Abstract :
Keywords Sensory; Brain; Thalamus; Prematurity; Human; MRI Highlights * Children born preterm have sensory processing difficulties at preschool age. * The association with neonatal pain and thalamic development was explored in extremely and very preterm born children. * In extremely preterm children, increased neonatal skin-breaks predicted slower thalamic growth and poorer sensory processing. * Sensitive windows in thalamic development may result in an enhanced vulnerability to procedural pain. Abstract Background Altered sensory processing is commonly reported in children born very preterm ([less than or equal to]32 weeks' gestational age [GA]). The immature nervous system, particularly the development of connections from the thalamus to the cortex, may show enhanced vulnerability to excessive sensory stimulation, and may contribute to altered sensory processing. Our objective was to determine whether sensory processing assessed at preschool-aged in children born very preterm was predicted by neonatal procedural pain and thalamic development. Methods In a prospective longitudinal cohort study, N = 140 very preterm infants (median GA at birth 28 weeks) underwent MRI early-in-life and again at term-equivalent age. Children returned for assessment at 4.5 years. Parents reported on child sensory processing behaviors on the Short Sensory Profile. General linear models were used to assess factors associated with sensory processing behaviors, adjusting for clinical and demographic factors. Results Among extremely preterm neonates (born 24--28 weeks' GA), but not very-preterm neonates (29--32 weeks' GA), more invasive procedures were associated with poorer sensory processing (B = -0.09, 95%CI [-0.17, -0.01] p = 0.03). In the overall cohort, fewer sensory processing problems were associated with greater thalamic growth between birth and term-equivalent age (B = 0.3, 95%CI [0.11, 0.42], p Conclusion Early exposure to pain and related alterations in the developing thalamus may be a key factor underlying later sensory problems in children born extremely preterm. Author Affiliation: (a) Applied Psychology, Faculty of Education, Western University, London, Canada (b) Department of Pediatrics, University of British Columbia, Vancouver, Canada (c) Department of Paediatrics, the Hospital for Sick Children and the University of Toronto, Toronto, Canada (d) BC Women's Hospital, Vancouver, Canada (e) BC Children's Hospital Research Institute, Vancouver, Canada * Corresponding author at: Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada. Article History: Received 9 November 2021; Revised 16 June 2022; Accepted 17 June 2022 Byline: Emma G. Duerden (a), Mia A. Mclean (b), Cecil Chau (b), Ting Guo (c), Margot Mackay (d), Vann Chau (c), Anne Synnes (b,d,e), Steven P. Miller (c), Ruth E. Grunau [rgrunau@bcchr.ca] (b,d,e,*)