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Cerebral modulation of the autonomic nervous system in term infants

Journal of Perinatology volume 37, pages 558–562 (2017)Cite this article

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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.

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Author information

Authors and Affiliations

  1. Department of Fetal and Transitional Medicine, Fetal Medicine Institute, Children’s National Health System, Washington, DC, USA

    N Schneebaum Sender, R B Govindan, M Metzler & A J du Plessis

  2. Department of Radiology, Children’s National Health System, Washington, DC, USA

    M T Whitehead

  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

    A N Massaro

  4. Division of Biostatistics and Study Methodology, Center for Translational Science, Children’s Research Institute, Children's National Health System, Washington, DC, USA

    J Wang & Y I Cheng

Authors
  1. N Schneebaum Sender
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  2. R B Govindan
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  4. A N Massaro
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Correspondence to N Schneebaum Sender.

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Author contributions

Conception and design: NSS, RG, ANM, JW, AJdP; collection and assembly of data: NSS, RG, ANM, MM, AJdP; analysis and interpretation of the data: NSS, RG, MTW, ANM, MM, JW, YIC, AJdP; intellectual contribution for drafting of the article: NSS, RG, MTW, ANM, MM, JW, YIC, AJdP; critical revision of the article for important intellectual content: NSS, RG, MTW, ANM, MM, JW, AJdP; final approval of the article: NSS, RG, MTW, ANM, MM, JW, YIC, AJdP.

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Schneebaum Sender, N., Govindan, R., Whitehead, M. et al. Cerebral modulation of the autonomic nervous system in term infants. J Perinatol 37, 558–562 (2017). https://doi.org/10.1038/jp.2016.248

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