch Dis Child Fetal Neonatal Ed 89:F139–F144PubMedCentralCrossRefPubMed Larroque B, Breart G, Kaminski M, Dehan M, Andre M, Burguet A, Grandjean H, Ledesert B, Leveque C, Maillard F, Matis J, Roze JC, Truffert P (2004) Survival of very preterm infants: epipage, a population based cohort study. Arch Dis Child Fetal Neonatal Ed 89:F139–F144PubMedCentralCrossRefPubMed
20.
Zurück zum Zitat Longin E, Schaible T, Lenz T, Konig S (2005) Short term heart rate variability in healthy neonates: normative data and physiological observations. Early Hum Dev 81:663–671CrossRefPubMed Longin E, Schaible T, Lenz T, Konig S (2005) Short term heart rate variability in healthy neonates: normative data and physiological observations. Early Hum Dev 81:663–671CrossRefPubMed
21.
Zurück zum Zitat Napadow V, Dhond R, Conti G, Makris N, Brown EN, Barbieri R (2008) Brain correlates of autonomic modulation: combining heart rate variability with fMRI. Neuroimage 42:169–177PubMedCentralCrossRefPubMed Napadow V, Dhond R, Conti G, Makris N, Brown EN, Barbieri R (2008) Brain correlates of autonomic modulation: combining heart rate variability with fMRI. Neuroimage 42:169–177PubMedCentralCrossRefPubMed
22.
Zurück zum Zitat Patural H, Barthelemy JC, Pichot V, Mazzocchi C, Teyssier G, Damon G, Roche F (2004) Birth prematurity determines prolonged autonomic nervous system immaturity. Clin Auton Res 14:391–395CrossRefPubMed Patural H, Barthelemy JC, Pichot V, Mazzocchi C, Teyssier G, Damon G, Roche F (2004) Birth prematurity determines prolonged autonomic nervous system immaturity. Clin Auton Res 14:391–395CrossRefPubMed
23.
Zurück zum Zitat Pincus SM (1990) Approximate entropy as a measure of system complexity. Proc Natl Acad Sci 88:2297–2301CrossRef Pincus SM (1990) Approximate entropy as a measure of system complexity. Proc Natl Acad Sci 88:2297–2301CrossRef
24.
Zurück zum Zitat Rosenstock EG, Cassuto Y, Zmora E (1999) Heart rate variability in the neonate and infant: analytical methods, physiological and clinical observations. Acta Paediatr 88:477–482CrossRefPubMed Rosenstock EG, Cassuto Y, Zmora E (1999) Heart rate variability in the neonate and infant: analytical methods, physiological and clinical observations. Acta Paediatr 88:477–482CrossRefPubMed
25.
Zurück zum Zitat Scher MS, Steppe DA, Dahl RE, Asthana S, Guthrie RD (1992) Comparison of EEG sleep measures in healthy full-term and preterm infants at matched conceptional ages. Sleep 15:442–448PubMed Scher MS, Steppe DA, Dahl RE, Asthana S, Guthrie RD (1992) Comparison of EEG sleep measures in healthy full-term and preterm infants at matched conceptional ages. Sleep 15:442–448PubMed
26.
Zurück zum Zitat Shaltout HA, Chappell MC, Rose JC, Diz DI (2011) Exaggerated sympathetic mediated responses to behavioral or pharmacological challenges following antenatal betamethasone exposure. Am J Physiol Endocrinol Metab 300:E979–E985PubMedCentralCrossRefPubMed Shaltout HA, Chappell MC, Rose JC, Diz DI (2011) Exaggerated sympathetic mediated responses to behavioral or pharmacological challenges following antenatal betamethasone exposure. Am J Physiol Endocrinol Metab 300:E979–E985PubMedCentralCrossRefPubMed
27.
Zurück zum Zitat Sugihara G, Allan W, Sobel D, Allan KD (1996) Non-linear control of heart rate variability in human infants. Proc Natl Acad Sci USA 93:2608–2613PubMedCentralCrossRefPubMed Sugihara G, Allan W, Sobel D, Allan KD (1996) Non-linear control of heart rate variability in human infants. Proc Natl Acad Sci USA 93:2608–2613PubMedCentralCrossRefPubMed
28.
Zurück zum Zitat Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability. Standards of measurement, physiological interpretation, and clinical use Eur Heart J. 17:354–381 Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability. Standards of measurement, physiological interpretation, and clinical use Eur Heart J. 17:354–381
29.
Zurück zum Zitat Thiriez G, Tournoud M, Wermenbol V, Vermeylen D, Ecochard R, Iwaz J, Lin JS, Franco P (2012) Decreased spontaneous arousability in preterm newborns with impaired neurological outcome. J Sleep Res 21:552–560CrossRefPubMed Thiriez G, Tournoud M, Wermenbol V, Vermeylen D, Ecochard R, Iwaz J, Lin JS, Franco P (2012) Decreased spontaneous arousability in preterm newborns with impaired neurological outcome. J Sleep Res 21:552–560CrossRefPubMed
30.
Zurück zum Zitat Van de Borne P, Nguyen H, Biston P, Linkowski P, Degaute JP (1994) Effects of wake and sleep stages on the 24-h autonomic control of blood pressure and heart rate in recumbent men. Am J Physiol 266:H548–H554PubMed Van de Borne P, Nguyen H, Biston P, Linkowski P, Degaute JP (1994) Effects of wake and sleep stages on the 24-h autonomic control of blood pressure and heart rate in recumbent men. Am J Physiol 266:H548–H554PubMed
31.
Zurück zum Zitat Vermeylen D, Franco P, Wermenbol V, Muller MF, Pardou A (2004) Neurodevelopment of extremely low birthweight infants born in Erasmus Hospital between 1992 and 2001. Rev Med Brux 25:449–455PubMed Vermeylen D, Franco P, Wermenbol V, Muller MF, Pardou A (2004) Neurodevelopment of extremely low birthweight infants born in Erasmus Hospital between 1992 and 2001. Rev Med Brux 25:449–455PubMed
32.
Zurück zum Zitat Yamamoto Y, Hughson RL (1991) Coarse-graining spectral analysis: new method for studying heart rate variability. J Appl Physiol 71:1143–1150PubMed Yamamoto Y, Hughson RL (1991) Coarse-graining spectral analysis: new method for studying heart rate variability. J Appl Physiol 71:1143–1150PubMed
Metadaten
Titel
Altered autonomic control in preterm newborns with impaired neurological outcomes
verfasst von
Gerard Thiriez
Clémence Mougey
Danièle Vermeylen
Vanessa Wermenbol
Jean-Pol Lanquart
Jian Sheng Lin
Patricia Franco
Publikationsdatum
01.08.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Autonomic Research / Ausgabe 4/2015
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-015-0298-6

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