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Mohamed SHM, Reissland N, Anand KJS. An Evidence-Based Discussion of Fetal Pain and Stress. Neonatology 2024:1-7. [PMID: 38781940 DOI: 10.1159/000538848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/10/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The concept of fetal pain results from procedures conducted without anesthesia in preterm newborns and fetuses, which indicate that it is possible to examine fetal pain based on stress hormone, metabolic, and behavioral changes. Anatomical and physiological data suggest that fetuses become capable of processing nociceptive stimuli around midgestation, although the associated changes in fetal brain development remain unclear. What constitutes fetal pain remains controversial in the light of the definition of pain adopted by the International Association for the Study of Pain (IASP), which posits pain as an "unpleasant sensory and emotional experience." SUMMARY Here, we examine the notion that human fetuses cannot "experience" pain and potential implications of this claim. We highlight the key scientific evidence related to fetal pain, including clinical studies on pain in fetuses and preterm newborns. We argue that consistent patterns of stress hormones, metabolic changes, body movements, hemodynamic changes, and pain-related facial expressions in fetuses exposed to invasive procedures overcome the need for subjective proof of pain as articulated in the IASP definition. No study to date has conclusively proven the absence of fetal pain beyond the age of viability. KEY MESSAGES Based on the current evidence, we propose that all fetuses receive anesthesia regardless of the invasive procedures being performed to guarantee the least possible pain and physiological, behavioral, or hormonal responses without exposing the mother or her baby to unnecessary complications.
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Affiliation(s)
- Samirah H M Mohamed
- Obstetric Clinic at the Clinics Hospital of the Medical School, The University of São Paulo, São Paulo, Brazil
- Research Department of the Hospital e Maternidade Vitória, São Paulo, Brazil
- Medical Tutor at the University Center of the Faculty of the Americas, São Paulo, Brazil
| | | | - Kanwaljeet J S Anand
- Departments of Pediatrics, Perioperative, and Pain Medicine, Stanford Child Wellness Lab, Maternal & Child Health Research Institute, Stanford University School of Medicine, Stanford, California, USA
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2
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Turk-Browne NB, Aslin RN. Infant neuroscience: how to measure brain activity in the youngest minds. Trends Neurosci 2024; 47:338-354. [PMID: 38570212 DOI: 10.1016/j.tins.2024.02.003] [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: 06/30/2023] [Revised: 01/08/2024] [Accepted: 02/09/2024] [Indexed: 04/05/2024]
Abstract
The functional properties of the infant brain are poorly understood. Recent advances in cognitive neuroscience are opening new avenues for measuring brain activity in human infants. These include novel uses of existing technologies such as electroencephalography (EEG) and magnetoencephalography (MEG), the availability of newer technologies including functional near-infrared spectroscopy (fNIRS) and optically pumped magnetometry (OPM), and innovative applications of functional magnetic resonance imaging (fMRI) in awake infants during cognitive tasks. In this review article we catalog these available non-invasive methods, discuss the challenges and opportunities encountered when applying them to human infants, and highlight the potential they may ultimately hold for advancing our understanding of the youngest minds.
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Affiliation(s)
- Nicholas B Turk-Browne
- Department of Psychology, Yale University, New Haven, CT 06520, USA; Wu Tsai Institute, Yale University, New Haven, CT 06510, USA.
| | - Richard N Aslin
- Department of Psychology, Yale University, New Haven, CT 06520, USA; Child Study Center, Yale School of Medicine, New Haven, CT 06520, USA
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3
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Bayne T, Seth AK, Massimini M, Shepherd J, Cleeremans A, Fleming SM, Malach R, Mattingley JB, Menon DK, Owen AM, Peters MAK, Razi A, Mudrik L. Tests for consciousness in humans and beyond. Trends Cogn Sci 2024; 28:454-466. [PMID: 38485576 DOI: 10.1016/j.tics.2024.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 05/12/2024]
Abstract
Which systems/organisms are conscious? New tests for consciousness ('C-tests') are urgently needed. There is persisting uncertainty about when consciousness arises in human development, when it is lost due to neurological disorders and brain injury, and how it is distributed in nonhuman species. This need is amplified by recent and rapid developments in artificial intelligence (AI), neural organoids, and xenobot technology. Although a number of C-tests have been proposed in recent years, most are of limited use, and currently we have no C-tests for many of the populations for which they are most critical. Here, we identify challenges facing any attempt to develop C-tests, propose a multidimensional classification of such tests, and identify strategies that might be used to validate them.
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Affiliation(s)
- Tim Bayne
- Department of Philosophy, Monash University, Melbourne, VIC, Australia; Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada.
| | - Anil K Seth
- Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada; Sussex Centre for Consciousness Science and School of Engineering and Informatics, University of Sussex, Brighton, UK
| | - Marcello Massimini
- Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada; Department of Biomedical and Clinical Science, University of Milan, Milan, Italy; IRCCS Fondazione Don Gnocchi
| | - Joshua Shepherd
- Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada; Universitat Autònoma de Barcelona, Belleterra, Spain; ICREA, Barcelona, Spain
| | - Axel Cleeremans
- Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada; Center for Research in Cognition and Neuroscience, ULB Institute of Neuroscience, Université libre de Bruxelles, Brussels, Belgium
| | - Stephen M Fleming
- Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada; Department of Experimental Psychology, University College London, London, UK; Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Rafael Malach
- Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada; The Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel
| | - Jason B Mattingley
- Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada; Queensland Brain Institute and School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - David K Menon
- Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada; University of Cambridge, Cambridge, UK
| | - Adrian M Owen
- Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada; University of Western Ontario, London, ON, Canada
| | - Megan A K Peters
- Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada; University of California, Irvine, Irvine, CA, USA
| | - Adeel Razi
- Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada; Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia; Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Liad Mudrik
- Canadian Institute for Advanced Research (CIFAR), Brain, Mind, and Consciousness Program, Toronto, ON, Canada; School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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4
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Panzani M, Mahmoudzadeh M, Wallois F, Dehaene-Lambertz G. Detection of regularities in auditory sequences before and at term-age in human neonates. Neuroimage 2023; 284:120428. [PMID: 37890563 DOI: 10.1016/j.neuroimage.2023.120428] [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: 03/24/2023] [Revised: 10/02/2023] [Accepted: 10/25/2023] [Indexed: 10/29/2023] Open
Abstract
During the last trimester of gestation, fetuses and preterm neonates begin to respond to sensory stimulation and to discover the structure of their environment. Yet, neuronal migration is still ongoing. This late migration notably concerns the supra-granular layers neurons, which are believed to play a critical role in encoding predictions and detecting regularities. In order to gain a deeper understanding of how the brain processes and perceives regularities during this stage of development, we conducted a study in which we recorded event-related potentials (ERP) in 31-wGA preterm and full-term neonates exposed to alternating auditory sequences (e.g. "ba ga ba ga ba"), when the regularity of these sequences was violated by a repetition (e.g., ``ba ga ba ga ga''). We compared the ERPs in this case to those obtained when violating a simple repetition pattern ("ga ga ga ga ga" vs. "ga ga ga ga ba"). Our results indicated that both preterm and full-term neonates were able to detect violations of regularity in both types of sequences, indicating that as early as 31 weeks gestational age, human neonates are sensitive to the conditional statistics between successive auditory elements. Full-term neonates showed an early and similar mismatch response (MMR) in the repetition and alternating sequences. In contrast, 31-wGA neonates exhibited a two-component MMR. The first component which was only observed for simple sequences with repetition, corresponded to sensory adaptation. It was followed much later by a deviance-detection component that was observed for both alternation and repetition sequences. This pattern confirms that MMRs detected at the scalp may correspond to a dual cortical process and shows that deviance detection computed by higher-level regions accelerates dramatically with brain maturation during the last weeks of gestation to become indistinguishable from bottom-up sensory adaptation at term.
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Affiliation(s)
- Marine Panzani
- GRAMFc, Inserm U 1105, Centre Universitaire de Recherches en Santé, CHU sud, Avenue Laennec, 80036 Amiens Cedex, France
| | - Mahdi Mahmoudzadeh
- GRAMFc, Inserm U 1105, Centre Universitaire de Recherches en Santé, CHU sud, Avenue Laennec, 80036 Amiens Cedex, France
| | - Fabrice Wallois
- GRAMFc, Inserm U 1105, Centre Universitaire de Recherches en Santé, CHU sud, Avenue Laennec, 80036 Amiens Cedex, France.
| | - Ghislaine Dehaene-Lambertz
- Cognitive Neuroimaging Unit U992, CNRS, INSERM,CEA,DRF/Institut Joliot, Université Paris-Saclay, NeuroSpin Center, 91191, Gif/Yvette, France
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5
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Bayne T, Frohlich J, Cusack R, Moser J, Naci L. Consciousness in the cradle: on the emergence of infant experience. Trends Cogn Sci 2023; 27:1135-1149. [PMID: 37838614 PMCID: PMC10660191 DOI: 10.1016/j.tics.2023.08.018] [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: 04/25/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 10/16/2023]
Abstract
Although each of us was once a baby, infant consciousness remains mysterious and there is no received view about when, and in what form, consciousness first emerges. Some theorists defend a 'late-onset' view, suggesting that consciousness requires cognitive capacities which are unlikely to be in place before the child's first birthday at the very earliest. Other theorists defend an 'early-onset' account, suggesting that consciousness is likely to be in place at birth (or shortly after) and may even arise during the third trimester. Progress in this field has been difficult, not just because of the challenges associated with procuring the relevant behavioral and neural data, but also because of uncertainty about how best to study consciousness in the absence of the capacity for verbal report or intentional behavior. This review examines both the empirical and methodological progress in this field, arguing that recent research points in favor of early-onset accounts of the emergence of consciousness.
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Affiliation(s)
- Tim Bayne
- Monash University, Melbourne, VIC, Australia; Brain, Mind, and Consciousness Program, Canadian Institute for Advanced Research, Toronto, Canada.
| | - Joel Frohlich
- Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tübingen, Tübingen, Germany; Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | - Rhodri Cusack
- Thomas Mitchell Professor of Cognitive Neuroscience, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Julia Moser
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, USA
| | - Lorina Naci
- Trinity College Institute of Neuroscience and Global Brain Health Institute, Trinity College, Dublin, Ireland
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6
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Kujala T, Partanen E, Virtala P, Winkler I. Prerequisites of language acquisition in the newborn brain. Trends Neurosci 2023; 46:726-737. [PMID: 37344237 DOI: 10.1016/j.tins.2023.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/13/2023] [Accepted: 05/24/2023] [Indexed: 06/23/2023]
Abstract
Learning to decode and produce speech is one of the most demanding tasks faced by infants. Nevertheless, infants typically utter their first words within a year, and phrases soon follow. Here we review cognitive abilities of newborn infants that promote language acquisition, focusing primarily on studies tapping neural activity. The results of these studies indicate that infants possess core adult auditory abilities already at birth, including statistical learning and rule extraction from variable speech input. Thus, the neonatal brain is ready to categorize sounds, detect word boundaries, learn words, and separate speech streams: in short, to acquire language quickly and efficiently from everyday linguistic input.
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Affiliation(s)
- Teija Kujala
- Cognitive Brain Research Unit, Centre of Excellence in Music, Mind, Body and Brain, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.
| | - Eino Partanen
- Cognitive Brain Research Unit, Centre of Excellence in Music, Mind, Body and Brain, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Paula Virtala
- Cognitive Brain Research Unit, Centre of Excellence in Music, Mind, Body and Brain, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - István Winkler
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
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7
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Frohlich J, Bayne T, Crone JS, DallaVecchia A, Kirkeby-Hinrup A, Mediano PA, Moser J, Talar K, Gharabaghi A, Preissl H. Not with a “zap” but with a “beep”: measuring the origins of perinatal experience. Neuroimage 2023; 273:120057. [PMID: 37001834 DOI: 10.1016/j.neuroimage.2023.120057] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
When does the mind begin? Infant psychology is mysterious in part because we cannot remember our first months of life, nor can we directly communicate with infants. Even more speculative is the possibility of mental life prior to birth. The question of when consciousness, or subjective experience, begins in human development thus remains incompletely answered, though boundaries can be set using current knowledge from developmental neurobiology and recent investigations of the perinatal brain. Here, we offer our perspective on how the development of a sensory perturbational complexity index (sPCI) based on auditory ("beep-and-zip"), visual ("flash-and-zip"), or even olfactory ("sniff-and-zip") cortical perturbations in place of electromagnetic perturbations ("zap-and-zip") might be used to address this question. First, we discuss recent studies of perinatal cognition and consciousness using techniques such as functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and, in particular, magnetoencephalography (MEG). While newborn infants are the archetypal subjects for studying early human development, researchers may also benefit from fetal studies, as the womb is, in many respects, a more controlled environment than the cradle. The earliest possible timepoint when subjective experience might begin is likely the establishment of thalamocortical connectivity at 26 weeks gestation, as the thalamocortical system is necessary for consciousness according to most theoretical frameworks. To infer at what age and in which behavioral states consciousness might emerge following the initiation of thalamocortical pathways, we advocate for the development of the sPCI and similar techniques, based on EEG, MEG, and fMRI, to estimate the perinatal brain's state of consciousness.
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8
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Thill B. The fetal pain paradox. FRONTIERS IN PAIN RESEARCH 2023; 4:1128530. [PMID: 37025166 PMCID: PMC10072285 DOI: 10.3389/fpain.2023.1128530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/21/2023] [Indexed: 04/08/2023] Open
Abstract
Controversy exists as to when conscious pain perception in the fetus may begin. According to the hypothesis of cortical necessity, thalamocortical connections, which do not form until after 24-28 weeks gestation, are necessary for conscious pain perception. However, anesthesiologists and neonatologists treat age-matched neonates as both conscious and pain-capable due to observable and measurable behavioral, hormonal, and physiologic indicators of pain. In preterm infants, these multimodal indicators of pain are uncontroversial, and their presence, despite occurring prior to functional thalamocortical connections, has guided the use of analgesics in neonatology and fetal surgery for decades. However, some medical groups state that below 24 weeks gestation, there is no pain capacity. Thus, a paradox exists in the disparate acknowledgment of pain capability in overlapping patient populations. Brain networks vary by age. During the first and second trimesters, the cortical subplate, a unique structure that is present only during fetal and early neonatal development, forms the first cortical network. In the third trimester, the cortical plate assumes this function. According to the subplate modulation hypothesis, a network of connections to the subplate and subcortical structures is sufficient to facilitate conscious pain perception in the fetus and the preterm neonate prior to 24 weeks gestation. Therefore, similar to other fetal and neonatal systems that have a transitional phase (i.e., circulatory system), there is now strong evidence for transitional developmental phases of fetal and neonatal pain circuitry.
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9
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Near birth experience: An exploratory study on the communication experiences with a hypothetical prenatal consciousness. Explore (NY) 2022:S1550-8307(22)00207-5. [DOI: 10.1016/j.explore.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
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A Transmissive Theory of Brain Function: Implications for Health, Disease, and Consciousness. NEUROSCI 2022. [DOI: 10.3390/neurosci3030032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Identifying a complete, accurate model of brain function would allow neuroscientists and clinicians to make powerful neuropsychological predictions and diagnoses as well as develop more effective treatments to mitigate or reverse neuropathology. The productive model of brain function, which has been dominant in the field for centuries, cannot easily accommodate some higher-order neural processes associated with consciousness and other neuropsychological phenomena. However, in recent years, it has become increasingly evident that the brain is highly receptive to and readily emits electromagnetic (EM) fields and light. Indeed, brain tissues can generate endogenous, complex EM fields and ultraweak photon emissions (UPEs) within the visible and near-visible EM spectra. EM-based neural mechanisms, such as ephaptic coupling and non-visual optical brain signaling, expand canonical neural signaling modalities and are beginning to disrupt conventional models of brain function. Here, we present an evidence-based argument for the existence of brain processes that are caused by the transmission of extracerebral, EM signals and recommend experimental strategies with which to test the hypothesis. We argue for a synthesis of productive and transmissive models of brain function and discuss implications for the study of consciousness, brain health, and disease.
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11
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Semeia L, Sippel K, Moser J, Preissl H. Evaluation of parameters for fetal behavioural state classification. Sci Rep 2022; 12:3410. [PMID: 35233073 PMCID: PMC8888564 DOI: 10.1038/s41598-022-07476-x] [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: 10/13/2021] [Accepted: 02/07/2022] [Indexed: 11/09/2022] Open
Abstract
Fetal behavioural states (fBS) describe periods of fetal wakefulness and sleep and are commonly defined by features such as body and eye movements and heart rate. Automatic state detection through algorithms relies on different parameters and thresholds derived from both the heart rate variability (HRV) and the actogram, which are highly dependent on the specific datasets and are prone to artefacts. Furthermore, the development of the fetal states is dynamic over the gestational period and the evaluation usually only separated into early and late gestation (before and after 32 weeks). In the current work, fBS detection was consistent between the classification algorithm and visual inspection in 87 fetal magnetocardiographic data segments between 27 and 39 weeks of gestational age. To identify how automated fBS detection could be improved, we first identified commonly used parameters for fBS classification in both the HRV and the actogram, and investigated their distribution across the different fBS. Then, we calculated a receiver operating characteristics (ROC) curve to determine the performance of each parameter in the fBS classification. Finally, we investigated the development of parameters over gestation through linear regression. As a result, the parameters derived from the HRV have a higher classification accuracy compared to those derived from the body movement as defined by the actogram. However, the overlapping distributions of several parameters across states limit a clear separation of states based on these parameters. The changes over gestation of the HRV parameters reflect the maturation of the fetal autonomic nervous system. Given the higher classification accuracy of the HRV in comparison to the actogram, we suggest to focus further research on the HRV. Furthermore, we propose to develop probabilistic fBS classification approaches to improve classification in less prototypical datasets.
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Affiliation(s)
- Lorenzo Semeia
- IDM/fMEG Center of the Helmholtz Center Munich at the University of Tübingen, University of Tübingen, German Center for Diabetes Research (DZD), Otfried-Müller-Str. 47, 72076, Tübingen, Germany. .,Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany.
| | - Katrin Sippel
- IDM/fMEG Center of the Helmholtz Center Munich at the University of Tübingen, University of Tübingen, German Center for Diabetes Research (DZD), Otfried-Müller-Str. 47, 72076, Tübingen, Germany.,Department of Internal Medicine IV, University Hospital of Tübingen, Tübingen, Germany
| | - Julia Moser
- IDM/fMEG Center of the Helmholtz Center Munich at the University of Tübingen, University of Tübingen, German Center for Diabetes Research (DZD), Otfried-Müller-Str. 47, 72076, Tübingen, Germany.,Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany
| | - Hubert Preissl
- IDM/fMEG Center of the Helmholtz Center Munich at the University of Tübingen, University of Tübingen, German Center for Diabetes Research (DZD), Otfried-Müller-Str. 47, 72076, Tübingen, Germany.,Department of Internal Medicine IV, University Hospital of Tübingen, Tübingen, Germany.,Department of Pharmacy and Biochemistry, Interfaculty Centre for Pharmacogenomics and Pharma Research, University of Tübingen, Tübingen, Germany
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12
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Ghio M, Cara C, Tettamanti M. The prenatal brain readiness for speech processing: A review on foetal development of auditory and primordial language networks. Neurosci Biobehav Rev 2021; 128:709-719. [PMID: 34274405 DOI: 10.1016/j.neubiorev.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 07/02/2021] [Accepted: 07/09/2021] [Indexed: 10/20/2022]
Abstract
Despite consolidated evidence for the prenatal ability to elaborate and respond to sounds and speech stimuli, the ontogenetic functional brain maturation of language responsiveness in the foetus is still poorly understood. Recent advances in in-vivo foetal neuroimaging have contributed to a finely detailed picture of the anatomo-functional hallmarks that define the prenatal neurodevelopment of auditory and language-related networks. Here, we first outline available evidence for the prenatal development of auditory and language-related brain structures and of their anatomical connections. Second, we focus on functional connectivity data showing the emergence of auditory and primordial language networks in the foetal brain. Third, we recapitulate functional neuroimaging studies assessing the prenatal readiness for sound processing, as a crucial prerequisite for the foetus to experientially respond to spoken language. In conclusion, we suggest that the state of the art has reached sufficient maturity to directly assess the neural mechanisms underlying the prenatal readiness for speech processing and to evaluate whether foetal neuromarkers can predict the postnatal development of language acquisition abilities and disabilities.
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Affiliation(s)
- Marta Ghio
- CIMeC - Center for Mind/Brain Sciences, University of Trento, Italy
| | - Cristina Cara
- CIMeC - Center for Mind/Brain Sciences, University of Trento, Italy
| | - Marco Tettamanti
- CIMeC - Center for Mind/Brain Sciences, University of Trento, Italy.
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