IS-045 Consciousness At The Basis Of Developmental Care

Abstract

The newborn human infant particularly the preterm infant was previously regarded as a sensory-motor organism without consciousness. By the introduction of developmental care neonatal nurses and doctors commenced to regard the preterm patient as an autonomous person with consciousness although at a minimal level. The thalamocortical connections from the sense organs are established from about the 23rd gestational week, indicating that the neuronal global workspace can function (see ref 1 ). From about 25 weeks cortical responses in the somatosensory area have been recorded by near-infrared spectroscopy (NIRS) and facial expressions similar to adults sustaining pain have been observed in preterm infants after 25 weeks The preterm infant is aware of its body, itself and to some extent of the outside world. It recognises faces, vowels and smells it has been exposed to. Recent NIRS studies have shown that the preterm brain reacts differently to female versus male voices. 2 It expresses emotions like joy. By functional MR it has been demonstrated that there is a spontaneous resting activity encompassing the somatosensory, auditory and visual cortex, although there is less activity in association area and the prefrontal cortex as compared with adults. There is an incomplete default mode network which is assumed to be related to consciousness. 3 References Lagercrantz H, Hanson, M., Ment, L., Rodeck, C. (Eds) The Newborn Brain 2nd ed. Cambridge University Press, 2010 Mahmoudzadeh M et al . Syllabic discrimination in premature human infants. PNAS . 2013;110:4846–4851 Raichle M. The brain’s dark energy. Scientific American . 2010;302:44–49