Inferring pain experience in infants using quantitative whole-brain functional MRI signatures: a cross-sectional, observational study.

摘要: Background In the absence of verbal communication, it is challenging to infer an individual's sensory and emotional experience. communicative adults, functional MRI (fMRI) has been used develop multivariate brain activity signatures, which reliably capture elements human pain We aimed translate whole-brain fMRI signatures that encode perception in adults newborn infant brain, advance understanding development early life. Methods this cross-sectional, observational study, we recruited at University Oxford (Oxford, UK) infants on postnatal wards John Radcliffe Hospital UK). Healthy full-term were eligible for inclusion if they clinically stable, self-ventilating air, had no neurological abnormalities. Infants consecutively two cohorts (A B) due installation a new scanner using same recruitment criteria. Adults (aged ≥18 years) postgraduate students or staff Oxford. Participants stimulated with low intensity nociceptive stimuli (64, 128, 256, 512 mN adults; 64 128 infants) during acquisition data. (neurologic signature [NPS] stimulus independent signature-1 [SIIPS1]), four control (the vicarious signature, picture-induced negative emotion [PINES], social rejection global signal signature) applied directly adult data translated brain. assessed concordance responses cosine similarity scores, encoding Spearman rank correlation test. also pro-pain anti-pain components signatures. Findings Between May 22, 2013, Jan 29, 2018, ten healthy participants cohort (five women five men; mean age 28·3 years [range 23-36]), 15 A (six girls nine boys; 4 days 1-11]), 22 B (11 11 3 1-10]). The NPS was activated both infants, encoded intensity. (p<0·0001) (p=0·048 A; p=0·001 B). SIIPS1 only expressed adults. Pro-pain regions showed similar activation patterns whereas divergent. Interpretation Basic information infants. However, translation indicated substantial differences cerebral processing information, might reflect their expectation, motivation, contextualisation associated pain. This study expands use non-verbal patients provides potential research approach assess impact analgesic interventions function Funding Wellcome Trust, Supporting Sick Newborn Parents Medical Research Fund.