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Sympathetic nervous system activity and pain-related response indexed by electrodermal activity during the earliest postnatal life in healthy term neonates.

ABSTRACT: Sympathetic nervous system (SNS) undergoes a prolonged period of fetal and neonatal development and maturation during which is vulnerable to a variety of influences (e.g. painful experiences). Thus, we aimed to evaluate SNS activity at rest and in response to stressful stimulus (pain) within the earliest postnatal life in healthy term neonates using electrodermal activity (EDA) measures. In twenty eutrophic healthy term neonates EDA was recorded within the first two hours after birth (measurement 1 - M1) and 72 h after birth (measurement 2 - M2) at rest and in response to pain (M1 - intramuscular K vitamin administration; M2 - heel stick). Evaluated parameters were skin conductance level (SCL), non-specific skin conductance responses (NS.SCRs), skin SCL 10 s before pain stimulus (SCL_10 before pain), skin conductance response (SCR) peak after pain stimulus, SCL 10 s after pain stimulus (SCL_10 after pain), SCR magnitude, latency, SCR rise/decline time, SCR half recovery time. SCL was significantly decreased at rest during M2 compared to M1 (p=0.010). SCL_10 before pain, SCR peak after pain, and SCL_10 after pain stimulus were significantly decreased in M2 compared to M1 (p=0.014, p=0.020, p=0.011, respectively). SCL was significantly decreased and NS.SCRs were significantly higher in the recovery period after the pain stimulus during M2 compared to M1 (p=0.015, p=0.032, respectively). Our results indicate EDA parameters sensitive to detect sympathetic changes during the earliest postnatal life reflecting its potential in early diagnosis of the autonomic maturation - linked pathological states in neonates.

SUBMITTER: Kuderava Z

PROVIDER: S-EPMC10668994 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Sympathetic nervous system activity and pain-related response indexed by electrodermal activity during the earliest postnatal life in healthy term neonates.

Kuderava Z Z Kozar M M Visnovcova Z Z Ferencova N N Tonhajzerova I I Prsova L L Zibolen M M

Physiological research 20230701 3

Sympathetic nervous system (SNS) undergoes a prolonged period of fetal and neonatal development and maturation during which is vulnerable to a variety of influences (e.g. painful experiences). Thus, we aimed to evaluate SNS activity at rest and in response to stressful stimulus (pain) within the earliest postnatal life in healthy term neonates using electrodermal activity (EDA) measures. In twenty eutrophic healthy term neonates EDA was recorded within the first two hours after birth (measuremen ...[more]

PMID: 37449751

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Project description:IntroductionLow back pain (LBP) is a prevalent and multifaceted health condition affecting over 619 million people globally. Today, pain evaluation heavily relies on subjective measures, so more advanced diagnosis and treatment methods are required. Electrodermal activity (EDA) could represent a potential objective tool to assess LBP. Despite its promise, EDA has been less studied in this context, and the methodologies vary across studies. The systematic review described thus aims to determine the relationship between EDA and LBP as well as the potential utility of EDA as a tool for evaluating LBP. The various EDA measurement methodologies employed to detect LBP will also be analysed to ultimately identify the most reliable and effective approaches.Methods and analysisThe primary databases include PubMed, Web of Science (all databases) and Scopus. The search strategy will be tailored to identify articles written in English or Spanish without imposing any time restrictions. The snowballing technique will also be used to identify additional studies by reviewing the reference lists of relevant articles or citing articles.Eligible studies will encompass adults with both acute and chronic LBP. A diverse range of research designs will be considered, focusing on the relationship between EDA and LBP. PEDro scale and Cochrane Risk of Bias tool 2.0 (RoB2) will be used to assess the methodological quality and risk of bias in the studies, respectively. Data synthesis will be based on a structured presentation of participant characteristics, methodological details and EDA-related variables.Ethics and disseminationThis protocol of systematic review, registered in the International Prospective Register of Systematic Reviews, adheres to the PRISMA checklist. The study findings will be disseminated through publication in peer-reviewed journals. The search process is forecast to end on 30 November 2024. Adhering to Spanish guidelines, ethical approval is deemed unnecessary for our secondary analyses, given the de-identification and anonymous analysis of all data.Prospero registration numberCRD42023464812.

Project description:AimsTo explore whether electrodermal activity (EDA) can serve as a complementary tool for pulpal diagnosis (Aim 1) and an objective metric to assess dental pain before and after local anaesthesia (Aim 2).MethodologyA total of 53 subjects (189 teeth) and 14 subjects (14 teeth) were recruited for Aim 1 and Aim 2, respectively. We recorded EDA using commercially available devices, PowerLab and Galvanic Skin Response (GSR) Amplifier, in conjunction with cold and electric pulp testing (EPT). Participants rated their level of sensation on a 0-10 visual analogue scale (VAS) after each test. We recorded EPT-stimulated EDA activity before and after the administration of local anaesthesia for participants who required root canal treatment (RCT) due to painful pulpitis. The raw data were converted to the time-varying index of sympathetic activity (TVSymp), a sensitive and specific parameter of EDA. Statistical analysis was performed using Python 3.6 and its Scikit-post hoc library.ResultsElectrodermal activity was upregulated by the stimuli of cold and EPT testing in the normal pulp. TVSymp signals were significantly increased in vital pulp compared to necrotic pulp by both cold test and EPT. Teeth that exhibited intensive sensitivity to cold with or without lingering pain had increased peak numbers of TVSymp than teeth with mild sensation to cold. Pre- and post-anaesthesia EDA activity and VAS scores were recorded in patients with painful pulpitis. Post-anaesthesia EDA signals were significantly lower compared to pre-anaesthesia levels. Approximately 71% of patients (10 of 14 patients) experienced no pain during treatment and reported VAS score of 0 or 1. The majority of patients (10 of 14) showed a reduction of TVSymp after the administration of anaesthesia. Two of three patients who experienced increased pain during RCT (post-treatment VAS > pre-treatment VAS) exhibited increased post-anaesthesia TVSymp.ConclusionsOur data show promising results for using EDA in pulpal diagnosis and for assessing dental pain. Whilst our testing was limited to subjects who had adequate communication skills, our future goal is to be able to use this technology to aid in the endodontic diagnosis of patients who have limited communication ability.

Project description:BackgroundSelf-reported pain levels, while easily measured, are often not reliable for quantifying pain. More objective methods are needed that supplement self-report without adding undue burden or cost to a study. Methods that integrate multiple measures, such as combining self-report with physiology in a structured and specific-to-pain protocol may improve measures.MethodWe propose and study a novel measure that combines the timing of the peak pain measured by an electronic visual-analog-scale (eVAS) with continuously-measured changes in electrodermal activity (EDA), a physiological measure quantifying sympathetic nervous system activity that is easily recorded with a skin-surface sensor. The new pain measure isolates and specifically quantifies three temporal regions of dynamic pain experience: I. Anticipation preceding the onset of a pain stimulus, II. Response rising to the level of peak pain, and III. Recovery from the peak pain level. We evaluate the measure across two pain models (cold pressor, capsaicin), and four types of treatments (none, A=pregabalin, B=oxycodone, C=placebo). Each of 24 patients made four visits within 8 weeks, for 96 visits total: A training visit (TV), followed by three visits double-blind presenting A, B, or C (randomized order). Within each visit, a participant experienced the cold pressor, followed by an hour of rest during which one of the four treatments was provided, followed by a repeat of the cold pressor, followed by capsaicin.ResultsThe novel method successfully discriminates the pain reduction effects of the four treatments across both pain models, confirming maximal pain for no-treatment, mild pain reduction for placebo, and the most pain reduction with analgesics. The new measure maintains significant discrimination across the test conditions both within a single-day's visit (for relative pain relief within a visit) and across repeated visits spanning weeks, reducing different-day-physiology affects, and providing better discriminability than using self-reported eVAS.ConclusionThe new method combines the subjectively-identified time of peak pain with capturing continuous physiological data to quantify the sympathetic nervous system response during a dynamic pain experience. The method accurately discriminates, for both pain models, the reduction of pain with clinically effective analgesics.

Dataset Information

Sympathetic nervous system activity and pain-related response indexed by electrodermal activity during the earliest postnatal life in healthy term neonates.

Publications

Sympathetic nervous system activity and pain-related response indexed by electrodermal activity during the earliest postnatal life in healthy term neonates.

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