Research Article| Volume 357, ISSUE 1-2, P257-263, October 15, 2015

Developmental alterations of the auditory brainstem centers — Pathogenetic implications in Sudden Infant Death Syndrome

  • Anna M. Lavezzi
    Corresponding author at: “Lino Rossi” Research Center for the study and prevention of unexpected perinatal death and sudden infant death syndrome (SIDS) - Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 19, 20122 Milano, Italy.
    “Lino Rossi” Research Center for the study and prevention of unexpected perinatal death and SIDS - Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
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  • Giulia Ottaviani
    “Lino Rossi” Research Center for the study and prevention of unexpected perinatal death and SIDS - Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy

    Department of Clinical Sciences and Community Health, University of Milan, Italy
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  • Luigi Matturri
    “Lino Rossi” Research Center for the study and prevention of unexpected perinatal death and SIDS - Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
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      • The auditory neurological structures located in the brainstem have been for the first time investigated in SIDS
      • A significant high incidence of developmental cytoarchitectural alterations was highlighted in SIDS
      • These defects were related to alterations of respiratory nuclei in the brainstem and to maternal smoking
      • Abnormal auditory structures can affect breathing in vulnerable infants leading to sudden death.


      Sudden Infant Death Syndrome (SIDS), despite the success of campaigns to reduce its risks, is the leading cause of infant death in the Western world. Even though the pathogenesis remains unexplained, brainstem abnormalities of the neuronal network that mediates breathing and protective responses to asphyxia, particularly in the arousal phase from sleep, are believed to play a fundamental role. This is the first study to identify, in SIDS, developmental defects of specific brainstem centers involved in hearing pathways, particularly in the cochlear and vestibular nuclei, in the superior olivary complex and in the inferior colliculus, suggesting a possible influence of the acoustic system on respiratory activity. In 49 SIDS cases and 20 controls an in-depth anatomopathological examination of the autonomic nervous system was performed, with the main aim of detecting developmental alterations of brainstem structures controlling both the respiratory and auditory activities. Overall, a significantly higher incidence of cytoarchitectural alterations of both the auditory and respiratory network components were observed in SIDS victims compared with matched controls. Even if there is not sufficient evidence to presume that developmental defects of brainstem auditory structures can affect breathing, our findings, showing that developmental deficit in the control respiratory areas are frequently accompanied by alterations of auditory structures, highlight an additional important element for the understanding the pathogenetic mechanism of SIDS.

      Graphical abstract


      ABS (auditory brainstem system), ANS (autonomic nervous system), CN (central nucleus), DC (dorsal cortex), DCN (dorsal cochlear nucleus), EC (external cortex), IC (inferior colliculus), IVN (inferior vestibular nucleus), KFN (Kölliker–Fuse nucleus), LSO (lateral superior olivary nucleus), LVN (lateral vestibular nucleus), MSO (medial superior olivary nucleus), MVN (medial vestibular nucleus), PO (periolivary nuclei), preBötN (preBötzinger nucleus), RT/PFC (Retrotrapezoid/Parafacial complex), SIDS (Sudden Infant Death Syndrome), SOC (superior olivary complex), SVN (superior vestibular nucleus), TEOAE (transient evoked otoacoustic emission), VCN (ventral cochlear nucleus)


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