Name: electrophysiological measurement of noxious-evoked brain activity in neonates using a flat-tip probe coupled to electroencephalography
Uploaded: 2017-11-29T15:00:00
Description: Watch this Scientific Journal Video about Electrophysiological Measurement of Noxious-evoked Brain Activity in Neonates Using a Flat-tip Probe Coupled to Electroencephalography at JoVE.com

作者要感谢卡罗琳·哈特利和 Rebeccah 斯莱特 (英国牛津大学儿科系) 对我们的论文和沃尔特 Magerl (生物医学和医学技术中心神经生理学系) 的评论。曼海姆 (CBTM), 德国海德堡大学) 支持我们的技术设备和知识。

这项研究得到了瑞士西北部主管道德委员会 (EKNZ 2015-079) 的批准, 并在测量前获得了有关参与者的书面父母同意。
1. 准备
<ol><li>确保孩子已经安顿好了。它应该是安静和安定的, 不用吮运动在录音期间由于运动文物。婴儿可以睡着9。</li>
	<li>用卷尺测量新生儿头部周长, 确定脑电图帽的大小。</li>
	<li>确定活动电极位置: Cz/顶点位置通过标记中间点之间的 nasio...

<ol>
	<li>Bonica, J. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+need+of+a+taxonomy.">The need of a taxonomy.</a> Pain. 6 (3), 247-248 (1979).</li><li>Duhn, L. J., Medves, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+systematic+integrative+review+of+infant+pain+assessment+tools.">A systematic integrative review of infant pain assessment tools.</a> Adv Neonatal Care. 4 (3), 126-140 (2004).</li><li>Witt, N., Coynor, S., Edwards, C., Bradshaw, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Guide+to+Pain+Assessment+and+Management+in+the+Neonate.">A Guide to Pain Assessment and Management in the Neonate.</a> Curr Emerg Hosp Med Rep. 4, 1-10 (2016).</li><li>Hummel, P., van Dijk, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pain+assessment:+current+status+and+challenges.">Pain assessment: current status and challenges.</a> Semin Fetal Neonatal Med. 11 (4), 237-245 (2006).</li><li>Slater, R., Fitzgerald, M., Meek, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Can+cortical+responses+following+noxious+stimulation+inform+us+about+pain+processing+in+neonates?.">Can cortical responses following noxious stimulation inform us about pain processing in neonates?.</a> Semin Perinatol. 31 (5), 298-302 (2007).</li><li>Hartley, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+relationship+between+nociceptive+brain+activity,+spinal+reflex+withdrawal+and+behaviour+in+newborn+infants.">The relationship between nociceptive brain activity, spinal reflex withdrawal and behaviour in newborn infants.</a> Sci Rep. , 31 (2015).</li><li>Iannetti, G. D., Baumg&#228;rtner, U., Tracey, I., Treede, R. D., Magerl, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pinprick-evoked+brain+potentials:+a+novel+tool+to+assess+central+sensitization+of+nociceptive+pathways+in+humans.">Pinprick-evoked brain potentials: a novel tool to assess central sensitization of nociceptive pathways in humans.</a> J Neurophysiol. 110 (5), 1107-1116 (2013).</li><li>Ziegler, E. A., Magerl, W., Meyer, R. A., Treede, R. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Secondary+hyperalgesia+to+punctate+mechanical+stimuli.+Central+sensitization+to+A-fibre+nociceptor+input.">Secondary hyperalgesia to punctate mechanical stimuli. Central sensitization to A-fibre nociceptor input.</a> Brain. 122 (Pt 12), 2245-2257 (1999).</li><li>Slater, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evoked+potentials+generated+by+noxious+stimulation+in+the+human+infant+brain.">Evoked potentials generated by noxious stimulation in the human infant brain.</a> Eur J Pain. 14 (3), 321-326 (2010).</li><li>Fabrizi, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+shift+in+sensory+processing+that+enables+the+developing+human+brain+to+discriminate+touch+from+pain.">A shift in sensory processing that enables the developing human brain to discriminate touch from pain.</a> Curr Biol. 21 (18), 1552-1558 (2011).</li><li>Hartley, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nociceptive+brain+activity+as+a+measure+of+analgesic+efficacy+in+infants.">Nociceptive brain activity as a measure of analgesic efficacy in infants.</a> Sci Transl Med. 9 (388), (2017).</li><li>Keil, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Committee+report:+publication+guidelines+and+recommendations+for+studies+using+electroencephalography+and+magnetoencephalography.">Committee report: publication guidelines and recommendations for studies using electroencephalography and magnetoencephalography.</a> Psychophysiology. 51 (1), 1-21 (2014).</li><li>Grunau, R. V., Johnston, C. C., Craig, K. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neonatal+facial+and+cry+responses+to+invasive+and+non-invasive+procedures.">Neonatal facial and cry responses to invasive and non-invasive procedures.</a> Pain. 42 (3), 295-305 (1990).</li><li>van den Broeke, E. N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterizing+pinprick-evoked+brain+potentials+before+and+after+experimentally+induced+secondary+hyperalgesia.">Characterizing pinprick-evoked brain potentials before and after experimentally induced secondary hyperalgesia.</a> J Neurophysiol. 114 (5), 2672-2681 (2015).</li><li>Verriotis, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cortical+activity+evoked+by+inoculation+needle+prick+in+infants+up+to+one-year+old.">Cortical activity evoked by inoculation needle prick in infants up to one-year old.</a> Pain. 156 (2), 222-230 (2015).</li><li>Rolke, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitative+sensory+testing+in+the+German+Research+Network+on+Neuropathic+Pain+(DFNS):+standardized+protocol+and+reference+values.">Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values.</a> Pain. 123 (3), 231-243 (2006).</li><li>Moultrie, F., Slater, R., Hartley, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improving+the+treatment+of+infant+pain.">Improving the treatment of infant pain.</a> Curr Opin Support Palliat Care. 11 (2), 112-117 (2017).</li><li>Hu, L., Zhang, Z. G., Mouraux, A., Iannetti, G. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multiple+linear+regression+to+estimate+time-frequency+electrophysiological+responses+in+single+trials.">Multiple linear regression to estimate time-frequency electrophysiological responses in single trials.</a> Neuroimage. 111, 442-453 (2015).</li><li>Hartley, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Changing+Balance+of+Spinal+Cord+Excitability+and+Nociceptive+Brain+Activity+in+Early+Human+Development.">Changing Balance of Spinal Cord Excitability and Nociceptive Brain Activity in Early Human Development.</a> Curr Biol. 26 (15), 1998-2002 (1998).</li><li>Evers, K. S., Wellmann, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Arginine+Vasopressin+and+Copeptin+in+Perinatology.">Arginine Vasopressin and Copeptin in Perinatology.</a> Front Pediatr. 4 (75), (2016).</li><li>Slater, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Oral+sucrose+as+an+analgesic+drug+for+procedural+pain+in+newborn+infants:+a+randomised+controlled+trial.">Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial.</a> Lancet. 376 (9748), 1225-1232 (2010).</li></ol>

这里介绍的方法显示了如何使用脑电图记录和平尖探针刺激对新生儿的有害诱发脑活动进行客观的测量, 以应用实验性的有害刺激。这项技术可用于各种临床设置, 以检测伤害,例如在非语言的人, 如新生儿。完整的研究可以在15分钟内完成, 包括放置婴儿, 识别, 准备和安装电极, 最后应用和记录50有害刺激。这种刺激不会引起婴儿的行为窘迫, 这一方法为评估婴儿的伤害提供了客观的方法。...

疼痛是一种不愉快的感觉和情感体验, 与实际或潜在的组织损害有关, 或在这种损害方面描述为1。无法口头交流并不能否定个人正在经历痛苦的可能性, 但却使评估减轻疼痛的治疗具有挑战性, 例如新生儿2。一些行为和生理指标被用来评估非语言患者的疼痛。不同的尺度已经发展了多年, 选择取决于类型的刺激, 孕龄和环境中的新生儿是嵌入式3,4,5。这些疼痛评估工具要么依赖于评分员的解释, 要么需要二级生理指标。
在这个视频中, 我们提出了一种方法来评估伤害的电生理记录优化用于新生儿。伤害被定义为有害刺激编码的神经过程。因此, 量化伤害是一个优雅和客观的方法来确定神经输入的非语言的人。此外, 脑电图 (eeg) 检测到的皮层活动与有害事件强度相关,5,6。
这里提出的方法结合脑电图记录与机械刺激产生的有害刺激与扁平尖端探针, 也称为针刺7, 这不是皮肤破损, 并没有造成行为困扰6。它已经表明, 伤害以下的加标点刺激主要是介导的 Aδ纤维, 不需要皮肤破裂病变8和伤害性特定电位的大小不依赖于睡眠状态9。在与新生儿的研究环境中应用这种方法时, 家长也很好地接受了这一探针。探针是电子连接到 eeg 记录系统, 使脑电图记录准确标签时, 探针接触皮肤。这大大简化了时间锁定的过程, 是所有后续脑电图分析的前提。为了最大限度地减少婴儿脑电图记录的准备时间, 我们使用了一个改进的国际10/20 电极放置系统, 我们减少了电极的数量, 以最低要求的三电极 (图 1)。中心顶点 Cz 电极, 其中有害诱发脑活动是最大的9,10,11, 与一个参考和一个接地电极一起使用。

<table>
	<tbody>
		<tr>
			<td>Easycap</td>
			<td>EASYCAP GmbH</td>
			<td>AC-32-C</td>
			<td>EEG caps for infants sizes 34 and 36</td>
		</tr>
		<tr>
			<td>actiCAP</td>
			<td>Brain Products GmbH</td>
			<td>BP-04243-SIG</td>
			<td>active electrodes</td>
		</tr>
		<tr>
			<td>ImpBox</td>
			<td>Brain Products GmbH</td>
			<td></td>
			<td>impedance measurement</td>
		</tr>
		<tr>
			<td>V-Amp</td>
			<td>Brain Products GmbH</td>
			<td></td>
			<td>EEG recording device</td>
		</tr>
		<tr>
			<td>Contact trigger for pinprick stimulation</td>
			<td>MRC Systems GmbH</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>PinPrick stimulator set</td>
			<td>MRC Systems GmbH</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>EEG prepping paste</td>
			<td>USB Pharmacy</td>
			<td></td>
			<td>contains sodium chloride, pumice stone, propylene glycol</td>
		</tr>
		<tr>
			<td>SuperVisc</td>
			<td>EASYCAP GmbH</td>
			<td></td>
			<td>Electrolyte-Gel for active electrodes</td>
		</tr>
		<tr>
			<td>Brain Vision Recorder</td>
			<td>Brain Products GmbH</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Brain Vision Analyzer</td>
			<td>Brain Products GmbH</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>MATLAB using EEGLAB
			
			
			
			
			
			</td>
			<td>Swartz Center for Computational Neuroscience, University of California San Diego</td>
			<td></td>
			<td>For EEG processing, including averaging of all EEG epochs
			
			
			
			</td>
		</tr>
	</tbody>
</table>

electrophysiological measurement of noxious-evoked brain activity in neonates using a flat-tip probe coupled to electroencephalography

疼痛是一种不愉快的感官和情感体验。在非语言患者中, 即使用疼痛评估工具也很难测量疼痛。这些工具是主观的或确定的次要生理指标, 也有一定的限制, 特别是在探索的有效性镇痛。由于皮质加工对疼痛知觉至关重要, 脑活动措施可为评估婴儿疼痛提供一种有用的方法。在这里, 我们提出了一种方法来评估伤害与电生理脑活动录音优化用于新生儿。为了产生高度标准化和可重复性的有害刺激, 我们应用了机械刺激与平尖端探针,例如, 针刺, 这不是皮肤破损, 不会造成行为困扰。有害诱发电位可客观测量非言语患者的伤害。这种方法可用于新生儿早在34周的孕龄。此外, 它可以应用在不同的情况下, 如测量镇痛或麻醉药物的功效。

图 1是使用修改过的国际10/20 电极放置系统的电极定位的图解表示。图 2显示了在使用带有 32 mN 力的平头探针进行一项单一有害刺激的应用之前和之后的脑电图活动, 这种刺激发生在新生儿的右手协议 (图 2A) 中。在大约 300 ms 后刺激开始 (时间 0), 毒性诱发反应是可见的。图 2B显示了50...

Watch this Scientific Journal Video about Electrophysiological Measurement of Noxious-evoked Brain Activity in Neonates Using a Flat-tip Probe Coupled to Electroencephalography at JoVE.com

Electrophysiological Measurement of Noxious-evoked Brain Activity in Neonates Using a Flat-tip Probe Coupled to Electroencephalography

应用平板探针结合脑电图对新生儿有害诱发脑活动的电生理测量

测量非语言患者的疼痛是一个挑战。在本研究中, 我们结合脑电记录与刺激使用平尖端探针检测有害诱发脑活动的客观方式。

Pain is an unpleasant sensory and emotional experience. In non-verbal patients, it is very difficult to measure pain, even with pain assessment tools. ...

Research

JoVE Journal

Medicine

Segmentation and Measurement of Fat Volumes in Murine Obesity Models Using X-ray Computed Tomography

利用X射线计算机断层扫描在小鼠肥胖模型的FAT卷的分割和测量

Obesity is associated with increased morbidity and mortality as well as reduced metrics in quality of life.1 Both environmental and genetic factors are ...

科研

医学

Epidural Intracranial Pressure Measurement in Rats Using a Fiber-optic Pressure Transducer

硬膜外颅内压测量中使用的光纤压力传感器的大鼠

Elevated intracranial pressure (ICP) is a significant problem in several forms of ischemic brain injury including stroke, traumatic brain injury and ...

The Measurement and Treatment of Suppression in Amblyopia

测量和制止在弱视治疗

Amblyopia, a developmental disorder of the visual cortex, is one of the leading causes of visual dysfunction in the working age population. Current ...

State of the Art Cranial Ultrasound Imaging in Neonates

艺术颅超声成像在新生儿的状态

Cranial ultrasound (CUS) is a reputable tool for brain imaging in critically ill neonates. It is safe, relatively cheap and easy to use, even when a ...

Molecular Probe Optimization to Determine Cell Mortality in a Photosynthetic Organism (Microcystis aeruginosa) Using Flow Cytometry

Molecular Probe Optimization to Determine Cell Mortality in a Photosynthetic Organism Microcystis aeruginosa Using Flow Cytometry

分子探针的优化，以确定细胞死亡的光合生物（<em&gt;铜绿微囊藻</em&gt;）使用流式细胞仪

Microbial subpopulations in field and laboratory studies have been shown to display high heterogeneity in morphological and physiological parameters. ...

Transcutaneous Microcirculatory Imaging in Preterm Neonates

经皮微循环成像在早产儿

Microcirculatory imaging (MI) is a relatively new research tool mainly used in the intensive care setting. MI provides a clear view of the smallest ...

Using Saccadometry with Deep Brain Stimulation to Study Normal and Pathological Brain Function

使用Saccadometry与深部脑刺激来研究正常和病理脑功能

The oculomotor system involves a large number of brain areas including parts of the basal ganglia, and various neurodegenerative diseases including ...

Imaging Metals in Brain Tissue by Laser Ablation - Inductively Coupled Plasma - Mass Spectrometry (LA-ICP-MS)

Imaging Metals in Brain Tissue by Laser Ablation - Inductively Coupled Plasma - Mass Spectrometry LA-ICP-MS

在脑组织成像金属激光剥蚀 - 电感耦合等离子体 - 质谱法（LA-ICP-MS）

Metals are found ubiquitously throughout an organism, with their biological role dictated by both their chemical reactivity and abundance within a ...

Repeated Measurement of Respiratory Muscle Activity and Ventilation in Mouse Models of Neuromuscular Disease

在神经肌肉疾病的模型小鼠呼吸肌肉活动和通风的重复测量

Accessory respiratory muscles help to maintain ventilation when diaphragm function is impaired. The following protocol describes a method for repeated ...