N Schneebaum Sender1, R B Govindan1, M T Whitehead2, A N Massaro3, M Metzler1, J Wang4, Y I Cheng4, A J du Plessis1. 1. Department of Fetal and Transitional Medicine, Fetal Medicine Institute, Children's National Health System, Washington, DC, USA. 2. Department of Radiology, Children's National Health System, Washington, DC, USA. 3. Division of Neonatology and Division of Fetal and Transitional Medicine, Children's National Health Systems Pediatrics, The George Washington University School of Medicine, Washington, DC, USA. 4. Division of Biostatistics and Study Methodology, Center for Translational Science, Children's Research Institute, Children's National Health System, Washington, DC, USA.
Abstract
OBJECTIVE: Central topography of autonomic nervous system (ANS) function has yet to be fully deciphered. In adults it has been shown to lateralize sympathetic and parasympathetic influence predominantly to the right and left cerebral hemispheres, respectively. We examined functional topography of central ANS in newborn subjects utilizing spectral analysis of heart rate variability (HRV), an established measure of ANS function. STUDY DESIGN: We studied newborns with hypoxic-ischemic encephalopathy participating in a prospective study undergoing a therapeutic hypothermia protocol.We included subjects with continuous heart rate data over the first 3 h of normothermia (post rewarming) and brain magnetic resonance imaging, which was reviewed and scored according to a 4 region scheme. HRV was evaluated by spectral analysis in the low-frequency (0.05 to 0.25 Hz) and high-frequency (0.3 to 1 Hz) ranges. The relationship between injured brain regions and HRV was studied using multiple regressions. RESULTS: Forty eight newborns were included. When examined in isolation, right hemisphere injury had a significant negative effect on HRV (-0.088; 95% CI: -0.225,-0.008). The combination of posterior fossa region injury with right hemispheric injury or left hemispheric injury demonstrated significant positive (0.299; 95% CI: 0.065, 0.518) and negative (-0.475; 95% CI: -0.852, -0.128) influences on HRV, respectively. The association between brain injury location and HRV in the high-frequency range did not reach significance. CONCLUSION: Our data support the notion that lateralized cerebral modulation of the ANS, specifically of its sympathetic component, is present in the term newborn, and suggest complex modulation of these tracts by components of the posterior fossa.
OBJECTIVE: Central topography of autonomic nervous system (ANS) function has yet to be fully deciphered. In adults it has been shown to lateralize sympathetic and parasympathetic influence predominantly to the right and left cerebral hemispheres, respectively. We examined functional topography of central ANS in newborn subjects utilizing spectral analysis of heart rate variability (HRV), an established measure of ANS function. STUDY DESIGN: We studied newborns with hypoxic-ischemicencephalopathy participating in a prospective study undergoing a therapeutic hypothermia protocol.We included subjects with continuous heart rate data over the first 3 h of normothermia (post rewarming) and brain magnetic resonance imaging, which was reviewed and scored according to a 4 region scheme. HRV was evaluated by spectral analysis in the low-frequency (0.05 to 0.25 Hz) and high-frequency (0.3 to 1 Hz) ranges. The relationship between injured brain regions and HRV was studied using multiple regressions. RESULTS: Forty eight newborns were included. When examined in isolation, right hemisphere injury had a significant negative effect on HRV (-0.088; 95% CI: -0.225,-0.008). The combination of posterior fossa region injury with right hemispheric injury or left hemispheric injury demonstrated significant positive (0.299; 95% CI: 0.065, 0.518) and negative (-0.475; 95% CI: -0.852, -0.128) influences on HRV, respectively. The association between brain injury location and HRV in the high-frequency range did not reach significance. CONCLUSION: Our data support the notion that lateralized cerebral modulation of the ANS, specifically of its sympathetic component, is present in the term newborn, and suggest complex modulation of these tracts by components of the posterior fossa.
Authors: Ipsita Goswami; Daphne Kamino; Elysa Widjaja; Melissa Paniccia; Nicholas Mitsakakis; Aideen Moore; Emily W Y Tam Journal: Pediatr Res Date: 2022-03-15 Impact factor: 3.953
Authors: Sarah B Mulkey; Laura Hitchings; Reva Persaud; Srinivas Kota; G Larry Maxwell; Robin Baker; Adre du Plessis; Rathinaswamy Govindan Journal: Clin Auton Res Date: 2021-03-14 Impact factor: 5.625
Authors: Sarah D Schlatterer; Rathinaswamy B Govindan; Jonathan Murnick; Scott D Barnett; Catherine Lopez; Mary T Donofrio; Sarah B Mulkey; Catherine Limperopoulos; Adre J du Plessis Journal: Pediatr Res Date: 2021-12-28 Impact factor: 3.953