ArticleCerebral cortex (New York, N.Y. : 1991)2022
Premature infants display discriminable behavioral, physiological, and brain responses to noxious and nonnoxious stimuli.
Article in Cerebral cortex (New York, N.Y. : 1991), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 15 papers.
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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.
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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.
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Who cites it
15 citing papers in PubMed, 27 citations in OpenAlex.
- Pain Assessment During Less Invasive Surfactant Administration Using Skin Conductance: A Prospective Cohort Study.Pediatric research · 2026Observational
- Electroencephalography during acute painful procedures in neonates: a scoping review.Pain reports · 2026Review
- Brain activity as a candidate biomarker for personalised caffeine treatment in premature neonates.Frontiers in pediatrics · 2026Article
- Machine learning classification of EEG responses to pain-related vs non-pain-related stimulus in preterm infants.Pain reports · 2025Article
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- Article
- Pharmacological treatment for apnoea of prematurity-the need for an individualised approach.Frontiers in pediatrics · 2025Review
- 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
- Biomarkers for assessing pain and pain relief in the neonatal intensive care unit.Frontiers in pain research (Lausanne, Switzerland) · 2024Review
- Sensory event-related potential morphology predicts age in premature infants.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2024Article
- Consciousness in the cradle: on the emergence of infant experience.Trends in cognitive sciences · 2023Review
- The fetal pain paradox.Frontiers in pain research (Lausanne, Switzerland) · 2023Review
- Article
- Toward personalized medicine for pharmacological interventions in neonates using vital signs.Paediatric & neonatal pain · 2021Review
Corrections and comments
- Erratum issued
Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
Abstract
Pain assessment in preterm infants is challenging as behavioral, autonomic, and neurophysiological measures of pain are reported to be less sensitive and specific than in term infants. Understanding the pattern of preterm infants' noxious-evoked responses is vital to improve pain assessment in this group. This study investigated the discriminability and development of multimodal noxious-evoked responses in infants aged 28-40 weeks postmenstrual age. A classifier was trained to discriminate responses to a noxious heel lance from a nonnoxious control in 47 infants, using measures of facial expression, brain activity, heart rate, and limb withdrawal, and tested in two independent cohorts with a total of 97 infants. The model discriminates responses to the noxious from the nonnoxious procedure with an overall accuracy of 0.76-0.84 and an accuracy of 0.78-0.79 in the 28-31-week group. Noxious-evoked responses have distinct developmental patterns. Heart rate responses increase in magnitude with age, while noxious-evoked brain activity undergoes three distinct developmental stages, including a previously unreported transitory stage consisting of a negative event-related potential between 30 and 33 weeks postmenstrual age. These findings demonstrate that while noxious-evoked responses change across early development, infant responses to noxious and nonnoxious stimuli are discriminable in prematurity.
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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.