Stroking modulates noxious-evoked brain activity in human infants

Deniz Gursul, Sezgi Goksan, Caroline Hartley, Gabriela Schmidt Mellado, Fiona Moultrie, Amy Hoskin, Eleri Adams, Gareth Hathway, Susannah Walker, Francis McGlone, Rebeccah Slater, Deniz Gursul, Sezgi Goksan, Caroline Hartley, Gabriela Schmidt Mellado, Fiona Moultrie, Amy Hoskin, Eleri Adams, Gareth Hathway, Susannah Walker, Francis McGlone, Rebeccah Slater

Abstract

A subclass of C fibre sensory neurons found in hairy skin are activated by gentle touch [1] and respond optimally to stroking at ∼1-10 cm/s, serving a protective function by promoting affiliative behaviours. In adult humans, stimulation of these C-tactile (CT) afferents is pleasant, and can reduce pain perception [2]. Touch-based techniques, such as infant massage and kangaroo care, are designed to comfort infants during procedures, and a modest reduction in pain-related behavioural and physiological responses has been observed in some studies [3]. Here, we investigated whether touch can reduce noxious-evoked brain activity. We demonstrate that stroking (at 3 cm/s) prior to an experimental noxious stimulus or clinical heel lance can attenuate noxious-evoked brain activity in infants. CT fibres may represent a biological target for non-pharmacological interventions that modulate pain in early life.

Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Figures

Figure 1
Figure 1
CT-optimal touch reduces noxious-evoked brain activity following experimental and clinically required noxious stimulation in infants. (A) Top: average background EEG activity, and responses to the first experimental noxious stimulus in the no-touch control, CT-optimal (∼3 cm/s), and CT non-optimal (∼30 cm/s) touch conditions (number of infants = 30). Traces are Woody filtered and shown overlaid with the template of noxious-evoked brain activity in red. This template was used to calculate the magnitude of the noxious-evoked brain activity within each individual trial — see experimental procedures in Supplemental Information. For reference, a magnitude of 1 represents the average evoked response to a heel lance in a group of term-aged infants. Black dashed lines indicate the point of noxious stimulation; pink shading indicates the time window of interest for noxious-evoked brain activity. Bottom: the magnitude of the noxious-evoked brain activity in the background period and in response to experimental noxious stimulation following the no-touch control, CT-optimal, and CT non-optimal touch conditions in the first trial. (B) Top: average limb reflex withdrawal response to the first experimental noxious stimulus in each condition. Bottom: the magnitude of the limb reflex withdrawal quantified using root mean square (RMS) following the first noxious stimulus. (C) Top: average EEG response in no-touch control and the CT-optimal touch conditions following a clinically required heel lance (number of infants = 16 in each group). Traces are Woody filtered and shown overlaid with the template of noxious-evoked brain activity in red. Black dashed lines indicate the time of the heel lance; pink shading indicates the time window of interest for noxious-evoked brain activity. Bottom: CT-optimal touch significantly reduced the magnitude of the noxious-evoked brain activity. Error bars indicate mean ± standard error; ∗ indicates p < 0.05; ∗∗ indicates p < 0.01.

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