Highlights
- •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.
Abstract
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
Graphical Abstract
Abbreviations:
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)Keywords
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Article info
Publication history
Published online: July 31, 2015
Accepted:
July 30,
2015
Received in revised form:
July 28,
2015
Received:
June 23,
2015
Identification
Copyright
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
