ArticlePain2019
Behavioural discrimination of noxious stimuli in infants is dependent on brain maturation.
Article in Pain, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Clinical rating scales for assessing pain in newborn infants.The Cochrane database of systematic reviews · 2025Pooled it
- Methodological Issues in the Study of the Development of Pain Responsivity in Preterm Neonates: A Systematic Review.International journal of environmental research and public health · 2020Pooled it
- Trial
- Quantifying the Pharmacodynamics of Morphine in the Treatment of Postoperative Pain in Preverbal Children.Journal of clinical pharmacology · 2022Trial
- Pain Assessment During Less Invasive Surfactant Administration Using Skin Conductance: A Prospective Cohort Study.Pediatric research · 2026Observational
- Parental experience and professional training shape the perception of comfort and discomfort in preterm and term newborns.Scientific reports · 2026Article
- Electroencephalography during acute painful procedures in neonates: a scoping review.Pain reports · 2026Review
- Objective Detection of Newborn Infant Acute Procedural Pain Using EEG and Machine Learning Algorithms.Paediatric & neonatal pain · 2025Article
- The Influence of Postmenstrual Age and Neurological Impairments on the Modified Pain Assessment Tool Score in Infants Admitted to Neonatal Intensive Care: A Retrospective Medical Record Review.Paediatric & neonatal pain · 2025Article
- Behavioral and physiological pain structures of PIPP-R and parental stress: structural equation modeling approach.Pediatric research · 2025Article
- Brain health in preterm infants: importance of early-life pain and analgesia exposure.Pediatric research · 2024Review
- Establishing a standardised approach for the measurement of neonatal noxious-evoked brain activity in response to an acute somatic nociceptive heel lance stimulus.Cortex; a journal devoted to the study of the nervous system and behavior · 2024Article
- Sensory event-related potential morphology predicts age in premature infants.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2024Article
- The fetal pain paradox.Frontiers in pain research (Lausanne, Switzerland) · 2023Review
- The outcomes of a healing environment and clustering nursing care on premature infants' vital signs, pain, and sleeping.Journal of medicine and life · 2022Article
- Premature infants display discriminable behavioral, physiological, and brain responses to noxious and nonnoxious stimuli.Cerebral cortex (New York, N.Y. : 1991) · 2022Article
- The development of descending serotonergic modulation of the spinal nociceptive network: a life span perspective.Pediatric research · 2022Review
- The impact of premature extrauterine exposure on infants' stimulus-evoked brain activity across multiple sensory systems.NeuroImage. Clinical · 2022Article
- Toward personalized medicine for pharmacological interventions in neonates using vital signs.Paediatric & neonatal pain · 2021Review
- Pain Behavioural Response to Acoustic and Light Environmental Changes in Very Preterm Infants.Children (Basel, Switzerland) · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
Changes in facial expression are an essential form of social communication and in nonverbal infants are often used to alert care providers to pain-related distress. However, studies of early human brain development suggest that premature infants aged less than 34 weeks' gestation do not display discriminative brain activity patterns to equally salient noxious and innocuous events. Here we examine the development of facial expression in 105 infants, aged between 28 and 42 weeks' gestation. We show that the presence of facial expression change after noxious and innocuous stimulation is age-dependent and that discriminative facial expressions emerge from approximately 33 weeks' gestation. In a subset of 49 infants, we also recorded EEG brain activity and demonstrated that the temporal emergence of facial discrimination mirrors the developmental profile of the brain's ability to generate discriminative responses. Furthermore, within individual infants, the ability to display discriminative facial expressions is significantly related to brain response maturity. These data demonstrate that the emergence of behavioural discrimination in early human life corresponds to our brain's ability to discriminate noxious and innocuous events and raises fundamental questions as to how best to interpret infant behaviours when measuring and treating pain in premature infants.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.