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04/05/2006

A high-tech grasp of the obvious

No kidding: Premature babies 'feel true pain', says a report of a new paper in the Journal of Neuroscience. They don't just flinch and tense their bodies and scrunch up their tiny faces and yell as loud as their underdeveloped lungs will let them. Now we know, thanks to a series of brain scans done on preemies, that parts of the brain later associated with high-level sensory processing light up when you stick a preemie's heel.

None of this surprises anyone who's, say, spent six weeks in a NICU, but what got to me was the unacknowledged technical tour de force involved in measuring the brain activity of babies down to 25 weeks without freaking the local research ethics committee right out. Preemies are, uh, delicate. When Charlie was born, you could look at him wrong and half a dozen alarms would go off. He'd desat when you turned the lights on.

The J. Neuroscience web site isn't giving me any damn help at all, so my imagination is running wild. First I think they must have used an MRI — visions of baby inserted into enormous magnet with LOUD, CLANKING moving parts. Baby, whose life depends on the metallic needles, probes, patches and wires inserted into or covering its body, inserted into enormous magnet. Hmmm, maybe not. You can also measure brain activity with PET scans — baby whose life is hanging by a thread shot up with radioactive glucose for the sake of science and inserted into enormous (but nonmagnetic and possibly nonclanking) machine. Um.

EEG? I've had a couple of those. Dozens of electrodes pasted onto baby's skull, while the researcher explains, "Kid, we need you to remain calm and unruffled while we glue all these patches to your head, but as soon as the nurse sticks your heel it's OK to register discomfort."

I'm clearly missing a brain-scan method or twelve here — anyone out there know the answer? It amazes me that gizmos have advanced to the point where you can safely do this kind of research on such fragile little blobs, and kinda awes me that the parents of these kids were willing to give consent to something that wouldn't help their babies a bit but might somehow make life in the NICU more comfortable for someone else's very sick baby.

UPDATE 315pm: A kind reader has sent a copy of the article, in which very reassuring things are said about how the infants were treated. There is also a picture of a photogenic 33-weeker being probed. The sensors, aka "optodes", are not very big at all, and apparently monitor blood flow (which translates to brain activity) right below wherever they're placed. So they're essentially the hyper-evolved cyborg cousins of a pulse-ox clip. Much simpler than I'd thoughtt, and a good thing too.

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