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ABSTRACT: The prone sleeping position, particularly in prematurely born infants, is associated with an increased risk of sudden infant death syndrome. A possible mechanism is an impaired ability to respond to respiratory compromise. The hypothesis that the ventilatory response to a carbon dioxide (CO(2)) challenge in convalescent, prematurely born infants would be lower in the prone compared with the supine position was therefore tested.
In each position, ventilatory responses to increasing levels of inspired CO(2) were assessed. The airway pressure change after the first 100 ms of an occluded inspiration (P(0.1)) and the maximum inspiratory pressure with an occluded airway during crying (P(imax)) were measured; the ratio of the P(0.1) to the P(imax) at each inspired CO(2) level and the slope of the P(0.1)/P(imax) response were calculated. Chest and abdominal wall asynchrony was assessed using inductance plethysmography and functional residual capacity (FRC) measured using a helium gas dilution technique.
Eighteen infants with a median postmenstrual age of 35 (range 35-37) weeks were studied. In the prone versus the supine position, the mean P(0.1) (p=0.002), the mean P(imax) (p=0.006), the increase in P(0.1) with increasing CO(2) (p=0.007) and the P(0.1)/P(imax) response slope (p=0.007) were smaller. Thoracoabdominal asynchrony was not significantly influenced by position or inspired CO(2). FRC was higher in the prone position (p=0.019).
Convalescent, prematurely born infants have a reduced ventilatory response to CO(2) challenge in the prone position, suggesting they may have an impaired ability to respond to respiratory compromise in that position.
Thorax 09/2010; 65(9):824-8. · 6.84 Impact Factor
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ABSTRACT: Prematurely born infants are at increased risk of sudden infant death syndrome (SIDS) if slept prone.
Prematurely born infants would have an impaired response to an added dead space and lower respiratory muscle strength in the prone compared to the supine position.
Prospective study. PATIENT-SUBJECT SELECTION: Twenty-five infants, median gestational age of 30 (range 26-32) weeks.
The infants were studied supine and prone at a median of 36 weeks postmenstrual age. Breath by breath minute volume was measured at baseline and after a dead space was incorporated into the breathing circuit; the time constant of the response was calculated. The maximum inspiratory occlusion pressure generated (MIOP) and the pressure generated over the first 100 msec (P(0.1)) during airway occlusion were assessed.
The median time constant was longer (26 (range 8-106) sec vs. 22 (range 6-92) sec (P = 0.045)) and the median MIOP (P = 0.001) and P(0.1) (P = 0.003) were lower in the prone compared to the supine position.
Prematurely born infants have a dampened response to tube breathing and reduced respiratory muscle strength in the prone compared to the supine position, which may contribute to their increased vulnerability to SIDS in the prone position.
Pediatric Pulmonology 05/2009; 44(4):387-91. · 2.53 Impact Factor
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ABSTRACT: Objectives
Prematurely born infants are at increased risk of sudden infant death syndrome (SIDS) if slept prone.Working HypothesisPrematurely born infants would have an impaired response to an added dead space and lower respiratory muscle strength in the prone compared to the supine position.Study designProspective study.Patient-Subject SelectionTwenty-five infants, median gestational age of 30 (range 26–32) weeks.MethodologyThe infants were studied supine and prone at a median of 36 weeks postmenstrual age. Breath by breath minute volume was measured at baseline and after a dead space was incorporated into the breathing circuit; the time constant of the response was calculated. The maximum inspiratory occlusion pressure generated (MIOP) and the pressure generated over the first 100 msec (P0.1) during airway occlusion were assessed.ResultsThe median time constant was longer (26 (range 8–106) sec vs. 22 (range 6–92) sec (P = 0.045)) and the median MIOP (P = 0.001) and P0.1 (P = 0.003) were lower in the prone compared to the supine position.Conclusion
Prematurely born infants have a dampened response to tube breathing and reduced respiratory muscle strength in the prone compared to the supine position, which may contribute to their increased vulnerability to SIDS in the prone position. Pediatr Pulmonol. 2009; 44:387–391. © 2009 Wiley-Liss, Inc.
Pediatric Pulmonology 03/2009; 44(4):387 - 391. · 2.53 Impact Factor
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ABSTRACT: In the present study, we used fMRI to assess patients suffering from post-traumatic stress disorder (PTSD) or depression, and trauma-exposed controls, during an episodic memory retrieval task that included non-trauma-related emotional information. In the study phase of the task neutral pictures were presented in emotional or neutral contexts. Participants were scanned during the test phase, when they were presented with old and new neutral images in a yes/no recognition memory task. fMRI results for the contrast between old and new items revealed activation in a predominantly left-sided network of cortical regions including the left middle temporal, bilateral posterior cingulate, and left prefrontal cortices. Activity common to all three groups when correctly judging pictures encoded in emotional contexts was much more limited. Relative to the control and depressed groups the PTSD group exhibited greater sensitivity to correctly recognised stimuli in the left amygdala/ventral striatum and right occipital cortex, and more specific sensitivity to items encoded in emotional contexts in the right precuneus, left superior frontal gyrus, and bilateral insula. These results are consistent with a substantially intact neural system supporting episodic retrieval in patients suffering from PTSD. Moreover, there was little indication that PTSD is associated with a marked change in the way negatively valenced information, not of personal significance, is processed.
Brain and Cognition 08/2008; 69(1):98-107. · 3.17 Impact Factor
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ABSTRACT: The ability to remember emotional events is crucial for adapting to biologically and socially significant situations. Little is known, however, about the nature of the neural interactions supporting the integration of mnemonic and emotional information. Using fMRI and dynamic models of effective connectivity, we examined regional neural activity and specific interactions between brain regions during a contextual memory retrieval task. We independently manipulated emotional context and relevance of retrieved emotional information to task demands. We show that retrieval of emotionally valenced contextual information is associated with enhanced connectivity from hippocampus to amygdala, structures crucially involved with encoding of emotional events. When retrieval of emotional information is relevant to current behavior, amygdala-hippocampal connectivity increases bidirectionally, under modulatory influences from orbitofrontal cortex, a region implicated in representation of affective value and behavioral guidance. Our findings demonstrate that both memory content and behavioral context impact upon large scale neuronal dynamics underlying emotional retrieval.
Neuron 03/2006; 49(4):631-8. · 14.74 Impact Factor
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ABSTRACT: In two experiments, we examined event-related potentials (ERPs) elicited in an old/new recognition memory test by emotionally neutral visual objects that, at encoding, had been associated with neutrally, negatively, or positively valenced background contexts. In Experiment 2, subjects also judged the context in which the item had been studied. In Experiment 1, "left parietal" old/new ERP effects were elicited by correctly recognized items. Items encoded in emotional contexts, but not those studied in neutral contexts, elicited additional effects early in the recording epoch over lateral temporal scalp and, later, over left temporo-frontal scalp. In Experiment 2, "left parietal" and "right frontal" ERP effects were elicited by recognized items that attracted correct source judgments. Additional effects, an early lateral temporal positivity and a late-onset, left-sided positivity, were elicited by items studied in emotionally valenced contexts and attracting correct source judgments. Together, the findings indicate that retrieval processing is influenced by the emotional valence of the context in which an item is encoded, regardless of whether contextual information is task relevant.
Journal of Cognitive Neuroscience 07/2004; 16(5):760-75. · 5.18 Impact Factor
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ABSTRACT: Episodic memory is often imbued with multisensory richness, such that the recall of an event can be endowed with the sights, sounds, and smells of its prior occurrence. While hippocampus and related medial temporal structures are implicated in episodic memory retrieval, the participation of sensory-specific cortex in representing the qualities of an episode is less well established. We combined functional magnetic resonance imaging (fMRI) with a cross-modal paradigm, where objects were presented with odors during memory encoding. We then examined the effect of odor context on neural responses at retrieval when these same objects were presented alone. Primary olfactory (piriform) cortex, as well as anterior hippocampus, was activated during the successful retrieval of old (compared to new) objects. Our findings indicate that sensory features of the original engram are preserved in unimodal olfactory cortex. We suggest that reactivation of memory traces distributed across modality-specific brain areas underpins the sensory qualities of episodic memories.
Neuron 06/2004; 42(4):687-95. · 14.74 Impact Factor
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ABSTRACT: There is considerable evidence that encoding and consolidation of memory are modulated by emotion, but the retrieval of emotional memories is not well characterized. Here we manipulated the emotional context with which affectively neutral stimuli were associated during encoding, allowing us to examine neural activity associated with retrieval of emotional memories without confounding the emotional attributes of cue items and the retrieved context. Using a source memory procedure we were also able to compare how retrieval processing was modulated when the emotional encoding context was recollected or not. An interaction between emotional encoding context and accuracy of source memory revealed that successful retrieval of emotional context was associated with activity in left amygdala, and a left frontotemporal network including anterior insula, prefrontal cortex and cingulate. In contrast, when contextual retrieval was unsuccessful, items encoded in emotional contexts elicited enhanced activity in right amygdala and a right-lateralized network that included extrastriate visual areas. These findings indicate distinct effects of emotion on successful and unsuccessful retrieval of source information, including lateralization of amygdala responses.
Learning & Memory 12(5):472-9. · 4.22 Impact Factor
