title: Effects of caffeine treatment for apnea of prematurity on cortical speech-sound differentiation in preterm infants.
abstract: Caffeine, standard treatment for apnea of prematurity, improves brainstem auditory processing. We hypothesized that caffeine also improves cortical differentiation of complex speech sounds. We used event-related potential methodology to measure responses to speech-sound contrasts in 45 intensive care neonates, stratified by cumulative exposure as no-, low-, and high-caffeine groups. Sound differentiation in the low-caffeine group and near-term no-caffeine infants was similar with repeated measures analysis of variance controlling for gestational and postnatal age. However, a generalized estimating equation approach demonstrated that, at equivalent postnatal age, differentiation was reduced in the high-caffeine (gestational age 25 weeks) compared to the low-caffeine group (gestational age 28 weeks), reflecting the importance of maturity at birth (Z = 2.77, P < .006). We conclude that caffeine improves measures of auditory processing associated with improved neurodevelopmental outcomes in preterm infants. However, current usage of caffeine for apnea of prematurity cannot fully compensate for the effects of brain immaturity on speech sound processing.
authors.affiliation: Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA nathalie.maitre@vanderbilt.edu.
authors.forename: Nathalie L
authors.initials: NL
authors.lastname: Maitre
authors.affiliation: Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Chan
authors.affiliation: Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Ann R
authors.initials: AR
authors.lastname: Stark
authors.affiliation: Kennedy Center for Research on Human Development & Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA.
authors.forename: Warren E
authors.initials: WE
authors.lastname: Lambert
authors.affiliation: Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Judy L
authors.initials: JL
authors.lastname: Aschner
authors.affiliation: Kennedy Center for Research on Human Development & Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA.
authors.forename: Alexandra P
authors.initials: AP
authors.lastname: Key
mesh_terms: D000161:Acoustic Stimulation; D000704:Analysis of Variance; D001049:Apnea / Q000188:drug therapy*; D001931:Brain Mapping; D002110:Caffeine / Q000494:pharmacology / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000494:pharmacology / Q000627:therapeutic use*; D002540:Cerebral Cortex / Q000503:physiopathology*; D002675:Child, Preschool; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography; D005071:Evoked Potentials / Q000187:drug effects*; D005260:Female; D006801:Humans; D007223:Infant; D007234:Infant, Premature; D008297:Male; D010700:Phonetics
chemical_list: D000697:Central Nervous System Stimulants; D002110:Caffeine
keywords: auditory; caffeine; event-related potential; neonate; preterm