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Hari Gopal S, Alenghat T, Pammi M. Early life epigenetics and childhood outcomes: a scoping review. Pediatr Res 2024:10.1038/s41390-024-03585-7. [PMID: 39289593 DOI: 10.1038/s41390-024-03585-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 08/28/2024] [Accepted: 09/07/2024] [Indexed: 09/19/2024]
Abstract
Epigenetics is the study of changes in gene expression, without a change in the DNA sequence that are potentially heritable. Epigenetic mechanisms such as DNA methylation, histone modifications, and small non-coding RNA (sncRNA) changes have been studied in various childhood disorders. Causal links to maternal health and toxin exposures can introduce epigenetic modifications to the fetal DNA, which can be detected in the cord blood. Cord blood epigenetic modifications provide evidence of in-utero stressors and immediate postnatal changes, which can impact both short and long-term outcomes in children. The mechanisms of these epigenetic changes can be leveraged for prevention, early detection, and intervention, and to discover novel therapeutic modalities in childhood diseases. We report a scoping review of early life epigenetics, the influence of maternal health, maternal toxin, and drug exposures on the fetus, and its impact on perinatal, neonatal, and childhood outcomes. IMPACT STATEMENT: Epigenetic changes such as DNA methylation, histone modification, and non-coding RNA have been implicated in the pathophysiology of various disease processes. The fundamental changes to an offspring's epigenome can begin in utero, impacting the immediate postnatal period, childhood, adolescence, and adulthood. This scoping review summarizes current literature on the impact of early life epigenetics, especially DNA methylation on childhood health outcomes.
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Affiliation(s)
- Srirupa Hari Gopal
- Dept. of Pediatrics, Division of Neonatology, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA.
| | - Theresa Alenghat
- Division of Immunobiology and Center for Inflammation and Tolerance, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Mohan Pammi
- Dept. of Pediatrics, Division of Neonatology, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA
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Petroff RL, Jester J, Riggs J, Alfafara E, Springer K, Kerr N, Issa M, Hall A, Rosenblum K, Goodrich JM, Muzik M. Longitudinal DNA methylation in parent-infant pairs impacted by intergenerational social adversity: An RCT of the Michigan Model of Infant Mental Health Home Visiting. Brain Behav 2024; 14:e70035. [PMID: 39295112 PMCID: PMC11410872 DOI: 10.1002/brb3.70035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 06/26/2024] [Accepted: 08/03/2024] [Indexed: 09/21/2024] Open
Abstract
INTRODUCTION Early childhood development is a strong predictor of long-term health outcomes, potentially mediated via epigenetics (DNA methylation). The aim of the current study was to examine how childhood experiences, punitive parenting, and an intergenerational psychotherapeutic intervention may impact DNA methylation in young children and their mothers. METHODS Mothers and their infants/toddlers between 0 and 24 months were recruited at baseline (n = 146, 73 pairs) to participate in a randomized control trial evaluating the effectiveness of The Michigan Model of Infant Mental Health Home Visiting (IMH-HV) parent-infant psychotherapy compared to treatment as usual. Baseline and 12-month post-enrollment data were collected in the family's home and included self-report questionnaires, biological saliva samples, home environment observation, video-taped parent-child interaction, and audio-recorded interviews. Saliva DNA methylation was measured at the genes, nuclear receptor subfamily 3 group C member 1 (NR3C1), solute carrier family 6 member 4 (SLC6A4), brain-derived neurotrophic factor (BDNF), and the genetic element, long interspersed nuclear element-1 (LINE1). RESULTS For mothers, baseline methylation of BDNF, SLC6A4, NR3C1, or LINE1 was largely not associated with baseline measures of their childhood adversity, adverse life experiences, demographic characteristics related to structurally driven inequities, or to IMH-HV treatment effect. In infants, there were suggestions that methylation in SLC6A4 and LINE1 was associated with parenting attitudes. Infant BDNF methylation suggested an overall decrease in response to IMH-HV psychotherapy over 12 months. CONCLUSIONS Overall, our findings suggest that the epigenome in infants and young children may be sensitive to both early life experiences and parent-infant psychotherapy.
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Affiliation(s)
- Rebekah L Petroff
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Jennifer Jester
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Jessica Riggs
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Emily Alfafara
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Katherine Springer
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Natalie Kerr
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Meriam Issa
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Alanah Hall
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Katherine Rosenblum
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
- Department of Obstetrics & Gynecology, Michigan Medicine, Ann Arbor, Michigan, USA
- Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Jaclyn M Goodrich
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Maria Muzik
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
- Department of Obstetrics & Gynecology, Michigan Medicine, Ann Arbor, Michigan, USA
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Manzotti A, Panisi C, Pivotto M, Vinciguerra F, Benedet M, Brazzoli F, Zanni S, Comassi A, Caputo S, Cerritelli F, Chiera M. An in-depth analysis of the polyvagal theory in light of current findings in neuroscience and clinical research. Dev Psychobiol 2024; 66:e22450. [PMID: 38388187 DOI: 10.1002/dev.22450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 09/04/2023] [Accepted: 12/01/2023] [Indexed: 02/24/2024]
Abstract
The polyvagal theory has led to the understanding of the functions of the autonomic nervous system in biological development in humans, since the vagal system, a key structure within the polyvagal theory, plays a significant role in addressing challenges of the mother-child dyad. This article aims to summarize the neurobiological aspects of the polyvagal theory, highlighting some of its strengths and limitations through the lens of new evidence emerging in several research fields-including comparative anatomy, embryology, epigenetics, psychology, and neuroscience-in the 25 years since the theory's inception. Rereading and incorporating the polyvagal idea in light of modern scientific findings helps to interpret the role of the vagus nerve through the temporal dimension (beginning with intrauterine life) and spatial dimension (due to the numerous connections of the vagus with various structures and systems) in the achievement and maintenance of biopsychosocial well-being, from the uterus to adulthood.
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Affiliation(s)
- Andrea Manzotti
- Division of Neonatology, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
- Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Cristina Panisi
- Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Micol Pivotto
- Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | | | - Matteo Benedet
- Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | | | - Silvia Zanni
- Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Alberto Comassi
- Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Sara Caputo
- Research Department, SOMA Istituto Osteopatia Milano, Milan, Italy
| | - Francesco Cerritelli
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | - Marco Chiera
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
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Mariani Wigley ILC, Björnsdotter M, Scheinin NM, Merisaari H, Saunavaara J, Parkkola R, Bonichini S, Montirosso R, Karlsson L, Karlsson H, Tuulari JJ. Infants' sex affects neural responses to affective touch in early infancy. Dev Psychobiol 2023; 65:e22419. [PMID: 37860896 DOI: 10.1002/dev.22419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/26/2023] [Accepted: 08/12/2023] [Indexed: 10/21/2023]
Abstract
Social touch is closely related to the establishment and maintenance of social bonds in humans, and the sensory brain circuit for gentle brushing is already active soon after birth. Brain development is known to be sexually dimorphic, but the potential effect of sex on brain activation to gentle touch remains unknown. Here, we examined brain activation to gentle skin stroking, a tactile stimulation that resembles affective or social touch, in term-born neonates. Eighteen infants aged 11-36 days, recruited from the FinnBrain Birth Cohort Study, were included in the study. During natural sleep, soft brush strokes were applied to the skin of the right leg during functional magnetic resonance imaging (fMRI) at 3 cm/s velocity. We examined potential differences in brain activation between males (n = 10) and females (n = 8) and found that females had larger blood oxygenation level dependent (BOLD) responses (brushing vs. rest) in bilateral orbitofrontal cortex (OFC), right ventral striatum and bilateral inferior striatum, pons, and cerebellum compared to males. Moreover, the psychophysiological interactions (PPI) analysis, setting the left and right OFC as seed regions, revealed significant differences between males and females. Females exhibited stronger PPI connectivity between the left OFC and posterior cingulate or cuneus. Our work suggests that social touch neural responses are different in male and female neonates, which may have major ramifications for later brain, cognitive, and social development. Finally, many of the sexually dimorphic brain responses were subcortical, not captured by surface-based neuroimaging, indicating that fMRI will be a relevant technique for future studies.
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Affiliation(s)
| | - Malin Björnsdotter
- Department of Affective Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
- Center for Cognitive and Computational Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Noora M Scheinin
- Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Harri Merisaari
- Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, University of Turku, Turku, Finland
- Department of Radiology, University of Turku, Turku, Finland
| | - Jani Saunavaara
- Department of Radiology, University of Turku, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, University of Turku, Turku, Finland
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Sabrina Bonichini
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Rosario Montirosso
- 0-3 Center for the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Linnea Karlsson
- Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
- Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland
| | - Hasse Karlsson
- Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
- Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland
| | - Jetro J Tuulari
- Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
- Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland
- Department of Psychiatry, University of Oxford, Oxford, UK
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Duff IT, Krolick KN, Mahmoud HM, Chidambaran V. Current Evidence for Biological Biomarkers and Mechanisms Underlying Acute to Chronic Pain Transition across the Pediatric Age Spectrum. J Clin Med 2023; 12:5176. [PMID: 37629218 PMCID: PMC10455285 DOI: 10.3390/jcm12165176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/01/2023] [Accepted: 08/05/2023] [Indexed: 08/27/2023] Open
Abstract
Chronic pain is highly prevalent in the pediatric population. Many factors are involved in the transition from acute to chronic pain. Currently, there are conceptual models proposed, but they lack a mechanistically sound integrated theory considering the stages of child development. Objective biomarkers are critically needed for the diagnosis, risk stratification, and prognosis of the pathological stages of pain chronification. In this article, we summarize the current evidence on mechanisms and biomarkers of acute to chronic pain transitions in infants and children through the developmental lens. The goal is to identify gaps and outline future directions for basic and clinical research toward a developmentally informed theory of pain chronification in the pediatric population. At the outset, the importance of objective biomarkers for chronification of pain in children is outlined, followed by a summary of the current evidence on the mechanisms of acute to chronic pain transition in adults, in order to contrast with the developmental mechanisms of pain chronification in the pediatric population. Evidence is presented to show that chronic pain may have its origin from insults early in life, which prime the child for the development of chronic pain in later life. Furthermore, available genetic, epigenetic, psychophysical, electrophysiological, neuroimaging, neuroimmune, and sex mechanisms are described in infants and older children. In conclusion, future directions are discussed with a focus on research gaps, translational and clinical implications. Utilization of developmental mechanisms framework to inform clinical decision-making and strategies for prevention and management of acute to chronic pain transitions in children, is highlighted.
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Affiliation(s)
- Irina T. Duff
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21218, USA;
| | - Kristen N. Krolick
- Department of Anesthesia, Cincinnati Children’s Hospital, Cincinnati, OH 45242, USA; (K.N.K.); (H.M.M.)
| | - Hana Mohamed Mahmoud
- Department of Anesthesia, Cincinnati Children’s Hospital, Cincinnati, OH 45242, USA; (K.N.K.); (H.M.M.)
| | - Vidya Chidambaran
- Department of Anesthesia, Cincinnati Children’s Hospital, Cincinnati, OH 45242, USA; (K.N.K.); (H.M.M.)
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Mariani Wigley ILC, Mascheroni E, Pastore M, Bonichini S, Montirosso R. Exploring maternal touch in the infant’s first 18 months of Life: A study on an Italian sample. Infant Behav Dev 2023; 71:101836. [PMID: 36990018 DOI: 10.1016/j.infbeh.2023.101836] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/07/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023]
Abstract
Affective touch is a crucial component of caregiving in early life and constitutes a key factor with a significant impact on infant later-life outcomes. The Parent-Infant Caregiving Touch Scale (PICTS) allows to quantify and qualify the caregiver's self-perception of touch in the first months of an infant's life. In the current study, we contributed to validation of the PICTS in the Italian language in order to explore whether early maternal touch would be associated with maternal emotional state, maternal history of affective touch experiences throughout the lifespan, and infants' sex and age. Data analyses were run on a sample of 377 Italian mothers (mean age = 33.29; SD = 4.79) participating in an online survey. Confirmatory factor analysis was applied. A three-dimensional structure of PICTS (i.e., stroking, affective communication, and holding) after removing one item out resulted in the best model in our sample. Maternal emotional state did not affect PICTS factor scores while maternal comfort and amount of affective touch experienced during adulthood was significantly associated with the stroking, affective communication, and holding factors. Regarding infants' dimensions, infants' sex and age were not associated with PICTS factor scores. Findings suggest that the PICTS Italian version is a good measurement of caregiver's self-perception of touch in early infancy and that maternal history of touch is associated with a mother's current use of touch.
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Affiliation(s)
| | - Eleonora Mascheroni
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy.
| | - Massimiliano Pastore
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Sabrina Bonichini
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Rosario Montirosso
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
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7
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Serra JF, Lisboa IC, Sampaio A, Pereira AF. Observational measures of caregiver's touch behavior in infancy: A systematic review. Neurosci Biobehav Rev 2023; 150:105160. [PMID: 37094739 DOI: 10.1016/j.neubiorev.2023.105160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/28/2023] [Accepted: 04/02/2023] [Indexed: 04/26/2023]
Abstract
The caregiver's touch behavior during early infancy is linked to multiple developmental outcomes. However, social touch remains a challenging construct to operationalize, and although observational tools have been a gold standard for measuring touch in caregiver-infant interactions, no systematic review has been conducted before. We followed the PRISMA guidelines and reviewed the literature to describe and classify the main characteristics of the available observational instruments. Of the 3042 publications found, we selected 45 that included an observational measure, and from those we identified 12 instruments. Most of the studies were of infants younger than six months of age and assessed touch in two laboratory tasks: face-to-face interaction and still-face procedure. We identified three approaches for evaluating the caregiver's touch behavior: strictly observational (the observable touch behavior), functional (the functional role of the touch behavior), or mixed (a combination of the previous two). Half of the instruments were classified as functional, 25% as strictly observational, and 25% as mixed. The lack of conceptual and operational uniformity and consistency between instruments is discussed.
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Affiliation(s)
- Juliana F Serra
- Centro de Investigação em Psicologia (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
| | - Isabel C Lisboa
- UNINOVA-CTS (Center of Technology and Systems), NOVA University of Lisbon, 2829-516 Monte da Caparica, Portugal; Centro de Investigação em Psicologia (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Adriana Sampaio
- Centro de Investigação em Psicologia (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal; Psychological Neuroscience Lab, Campus de Gualtar, CPsi, School of Psychology, University of Minho, 4710-057 Braga, Portugal.
| | - Alfredo F Pereira
- UNINOVA-CTS (Center of Technology and Systems), NOVA University of Lisbon, 2829-516 Monte da Caparica, Portugal; Centro de Investigação em Psicologia (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
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Zheng W, Chotipanvithayakul R, Ingviya T, Xia X, Xie L, Gao J. Sensory stimulation program improves developments of preterm infants in Southwest China: A randomized controlled trial. Front Psychol 2022; 13:867529. [PMID: 36046409 PMCID: PMC9421138 DOI: 10.3389/fpsyg.2022.867529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Preterm infants are prone to growth and developmental delay, especially social-emotional development. Sensory stimulation may benefit developmental outcomes for these vulnerable infants. This study aims to determine whether 5-integrated sensory stimulation (5-ISS) improves preterm infant social-emotional development. A randomized, parallel trial was conducted from November 2018 to January 2020 at three tertiary hospitals in Kunming, China. Preterm infants were eligible if gestational ages were from 28 to 36 weeks based on ultrasound results when discharged from neonatal wards. Two hundred preterm infants (male n = 110, female n = 90) were randomly allocated to the 5-ISS intervention group (n = 98) and the standard care group (n = 102). Social-emotional development was assessed with the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE). Temperament was assessed with the Infant Behavior Questionnaire-Revised. Anthropometry, which included weight, length, and head circumference, was measured at corrected ages of 1, 3, and 6 months. Demographic and clinical characteristics were similar between the intervention and the standard care groups. At 1- and 3-month corrected age, no significant differences between the two groups were observed in terms of infant development and temperament. At 6 months, significant disparities were found in the social-emotional development scale (mean difference −0.29, 95% CI: −0.58, < -0.001, p = 0.01), infant length (mean difference 0.70, 95% CI: < 0.001, 1.4, p = 0.03), distress to limitation (p = 0.04), and sadness (p = 0.03). A mixed model revealed that the 5-ISS intervention positively affected social-emotional development, length, distress to limitation, and sadness for preterm infants. Integrated sensory stimulation has benefits on social-emotional development, temperament, and length for preterm infants. This program provides a feasible method to promote social-emotional development for preterm infants.
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Affiliation(s)
- Wenjing Zheng
- Department of Pediatrics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Rassamee Chotipanvithayakul
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
- Research Center for Kids and Youth Development, Prince of Songkla University, Hat Yai, Thailand
- *Correspondence: Rassamee Chotipanvithayakul,
| | - Thammasin Ingviya
- Department of Family Medicine and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
- Research Center for Applied Medical Data Analytics, Prince of Songkla University, Hat Yai, Thailand
| | - Xiaoling Xia
- Department of Pediatrics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lu Xie
- Department of Neonatology, Kunming University Affiliated Maternal and Child Health Hospital, Kunming, China
| | - Jin Gao
- Department of Neonatology, Kunming Children Hospital, Kunming, China
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Jackson EE, McGlone FP, Haggarty CJ. The social brain has a nerve: insights from attachment and autistic phenotypes. Curr Opin Behav Sci 2022. [DOI: 10.1016/j.cobeha.2022.101114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Manzotti A, Cerritelli F, Lombardi E, Monzani E, Savioli L, Esteves JE, Galli M, La Rocca S, Biasi P, Chiera M, Lista G. Osteopathic Manipulative Treatment Regulates Autonomic Markers in Preterm Infants: A Randomized Clinical Trial. Healthcare (Basel) 2022; 10:813. [PMID: 35627950 PMCID: PMC9141319 DOI: 10.3390/healthcare10050813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 11/24/2022] Open
Abstract
Osteopathic manipulative treatment (OMT) has been found to be effective in the context of premature infants. Nonetheless, no studies have investigated the immediate effects of OMT on heart rate variability (HRV). As altered HRV reflects poor or worsening newborn's clinical conditions and neurodevelopment, should OMT improve HRV fluctuations, it could become a relevant intervention for improving the care of preterm newborns. Therefore, this study aimed to evaluate whether OMT could affect HRV. The study was carried out at the Buzzi Hospital in Milan. From the neonatal intensive care unit, ninety-six preterm infants (41 males) were enrolled and were randomly assigned to one of two treatment groups: OMT or Static Touch. The infants were born at 33.5 weeks (±4.3) and had a mean birth weight of 2067 g (±929). The study had as primary outcome the change in the beat-to-beat variance in heart rate measured through root mean square of consecutive RR interval differences (RMSSD); other metrics were used as secondary and exploratory analyses. Despite the lack of statistically significant results regarding the primary outcomeand some study limitations, compared to static touch, OMT seemed to favor a parasympathetic modulation and improved HRV, which could reflect improvement in newborn's clinical conditions and development.
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Affiliation(s)
- Andrea Manzotti
- RAISE Lab, Foundation COME Collaboration, 65121 Pescara, Italy; (A.M.); (E.L.); (E.M.); (L.S.); (J.E.E.); (M.G.); (S.L.R.); (P.B.); (M.C.)
- Division of Neonatology, “V. Buzzi” Children’s Hospital, ASST-FBF-Sacco, 20157 Milan, Italy;
- Research Department, SOMA, Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Francesco Cerritelli
- RAISE Lab, Foundation COME Collaboration, 65121 Pescara, Italy; (A.M.); (E.L.); (E.M.); (L.S.); (J.E.E.); (M.G.); (S.L.R.); (P.B.); (M.C.)
| | - Erica Lombardi
- RAISE Lab, Foundation COME Collaboration, 65121 Pescara, Italy; (A.M.); (E.L.); (E.M.); (L.S.); (J.E.E.); (M.G.); (S.L.R.); (P.B.); (M.C.)
- Research Department, SOMA, Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Elena Monzani
- RAISE Lab, Foundation COME Collaboration, 65121 Pescara, Italy; (A.M.); (E.L.); (E.M.); (L.S.); (J.E.E.); (M.G.); (S.L.R.); (P.B.); (M.C.)
| | - Luca Savioli
- RAISE Lab, Foundation COME Collaboration, 65121 Pescara, Italy; (A.M.); (E.L.); (E.M.); (L.S.); (J.E.E.); (M.G.); (S.L.R.); (P.B.); (M.C.)
| | - Jorge E. Esteves
- RAISE Lab, Foundation COME Collaboration, 65121 Pescara, Italy; (A.M.); (E.L.); (E.M.); (L.S.); (J.E.E.); (M.G.); (S.L.R.); (P.B.); (M.C.)
- Research Department, Malta ICOM Educational, GZR 1071 Gzira, Malta
| | - Matteo Galli
- RAISE Lab, Foundation COME Collaboration, 65121 Pescara, Italy; (A.M.); (E.L.); (E.M.); (L.S.); (J.E.E.); (M.G.); (S.L.R.); (P.B.); (M.C.)
- Research Department, SOMA, Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Simona La Rocca
- RAISE Lab, Foundation COME Collaboration, 65121 Pescara, Italy; (A.M.); (E.L.); (E.M.); (L.S.); (J.E.E.); (M.G.); (S.L.R.); (P.B.); (M.C.)
- Research Department, SOMA, Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Pamela Biasi
- RAISE Lab, Foundation COME Collaboration, 65121 Pescara, Italy; (A.M.); (E.L.); (E.M.); (L.S.); (J.E.E.); (M.G.); (S.L.R.); (P.B.); (M.C.)
- Research Department, SOMA, Istituto Osteopatia Milano, 20126 Milan, Italy
| | - Marco Chiera
- RAISE Lab, Foundation COME Collaboration, 65121 Pescara, Italy; (A.M.); (E.L.); (E.M.); (L.S.); (J.E.E.); (M.G.); (S.L.R.); (P.B.); (M.C.)
| | - Gianluca Lista
- Division of Neonatology, “V. Buzzi” Children’s Hospital, ASST-FBF-Sacco, 20157 Milan, Italy;
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