@article {10801, title = {Infant Analgesia With a Combination of Breast Milk, Glucose, or Maternal Holding.}, journal = {Pediatrics}, volume = {142}, year = {2018}, month = {2018 Sep}, abstract = {

OBJECTIVES: We studied neonatal cortical brain response to 4 types of nonpharmacological analgesia (oral glucose, expressed breast milk, maternal holding plus oral glucose, breastfeeding). We aimed to assess the differential effect of oral solutions (glucose, breast milk) given alone or combined with the maternal-infant relationship (holding, breastfeeding).

METHODS: Eighty healthy term newborns undergoing a heel stick were randomly assigned to 4 parallel groups of 20 infants each: group 1, infants received a glucose solution on a changing table; group 2, infants received expressed breast milk on a changing table; group 3, infants received a glucose solution in their mothers{\textquoteright} arms; and group 4, infants were breastfed by their mothers. Cortical activation in parietal, temporal, and frontal cortices was assessed by multichannel near-infrared spectroscopy. Pain expression was also evaluated.

RESULTS: Oral glucose alone or combined with maternal holding was associated with no cortical activation during heel stick. Expressed breast milk was associated with localized bilateral activation of somatosensory and motor cortices ( < .01). Breastfeeding was associated with extensive bilateral activation of somatomotor, somatosensory, and right parietal cortices ( < .01). Pain expression was lower with the maternal-infant relationship ( = .007).

CONCLUSIONS: Oral glucose, either alone or combined with maternal holding, appears to block or weaken cortical pain processing. Breast milk alone is associated with localized cortical activation. Breastfeeding is associated with extensive activation and may act by extending cortical processing. Maternal relationship, both combined with oral glucose and in breastfeeding, shows the greatest analgesic effect, although the neural patterns involved are distributed differently.

}, issn = {1098-4275}, doi = {10.1542/peds.2017-3416}, author = {Bembich, Stefano and Cont, Gabriele and Causin, Enrica and Paviotti, Giulia and Marzari, Patrizia and Demarini, Sergio} } @article {10470, title = {Bolus feeding has no effect on cerebral hemodynamics, irrespective of gestational age.}, journal = {J Matern Fetal Neonatal Med}, volume = {30}, year = {2017}, month = {2017 May}, pages = {1029-1031}, abstract = {

OBJECTIVE: By multichannel near-infrared spectroscopy, we studied if gestational age has any influence on preterm cerebral hemodynamics, during bolus feeding.

METHODS: Oxy-haemoglobin (HbO), as cerebral blood flow estimate, and the ratio between HbO and total haemoglobin (HbO/HbTot), as cerebral oxygenation estimate, were assessed in 40 stable premature infants, during a 10 min bolus feeding.

RESULTS: We found no effect of any of the gestational ages studied (25-34 weeks) either on cerebral blood flow or on oxygenation, during a bolus feeding procedure.

CONCLUSIONS: Bolus feeding appears not to affect cerebral hemodynamics of uncritically preterm infants, irrespective of gestational age.

}, keywords = {Cerebrovascular Circulation, Enteral Nutrition, Female, Gestational Age, Heart Rate, Humans, Infant, Newborn, Infant, Premature, Intensive Care Units, Neonatal, Male, Oxygen, Oxyhemoglobins, Spectroscopy, Near-Infrared}, issn = {1476-4954}, doi = {10.1080/14767058.2016.1199672}, author = {Bembich, Stefano and Cont, Gabriele and Bua, Jenny and Orlando, Chiara and Di Benedetto, Donatella and Demarini, Sergio} } @article {10484, title = {Longitudinal Responses to Weighing and Bathing Procedures in Preterm Infants.}, journal = {J Perinat Neonatal Nurs}, volume = {31}, year = {2017}, month = {2017 Jan/Mar}, pages = {67-74}, abstract = {

Knowledge of the effects of nursing-induced stress on short-term outcomes in preterm infants is limited. Effects of 2 standard nursing procedures-weighing and bathing-on autonomic and motor stability of preterm infants were studied during their hospitalization. Outcomes were evaluated during and after the procedures. Eleven preterm infants were observed between 32 and 35 weeks{\textquoteright} postmenstrual age (PMA) (postnatal days range: 4-63). Neonatal responses were assessed according to the Synactive Theory of Development and nursing was performed taking into account Newborn Individualized Developmental Care and Assessment Program (NIDCAP) principles. Effects of the studied nursing procedures on infants{\textquoteright} stability during and after their execution were evaluated by nonparametric statistics. During monitored procedures, stress responses in autonomic and motor systems were observed at all PMAs. However, after 32 weeks{\textquoteright} PMA, preterm infants also showed an autonomic and motor stability recovery 5 minutes after procedure completion. Contrary to our hypothesis, preterm infants showed to be stressed by weighing and bathing procedures up to 35 weeks{\textquoteright} PMA. However, if facilitated and supported after nursing conclusion by interventions such as swaddling and nesting, according to NIDCAP principles, they recovered autonomic and motor stability by 5 minutes after ending procedures.

}, keywords = {Baths, Body Weight, Female, Humans, Infant Behavior, Infant Care, Infant, Newborn, Infant, Premature, Male, Neonatal Nursing}, issn = {1550-5073}, doi = {10.1097/JPN.0000000000000228}, author = {Bembich, Stefano and Fiani, Giulia and Strajn, Tamara and Sanesi, Cecilia and Demarini, Sergio and Sanson, Gianfranco} } @article {8349, title = {The cortical response to a noxious procedure changes over time in preterm infants.}, journal = {Pain}, volume = {157}, year = {2016}, month = {2016 Sep}, pages = {1979-87}, abstract = {

The aim of the study was to investigate whether cortical response to a repeated noxious procedure may change over time in preterm infants. Possible reasons for change are: (1) advancing maturation of central nervous system; and (2) increasing experience with noxious procedures during hospital stay. Sixteen preterm infants were recruited, with a postmenstrual age (PMA) ranging between 29 and 36 weeks. Newborns were assessed during a heel-prick procedure, once a week for at least 3 consecutive times. Multichannel near-infrared spectroscopy was used to detect cortical activation, by measuring increase in cortical oxy-haemoglobin (HbO2). Parietal, temporal, and posterior frontal areas were monitored bilaterally. By regression analysis, we studied the effect of (1) increasing PMA and (2) increasing number of heel pricks, on the magnitude of cortical activation. We observed a bilateral nociceptive event-related activation of the posterior frontal cortex, mainly contralateral to the side pricked. Additionally, we found a significant positive effect of PMA, as HbO2 progressively increased in the posterior frontal cortex (P < 0.001), bilaterally, over time. Conversely, the degree of cortical activation decreased as the number of noxious events increased (P < 0.002). We conclude the following: (1) Preterm newborns showed a significant activation of the posterior frontal cortex in association with noxious stimuli; (2) Cortical activation was progressively greater with increasing PMA; (3) There was an inverse relationship between cortical activation and the number of heel pricks. We speculate that such findings may be due to both endogenous cortical maturation and experience-dependent neuroplasticity of the developing brain (eg, synaptogenesis, synaptic pruning).

}, issn = {1872-6623}, doi = {10.1097/j.pain.0000000000000605}, author = {Bembich, Stefano and Marrazzo, Francesca and Barini, Alice and Ravalico, Paola and Cont, Gabriele and Demarini, Sergio} } @article {3604, title = {Cerebral oxygenation with different nasal continuous positive airway pressure levels in preterm infants.}, journal = {Arch Dis Child Fetal Neonatal Ed}, volume = {100}, year = {2015}, month = {2015 Mar}, pages = {F165-8}, abstract = {

OBJECTIVES: This study evaluates the effect of varying nasal continuous positive airway pressure (NCPAP) level on cerebral blood flow (CBF) and oxygenation in preterm infants.

METHODS: Oxy-haemoglobin (HbO2) and total haemoglobin (HbTot), as CBF estimates, and the ratio between HbO2 and HbTot (HbO2/HbTot), as cerebral oxygenation estimate, were assessed by near-infrared spectroscopy in 26 stable preterm newborns at a postmenstrual age between 26 and 33 weeks. Baseline HbO2, HbTot and HbO2/HbTot values were initially collected with NCPAP at 5 cm H2O and then compared with values obtained with NCPAP levels at both 3 and 8 cm H2O.

RESULTS: Compared with 5 cm H2O, cerebral HbO2, HbTot and HbO2/HbTot remained unchanged both after increasing (to 8 cm H2O) and decreasing (to 3 cm H2O) the NCPAP level. This result was observed both in regional areas (24 sites) and in the overall monitored area (frontal and parietal cortex). Compared with 8 cm H2O, peripheral oxygen saturation significantly decreased at 3 cm H2O (p=0.021). Heart rate did not change.

CONCLUSIONS: No differences in CBF and cerebral oxygenation were observed with NCPAP levels in the range 3-8 cm H2O despite a decrease in peripheral oxygenation with 3 cm H2O.

}, keywords = {Cerebrovascular Circulation, Continuous Positive Airway Pressure, Female, Hemoglobins, Humans, Infant, Newborn, Infant, Premature, Intensive Care, Neonatal, Male, Nasal Cavity, Oxygen, Oxygen Consumption, Oxyhemoglobins, Spectroscopy, Near-Infrared}, issn = {1468-2052}, doi = {10.1136/archdischild-2014-306356}, author = {Bembich, Stefano and Travan, Laura and Cont, Gabriele and Bua, Jenny and Strajn, Tamara and Demarini, Sergio} } @article {7786, title = {Intranasal adminsitration of oxytocin in postnatal depression: implications for psychodynamic psychotherapy from a randomized double-blind pilot study.}, journal = {Front Psychol}, volume = {6}, year = {2015}, month = {2015}, pages = {426}, abstract = {

Oxytocin is a neuropeptide that is active in the central nervous system and is generally considered to be involved in prosocial behaviors and feelings. In light of its documented positive effect on maternal behavior, we designed a study to ascertain whether oxytocin exerts any therapeutic effects on depressive symptoms in women affected by maternal postnatal depression. A group of 16 mothers were recruited in a randomized double-blind study: the women agreed to take part in a brief course of psychoanalytic psychotherapy (12 sessions, once a week) while also being administered, during the 12-weeks period, a daily dose of intranasal oxytocin (or a placebo). The pre-treatment evaluation also included a personality assessment of the major primary-process emotional command systems described by Panksepp () and a semi-quantitative assessment by the therapist of the mother{\textquoteright}s depressive symptoms and of her personality. No significant effect on depressive symptomatology was found following the administration of oxytocin (as compared to a placebo) during the period of psychotherapy. Nevertheless, a personality trait evaluation of the mothers, conducted in our overall sample group, showed a decrease in the narcissistic trait only within the group who took oxytocin. The depressive (dysphoric) trait was in fact significantly affected by psychotherapy (this effect was only present in the placebo group so it may reflect a positive placebo effect enhancing the favorable influence of psychotherapy on depressive symptoms) but not in the presence of oxytocin. Therefore, the neuropeptide would appear to play some role in the modulation of cerebral functions involved in the self-centered (narcissistic) dimension of the suffering that can occur with postnatal depression. Based on these results, there was support for our hypothesis that what is generally defined as postnatal depression may include disturbances of narcissistic affective balance, and oxytocin supplementation can counteract that type of affective disturbance. The resulting improvements in well-being, reflected in better self-centering in post-partuent mothers, may in turn facilitate better interpersonal acceptance of (and interactions with) the child and thereby, improved recognition of the child{\textquoteright}s needs.

}, issn = {1664-1078}, doi = {10.3389/fpsyg.2015.00426}, author = {Clarici, Andrea and Pellizzoni, Sandra and Guaschino, Secondo and Alberico, Salvatore and Bembich, Stefano and Giuliani, Rosella and Short, Antonia and Guarino, Giuseppina and Panksepp, Jaak} } @article {7742, title = {Maternal holding vs oral glucose administration as nonpharmacologic analgesia in newborns: a functional neuroimaging study.}, journal = {JAMA Pediatr}, volume = {169}, year = {2015}, month = {2015 Mar}, pages = {284-5}, keywords = {Administration, Oral, Analgesia, Blood Specimen Collection, Female, Functional Neuroimaging, Glucose, Humans, Infant, Newborn, Mother-Child Relations, Pain, Pain Management, Spectroscopy, Near-Infrared}, issn = {2168-6211}, doi = {10.1001/jamapediatrics.2014.3052}, author = {Bembich, Stefano and Cont, Gabriele and Baldassi, Giulio and Bua, Jenny and Demarini, Sergio} } @article {7721, title = {Pain activates a defined area of the somatosensory and motor cortex in newborn infants.}, journal = {Acta Paediatr}, volume = {104}, year = {2015}, month = {2015 Nov}, pages = {e530-3}, issn = {1651-2227}, doi = {10.1111/apa.13122}, author = {Bembich, Stefano and Brovedani, Pierpaolo and Cont, Gabriele and Travan, Laura and Grassi, Veronica and Demarini, Sergio} } @article {8076, title = {PRE- AND POSTNATAL MODIFICATIONS IN PARENTAL MENTAL REPRESENTATIONS IN THREE CASES OF FETAL GASTROSCHISIS DIAGNOSED DURING PREGNANCY.}, journal = {Infant Ment Health J}, year = {2015}, month = {2015 Nov 10}, abstract = {

The aim of this study was to identify possible effects of gastroschisis on parents{\textquoteright} intrapsychic dynamics by applying an observational clinical approach. More specifically, we intend to (a) evaluate the representational style of parents informed about the diagnosis of fetal gastroschisis during pregnancy using the Interview of Maternal Representations During Pregnancy and the Interview of Paternal Representations During Pregnancy (M. Ammaniti, C. Candelori, M. Pola, \& R. Tambelli, ) and (b) observe whether the baby{\textquoteright}s birth influences the parents{\textquoteright} representational styles through the application of the same tools (the Interview of Maternal Representations After the Birth, M. Ammaniti \& R. Tambelli, , and the Interview of Paternal Representations After the Birth, M. Ammaniti \& R. Tambelli, ), adapted to the postnatal period. During the prenatal period, all parents showed a restricted/disinvested style. Three parents-one mother and two fathers-changed their styles from restricted/disinvested to integrated between pregnancy and Month 6 after the birth of their child. Clinical data from the interviews and observations are discussed in an attempt at better defining intrapsychic dynamics of parents after a diagnosis of gastroschisis.

}, issn = {1097-0355}, doi = {10.1002/imhj.21534}, author = {Tripani, Antonella and Pellizzoni, Sandra and Giuliani, Rosella and Bembich, Stefano and Clarici, Andrea and Lonciari, Isabella and Ammaniti, Massimo} } @article {8096, title = {Validation of the Italian translation of the affective neuroscience personality scales.}, journal = {Psychol Rep}, volume = {116}, year = {2015}, month = {2015 Feb}, pages = {97-115}, abstract = {

The theoretical perspective on affective neuroscience advanced by Panksepp, identified six basic innate affective systems: the SEEK, FEAR, ANGER, SADNESS, PLAY, and CARE systems. (3) It has been proposed that the fundamental elements of human personality and its variants may be based on the different expressions of these basic emotional systems and their combinations. A self-report inventory, the Affective Neuroscience Personality Scales (ANPS), has been devised with the aim of studying and evaluating personality from this perspective. This study reports data on the initial validation of ANPS Italian translation on a sample of 418 adult participants. Descriptive statistics for each scale were calculated, assessing also their internal consistency, as a measure of reliability and factorial validity. Acceptable internal consistency was found in all but one scale (SADNESS), and a second-order factor analysis identified a more general affective feature of personality hinging on relational characteristics, independent of the dimensions of general positive and negative affect.

}, keywords = {Adolescent, Adult, Affect, Aged, Aged, 80 and over, Female, Humans, Italy, Male, Middle Aged, Neurosciences, Personality, Personality Inventory, Psychometrics, Young Adult}, issn = {0033-2941}, doi = {10.2466/08.09.PR0.116k13w4}, author = {Pascazio, Lorenzo and Bembich, Stefano and Nardone, Ilaria B and Vecchiet, Cristina and Guarino, Giuseppina and Clarici, Andrea} } @article {3605, title = {Differences in time course activation of dorsolateral prefrontal cortex associated with low or high risk choices in a gambling task.}, journal = {Front Hum Neurosci}, volume = {8}, year = {2014}, month = {2014}, pages = {464}, abstract = {

Prefrontal cortex plays an important role in decision making (DM), supporting choices in the ordinary uncertainty of everyday life. To assess DM in an unpredictable situation, a playing card task, such as the Iowa Gambling Task (IGT), has been proposed. This task is supposed to specifically test emotion-based learning, linked to the integrity of the ventromedial prefrontal cortex (VMPFC). However, the dorsolateral prefrontal cortex (DLPFC) has demonstrated a role in IGT performance too. Our aim was to study, by multichannel near-infrared spectroscopy, the contribution of DLPFC to the IGT execution over time. We tested the hypothesis that low and high risk choices would differentially activate DLPFC, as IGT execution progressed. We enrolled 11 healthy adults. To identify DLPFC activation associated with IGT choices, we compared regional differences in oxy-hemoglobin variation, from baseline to the event. The time course of task execution was divided in four periods, each one consisting of 25 choices, and DLPFC activation was distinctly analyzed for low and high risk choices in each period. We found different time courses in DLPFC activation, associated with low or high risk choices. During the first period, a significant DLPFC activation emerged with low risk choices, whereas, during the second period, we found a cortical activation with high risk choices. Then, DLPFC activation decreased to non-significant levels during the third and fourth period. This study shows that DLPFC involvement in IGT execution is differentiated over time and according to choice risk level. DLPFC is activated only in the first half of the task, earlier by low risk and later by high risk choices. We speculate that DLPFC may sustain initial and more cognitive functions, such as attention shifting and response inhibition. The lack of DLPFC activation, as the task progresses, may be due to VMPFC activation, not detectable by fNIRS, which takes over the IGT execution in its second half.

}, issn = {1662-5161}, doi = {10.3389/fnhum.2014.00464}, author = {Bembich, Stefano and Clarici, Andrea and Vecchiet, Cristina and Baldassi, Giulio and Cont, Gabriele and Demarini, Sergio} } @article {1809, title = {Effects of prone and supine position on cerebral blood flow in preterm infants.}, journal = {J Pediatr}, volume = {160}, year = {2012}, month = {2012 Jan}, pages = {162-4}, abstract = {

We evaluated the effect of prone and supine position on cerebral blood flow (CBF) in stable preterm infants. CBF, PO(2), and PCO(2) were measured in the two positions. Peripheral oxygenation increased and CBF decreased in prone position. We speculate that CBF autoregulation may compensate for increased peripheral oxygenation, by decreasing CBF.

}, keywords = {Cerebrovascular Circulation, Female, Humans, Infant, Newborn, Infant, Premature, Male, Prone Position, Regional Blood Flow, Supine Position}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2011.08.056}, author = {Bembich, Stefano and Oretti, Chiara and Travan, Laura and Clarici, Andrea and Massaccesi, Stefano and Demarini, Sergio} } @article {1783, title = {Non-invasive assessment of hemispheric language dominance by optical topography during a brief passive listening test: a pilot study.}, journal = {Med Sci Monit}, volume = {17}, year = {2011}, month = {2011 Dec}, pages = {CR692-7}, abstract = {

BACKGROUND: The Wada test is usually used for pre-surgical assessment of language lateralization. Considering its invasiveness and risk of complications, alternative methods have been proposed but they are not always applicable to non-cooperative patients. In this study we explored the possibility of using optical topography (OT)--a multichannel near-infrared system--for non-invasive assessment of hemispheric language dominance during passive listening.

MATERIAL/METHODS: Cortical activity was monitored in a sample of healthy, adult Italian native speakers, all right-handed. We assessed changes in oxy-haemoglobin concentration in temporal, parietal and posterior frontal lobes during a passive listening of bi-syllabic words and vowel-consonant-vowel syllables lasting less then 3 minutes. Activated channels were identified by t tests.

RESULTS: Left hemisphere showed significant activity only during the passive listening of bi-syllabic words. Specifically, the superior temporal gyrus, the supramarginal gyrus and the posterior inferior parietal lobe were activated.

CONCLUSIONS: During passive listening of bi-syllabic words, right handed healthy adults showed a significant activation in areas already known to be involved in speech comprehension. Although more research is needed, OT proved to be a promising alternative to the Wada test for non-invasive assessment of hemispheric language lateralization, even if using a particularly brief trial, which has been designed for future applications with non-cooperative subjects.

}, keywords = {Acoustic Stimulation, Adult, Cerebrum, Diagnostic Techniques and Procedures, Dominance, Cerebral, Female, Humans, Language, Male, Middle Aged, Oxyhemoglobins, Pilot Projects, Spectroscopy, Near-Infrared}, issn = {1643-3750}, author = {Bembich, Stefano and Demarini, Sergio and Clarici, Andrea and Massaccesi, Stefano and Grasso, Domenico Loenardo} } @article {1622, title = {Individual differences in prefrontal cortex activity during perception of bitter taste using fNIRS methodology.}, journal = {Chem Senses}, volume = {35}, year = {2010}, month = {2010 Nov}, pages = {801-12}, abstract = {

Although bitter taste has a crucial role in nutrition by preventing the ingestion of toxic foods, there are few studies on bitter taste neuroimaging. To identify cortical areas involved in bitter taste perception and to determine if individual differences in taste sensitivity to 6-n-propylthiouracil (PROP) are represented in the brain by different cortical activation patterns, we examined 48 healthy volunteers using functional near-infrared spectroscopy. Participants rated the perceived intensity of filter paper disks impregnated with PROP and NaCl during the imaging procedure and were then classified as PROP tasters and nontasters. We monitored cortical activity in both the anterior and posterior regions of the dorsolateral prefrontal cortex (DLPFC) and in the ventrolateral prefrontal cortex (VLPFC). No activity was detected in the anterior DLPFC in any of the participants. However, during the administration of PROP, significant cortical activation was detected in the more posterior regions of the left DLPFC and in the left and right VLPFC but only in PROP tasters. PROP nontasters showed no cortical activity in these areas. These data suggest that the prefrontal cortex is involved in the conscious perception of the bitter taste of PROP and that the pattern of activity is consistent with individual differences in the ability to taste this compound. Thus, the PROP phenotype is associated with fundamental differences in cortical taste processing.

}, keywords = {Adult, Eating, Female, Food Preferences, Humans, Individuality, Male, Perception, Phenotype, Prefrontal Cortex, Propylthiouracil, Sodium Chloride, Spectroscopy, Near-Infrared, Taste, Taste Threshold, Young Adult}, issn = {1464-3553}, doi = {10.1093/chemse/bjq080}, author = {Bembich, Stefano and Lanzara, Carmela and Clarici, Andrea and Demarini, Sergio and Tepper, Beverly J and Gasparini, Paolo and Grasso, Domenico L} }