EEG, behavioural, and physiological responses to a painful procedure in human neonates with relevant medical history

Cortical pain responses from 112 human neonates were measured using EEG to a single painful procedure (clinically required blood test). Behavioural and physiological responses were also recorded as part of a standard composite pain score, Premature Infant Pain Profile (PIPP). Extensive notes were collected regarding the infant’s medical and pain history up to the day of the procedure. The data includes 4 second epochs from a 20 channel EEG recording that was time-locked to heel lance, control, and auditory stimuli. PIPP scores for each of the 3 stimulus types are also provided. Up to the time of the procedure, we have collected detailed information from the medical notes for each infant. This information includes: the condition at birth, diagnoses, medications, previous painful procedures, and injuries. Written parental consent was obtained prior to each study. The study was approved by the NHS Health Research Authority and the study conformed to the standards set by the Declaration of Helsinki.Many infants are born too young or too small or with serious medical conditions. As a result, these infants will need to spend time in hospital and undergo numerous clinical procedures, many of which are painful. While even the youngest preterm infant can show behavioural reactions to pain, we do not know how much the pain is processed in their brain. This is important because the brain is responsible for the actual feeling of pain: how much it hurts, where it is and how unpleasant it is. Our research aims to discover this so that infant pain can be prevented or adequately treated. Too much injury and stress in early life, when the brain is still forming connections, is thought to alter normal development of pain pathways in the brain, but this process is poorly understood. We intend to clarify this by measuring brain activity, tissue injury and physiological stress independently and analysing how they influence each other in intensive care. Finally, since each infant is an individual, we need to know how pain pathways in the brain differ between infants and what factors are responsible for these differences. Our work will help ensure that each hospitalised infant receives appropriate pain relief.