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Neonatal ICU Stressors Alter Brain Structure, Function

Exposure to stressors decreases brain width, function; alters motor behavior in preterm infants

WEDNESDAY, Oct. 5 (HealthDay News) -- Exposure to stressors in the neonatal intensive care unit (NICU) is associated with alterations in regional brain structure and function in preterm infants, according to a study published online Oct. 4 in the Annals of Neurology.

Gillian C. Smith, from the Washington University School of Medicine in St. Louis, and colleagues investigated the impact of exposure to stressors in the NICU on the brain structure and functional outcomes of preterm infants born at less than 30 weeks of gestation. Neonatal Infant Stressor Scale scores derived from recordings of procedures and cares by trained nurses were used to measure exposure to stressors. Cerebral structure and function were assessed by magnetic resonance imaging (brain metrics, diffusion, and functional magnetic resonance imaging), and neurobehavioral examinations at term-equivalent postmenstrual age. These relationships were analyzed using simple and partial correlations after correcting for confounders, including immaturity and severity of illness.

The investigators found that the amount of exposure to stressors varied significantly between infants and over the course of a single infant's admission. Exposure to a higher number of stressors correlated with decreased brain width in the frontal and parietal regions, altered functional connectivity and diffusion measures within the temporal lobes, and altered motor behavior on neurobehavioral examination.

"Our data suggest an important vulnerability of the preterm brain to stressful exposures, independent of measures of severity of illness, that is highly worthy of research focus," the authors write.

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