HEART RATE VARIABILITY AND LEARNING IN THE 28-34 WEEK PREMIE Krueger, C., Behnke, M., Gerhardt, K.,...
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HEART RATE VARIABILITY AND LEARNING IN THE 28-34 WEEK PREMIE Krueger, C., Behnke, M., Gerhardt, K., DeCasper, A., vanOostrom, H. Pilot Study funded through the Biobehavioral Research Center General Clinical Research Center University of Florida
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Transcript of HEART RATE VARIABILITY AND LEARNING IN THE 28-34 WEEK PREMIE Krueger, C., Behnke, M., Gerhardt, K.,...
HEART RATE VARIABILITY AND LEARNING
IN THE 28-34 WEEK PREMIE
Krueger, C., Behnke, M., Gerhardt, K., DeCasper, A., vanOostrom, H.
Pilot Study funded through the Biobehavioral Research Center
General Clinical Research Center
University of Florida
Premature Infants
• Learning Disabilities
• Delayed Speech and Language
• Neurological Disorders
Survival Rates Have Increased
Incidence of Disabilities has Stagnated
Interventions are preceded by
complete descriptions of normal development
Thus often unreliable and ineffective
RESEARCH QUESTIONS
• What are the developmental changes in HRV?
• What are the developmental changes in the learning capabilities?
• Are there interactions between with HRV as learning occurs?
Heart Rate Variability via Spectral Analysis
• Autonomic Nervous System Development– Chatow
– Karin
– Kotini
• Predict for Later Developmental Delay– DiPietro
– Porges
Learning Capabilities as Indicated by Movement and Cardiac Orienting Response
Time From Stimulus Onset (5-Sec Intervals)
-20 -10 0 10 20 30 40
Mea
n D
iffer
ence
Sco
re in
BP
M-2
-1
0
1Control GroupTarget Group
• Description of Learning Capabilities– Movement
• Lecanuet
• Kiselevsky
– Cardiac Orienting Response
• DeCasper
• Krueger
HF
Interactions Between Learning and HRV
PolyVagal Theory
Time From Stimulus Onset (5-Sec Intervals)
-20 -10 0 10 20 30 40
Mea
n D
iffer
ence
Sco
re in
BP
M
-2
-1
0
1Control GroupTarget Group
PURPOSE
Describe longitudinal changes in HRV and the learning capabilities of
the premature infant (28-34 wk)
CONCEPTUAL MODEL
A Systems Approach to Behavioral Development
Environmental
A Systems Approach to Behavioral Development
Behavioral
Neural
Genetic
Individual Development
Environmental
A Systems Approach to Behavioral Development
Behavioral
Neural
Genetic
MATERNAL VOICE
Environmental
A Systems Approach to Behavioral Development
Behavioral
Neural
Genetic
COR MOVEMENT
MATERNAL VOICE
Environmental
A Systems Approach to Behavioral Development
Behavioral
Neural
Genetic
COR MOVEMENT
HRV
MATERNAL VOICE
Environmental
A Systems Approach to Behavioral Development
Behavioral
Neural
Genetic
COR MOVEMENT
HRV
MATERNAL VOICE
Subjects and Setting
• Convenience sample
• 28 premature infants
• Neonatal Intensive Care Unit– General Clinical Research Center
•Inclusion Criteria
–28 weeks post menstrual age
–English as native language
–Dubowitz confirmation of age
•Exclusion Criteria
–Abnormal head ultrasound
–Cardiac abnormality
–Viral/bacterial infection
–Sensorineural hearing loss
• Independent Variable– Nursery Rhyme
• Dependent Variable– Heart Rate Variability
• Via spectral analysis
– Cardiac Orienting Response– Movement
Group 1
Group 2
28 29 30 31 32 33 34
Gestational Age in Weeks
Nursery Rhyme
• CD Recording of Maternal Recitation– Twice a day– 15 min after meal– Quiet
• CD Recording of Unfamiliar Female– Once a week– 15 min after meal– Quiet
55 + 5 dB
20cm from ear
WEEKLY TEST SESSION
Quiet Rhyme
HRV COR
HRV
Movement
Layout of NICU
4
3
1
2
6
Sink
9
7
8
5
Computer Door Door Sink
General Work Station
Sound Levels Across the Different Monitoring Stations
Sound Monitoring Station
1 2 3 4 5 6 7 8 9
So
un
d L
eve
l in
De
cib
els
40
50
60
70
80
90
100 LeqLmax
Sound Levels Across Time of Day
Time of Day
7am 8am 9am 10am 11am 12am 1pm 2pm
So
un
d L
evel
in D
ecib
els
40
50
60
70
80
90
100
LeqLmax
Auditory Stimulus 57-59 dB
Subject 05
Before During After
0 50 100 150 200 250 300 350 400
He
art
Ra
te in
Bea
ts p
er M
inut
e
60
80
100
120
140
160
180
200
Subject 06
Before During After
0 50 100 150 200 250 300 350 400 450 500
He
art
Ra
te in
Bea
ts p
er
Min
ute
60
80
100
120
140
160
180
200
Subject 03
Before During After
0 50 100 150 200 250 300 350
He
art
Ra
te in
Bea
ts p
er M
inu
te
60
80
100
120
140
160
180
200
Subject 02
Before During After
0 50 100 150 200 250 300 350 400
He
art
Ra
te in
Bea
ts p
er M
inu
te
60
80
100
120
140
160
180
200
28 week
Auditory Stimulus 51-54 dB
#012
Before During After
0 50 100 150 200 250 300 350 400
He
art
Ra
te in
Bea
ts p
er M
inu
te
60
80
100
120
140
160
180
200
011
Before During After
0 50 100 150 200 250 300 350 400
He
art
Ra
te in
Bea
ts p
er M
inu
te
60
80
100
120
140
160
180
200
Subject 010
Before During After
0 50 100 150 200 250 300 350 400
He
art
Ra
te in
Bea
ts p
er M
inut
e
60
80
100
120
140
160
180
200
Subject 09
Before During After
0 50 100 150 200 250 300 350 400
He
art
Ra
te in
Bea
ts p
er M
inut
e
60
80
100
120
140
160
180
200
07
Before During After
0 50 100 150 200 250 300 350 400 450
Hea
rt R
ate
in B
eats
per
Min
ute
60
80
100
120
140
160
180
200
28 weeks
Challenges Encountered
• Technological
• Physiological
• Environmental
Developmental Changes in HRV
Total Power via Spectral Analysis
High Frequency Component of HRV
Developmental Changes
Learning Capabilities
• Cardiac Orienting Response
• Movement
Time From Stimulus Onset (5-Sec Intervals)
-20 -10 0 10 20 30 40
Mea
n D
iffer
ence
Sco
re in
BP
M
-2
-1
0
1Control GroupTarget Group
32 Weeks Post-Menstrual Age
33 Weeks Post-Menstrual Age
34 Weeks Post-Menstrual Age
Arm Movements
Before During After
Maternal 32 weeks: total 9, mean 0.10, range 0-5
Maternal 34 weeks: total 29, mean 0.54, range 2-5
Non-maternal 32 weeks: total 36, mean 0.2, range 2-6
Non-maternal 34 weeks: total 40, mean 0.74, range 3-6
Mouth Movements
Before During After
Maternal 32 weeks: total 6, mean 0.07, range 0-4
Maternal 34 weeks: total 36, mean 0.70, range 2-5
Non-maternal 32 weeks: total 14, mean 0.19, range 0-4
Non-maternal 34 weeks: total 7, mean 0.13, range 0-4
Respiratory Movements
Before During After
Maternal 32 weeks: total 7, mean 0.07, range 0-4
Maternal 34 weeks: total 1, mean 0.02, range 0-1
Non-maternal 32 weeks: total 10, mean 0.14, range 0-3
Non-maternal 34 weeks: total 20, mean 0.37, range 0-4
HF
Interactions Between Learning and HRV
34 Weeks Gestation
Time in Seconds
-15s -10s -5s 5s 10s 15s
Diff
eren
ce S
core
in
BP
M
-6
-4
-2
0
2
4
6
8
10
12
14
Group 1Group 2
Interactions Between Learning and HRV
33 Weeks Gestation
Time in Seconds
-20 -15 -10 -5 0 5 10 15 20
Diffe
rence
Sco
re in B
PM
-6
-4
-2
0
2
4
6
Group 1Group 2
34 Weeks Gestation
Time in Seconds
-20 -15 -10 -5 0 5 10 15 20
Diffe
ren
ce S
core
in
BP
M
-6
-4
-2
0
2
4
6
Group 1Group 2
Program of Research Fetus Premie
34 Weeks Gestation
Time in Seconds
-15s -10s -5s 5s 10s 15s
Diff
eren
ce S
core
in
BP
M
-6
-4
-2
0
2
4
6
8
10
12
14
Group 1Group 2
TENTATIVE CONCLUSIONS
• Experience• Maturation of ANS• Interactions across
levels of analysis• Maternal voice
– Premature Infant
34 Weeks
Timing in Relation to Rhyme
Before During After
Pow
er .
2-.4
0
10
20
30
40
50
Group1 Group 2
34 Weeks Gestation
Time in Seconds
-15s -10s -5s 5s 10s 15s
Diff
eren
ce S
core
in
BP
M
-6
-4
-2
0
2
4
6
8
10
12
14
Group 1Group 2
FUTURE RESEARCH
• 28-40 weeks gestation (R-15)– Memory
• Underlying behavioral process (NSF)
