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Amplitude-integrated EEG and range-EEG modulation associated with pneumatic orocutaneous stimulation in preterm infants

Journal of Perinatology volume 34, pages 213–219 (2014)Cite this article

Subjects

Abstract

Objective:

Controlled somatosensory stimulation strategies have demonstrated merit in developing oral feeding skills in premature infants who lack a functional suck, however, the effects of orosensory entrainment stimulation on electrocortical dynamics is unknown. The objective of the study was to determine the effects of servo-controlled pneumatic orocutaneous stimulation presented during gavage feedings on the modulation of amplitude-integrated electroencephalogram (aEEG) and range electroencephalogram (rEEG) activity.

Study Design:

Two-channel EEG recordings were collected during 180 sessions that included orocutaneous stimulation and non-stimulation epochs among 22 preterm infants (mean gestational age=28.56 weeks) who were randomized to treatment and control ‘sham’ conditions. The study was initiated at around 32 weeks post-menstrual age. The raw EEG was transformed into aEEG margins, and rEEG amplitude bands measured at 1-min intervals and subjected to a mixed models statistical analysis.

Result:

Multiple significant effects were observed in the processed EEG during and immediately following 3-min periods of orocutaneous stimulation, including modulation of the upper and lower margins of the aEEG, and a reorganization of rEEG with an apparent shift from amplitude bands D and E to band C throughout the 23-min recording period that followed the first stimulus block when compared with the sham condition. Cortical asymmetry also was apparent in both EEG measures.

Conclusion:

Orocutaneous stimulation represents a salient trigeminal input, which has both short- and long-term effects in modulating electrocortical activity, and thus is hypothesized to represent a form of neural adaptation or plasticity that may benefit the preterm infant during this critical period of brain maturation.

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Acknowledgements

Implementation of this program would not have been possible without extreme dedication of SCVMC NICU staff and families, Santa Clara County First Five and Valley Medical Center Foundation. This study was supported in part by grants NIH R01 DC003311 (SM Barlow), NIH P30 HD02528 and the Sutherland Family Foundation.

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Authors and Affiliations

  1. SPLH-Neuroscience and Bioengineering, University of Kansas, Lawrence, KS, USA

    S M Barlow, J Wang & A Oder

  2. Santa Clara Valley Medical Center, Neonatology, San Jose, CA, USA

    P Jegatheesan, S Weiss, B Govindaswami & D Song

  3. Center for Research Methods and Data Analysis, University of Kansas, Lawrence, KS, USA

    J Lee

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  1. S M Barlow
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  2. P Jegatheesan
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Correspondence to S M Barlow.

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Competing interests

None of the authors have a direct financial relation with the manufacturers of the Soothie pacifier, Brainz EEG monitor and Analyze software, nor with the SAS statistical software. Dr Barlow is the inventor of the NTrainer System, which is registered and licensed by the University of Kansas to Innara Health, Incorporated (Olathe, KS, USA).

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Barlow, S., Jegatheesan, P., Weiss, S. et al. Amplitude-integrated EEG and range-EEG modulation associated with pneumatic orocutaneous stimulation in preterm infants. J Perinatol 34, 213–219 (2014). https://doi.org/10.1038/jp.2013.150

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