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Ahead of an exhibition at Oxford's Museum of Natural History, Professor Rebeccah Slater from the Department of Paediatrics explains how she became interested in the area of pain in babies and pre-term babies.

A new exhibition at Oxford’s Museum of Natural History in partnership with Oxford Neuroscience, opens on 10 March 2017. ‘Brain Diaries’ charts the astonishing development of the human brain, from conception through childhood and adulthood to old age.

Professor Rebeccah Slater is taking part in the launch of this celebration and exploration of the work of Oxford's thriving community of neuroscientists.

Here she talks about her work, and her hopes for how the research will offer better and more targeted pain relief in infants.

Q: How did you first get interested in the research area of pain in babies and pre-term babies?

A: I’ve always been curious about how children change with age – at 14 I chose to do a GCSE in Child Development! Later I did a Physics degree and Neuroscience Masters, which led me to developing an interest in brain imaging. Professor Maria Fitzgerald at UCL who worked in infant pain inspired me to work in this field. Given that babies cannot describe their pain experience, it seemed important to try and find out what was happening in the brain during a painful experience. I thought this may help us to provide better pain treatment for babies.

Q: What do you think is the most significant discovery you have made about the infant brain and how it processes pain?

A: My major research contribution has been to develop the methodology to measure pain-related brain activity in the human infant. This work demonstrated that pain-related information is transmitted and processed by the infant brain, even in the most premature infants. It also suggested that currently used clinical pain scores based on behaviours such as facial grimacing, could underestimate infant pain experience. More recently, I have been able to use these brain-derived measures in a clinical trial where we are trying to find out whether morphine could provide effective pain relief for prematurely-born infants who require regular eye exams which can prevent blindness, but are considered to be extremely painful.

In adults MRI scanners have been used to understand what happens in the adult brain during a painful event. By using the same technology in infants we have been able to identify the brain structures in the infant that are active during experiences that an adult would describe as painful. - Professor Rebeccah Slater

 

Q: What new technology is the most revealing for learning about babies’ responses to pain?

A: By comparing the infant brain activity to an adult, this revealed that many of the brain regions that are active in adult pain, including those associated with the more emotional aspects of pain experience, are also active in infants.  

 

 

 

 

 

 

Q: Why is it important to learn about pain in babies?

A: Thirty years ago, it was commonly believed that infants do not feel pain. Surgeries were carried without adequate pain relief, based on the misconception that the infant nervous system was too immature to process pain and on concerns about side-effects of pain-relieving drugs. Happily, this has changed, and infants now routinely receive pain-relief during surgery. But there is still an acceptance that medical procedures – such as taking blood samples, vaccinations, or tongue-tie division – will be performed without pain medication. For a hospitalised infant, medical procedures are an everyday reality, and the youngest and sickest infants may experience more than 50 painful procedures per day.

Q: Has your research given insights into babies’ responses to the opposite of pain e.g. comforting, soothing touch?

A: I am also interested in how the infant brain responds to other events, such as light, sound and touch. My most memorable experience is using our brain recordings to look at the how the brain of an extremely premature baby responded to a light touch on the foot. The baby’s mum was with me at the time, and she was able to see that each time I touched her baby’s foot, a small pattern of brain activity was recorded on our EEG equipment. She touched her baby’s foot too and was able to see a small change in brain activity on our equipment. Afterwards she told me that she had initially been anxious about handling her baby because he was in an incubator and was so small, but she was so happy to know that information about her gentle touch had been experienced in her baby’s brain.

Q: What does this look like in the brain?

A: It is hard to describe what pain-related brain activity looks like in words. Recently we have created some interactive 3d sculptures that can show you what happens to the brain when an adult or an infant experiences pain. The different parts of the brain that are active during a painful experience can be seen in our light-up models. We have also created some models of infant brains at different stages of development. From these we can see how brain structures changes as we grow. By handling the models, subtle variations in texture and structure can be felt through the finger tips, revealing, for example, how smooth brain structures in the youngest infants contrast dramatically with the convoluted structures seen in older children and adults.

Q: What is your greatest hope for how your research might influence the way infant pain is understood and treated?

A: Ultimately I would like to improve the treatment of pain in babies. By developing new ways to measure infant pain, we may be able to find out whether new pain treatments work for babies. I would hope that this would reduce some of the short-term discomfort and long-term consequences associated with exposure to pain in early life.

Find out more about Brain Diaries.

Read about what happens when Oxford's neuroscientists come out to play on Medium.