UCL News


UCL team measures brain responses to pain in premature infants

5 April 2006

A research team from UCL Anatomy & Developmental Biology, Great Ormond Street Hospital for Children and UCLH is due to publish a paper in the 'Journal of Neuroscience' looking at pain in babies.

'Cortical Pain Responses in Human Infants' reports on collaborative work conducted at the UCLH neonatal unit, and shows that babies born prematurely - as little as 25 weeks after conception - feel pain as a result of routine treatment in hospitals.

In the past it has been very difficult to measure pain in pre-verbal infants. Previous methods for assessing pain in infants have used measures such as behavioural responses and reflexes, which are indirect and therefore inconclusive. The research team used near-infrared spectroscopy to demonstrate that babies have an increased haemodynamic response in the brain following painful stimulation. This response is a reliable measure of pain as it directly relates brain activity with painful stimulation. All the studies were undertaken during routine procedures that are essential for clinical care.

The findings indicate that there is much more that doctors can do to relieve pain in paediatric care. Provision of pain-relief for premature babies is sporadic, and yet the UK has the highest rate of low birthweight babies in Western Europe. Twelve per cent of all babies need some level of special care at birth (about 80,000 per year) and 2.5 per cent need neonatal intensive care (about 17,000 per year). It is estimated that a baby is subjected to an average of 14 procedures per day in intensive care, the majority of which are considered painful by clinical staff.

Maria Fitzgerald, UCL Anatomy & Developmental Biology, who led the research team at UCLH, said: "There is evidence that these repeated painful procedures are a significant stressor and lead to increased sensitivity to other non-painful procedures. Since pain information is transmitted to the preterm infant cortex from 25 weeks, there is the potential for pain experience to influence brain development from a very early age, as the brain is highly malleable at this stage of development."

The UK Commissioner for Children, Professor Al Aynsley-Green, has warned that: "Sick and injured children are still not receiving adequate pain relief". He has also stressed that pain should be at the centre of everybody's thinking about managing a very sick child.

The research was funded by the London Pain Consortium (LPC) and by the UCLH Special Trustees. The LPC was formed by a group of researchers in June 2002 by a grant from the Wellcome Trust, under its Integrative Animal and Human Physiology Initiative. The contre focuses on chronic pain, which is an increasingly common but poorly understood condition.