Preliminary Evidence Suggesting Delayed Development in the Hypoglossal and Vagal Nuclei of SIDS Infants: A Necropsy Study

Abstract

Little neuropathology has been documented in sudden infant death syndrome (SIDS) infants. Two hypotheses predict abnormalities in the hypoglossal nucleus and dorsal motor nucleus of the vagus: first, that upper airways are obstructed as a result of abnormal innervation (principally the hypoglossal nerve), and second, that they are obstructed as a result of abnormal cardiorespiratory control (the vagus nerve). A quantitative morphometric analysis was carried out to test these hypotheses in SIDS infants and controls (who died in accidents). The following nuclei dimensions were analyzed; length, volume, density, and estimated total cell number. In addition, cell size was analyzed. There were no differences in the anatomical distribution, site, or number of neurons between the groups. The most significant difference between the SIDS and control infants was the neuronal size: control infants had significantly larger neurons. In many other variables, there were trends suggesting a difference between the groups: the volume occupied by the neuronal populations was smaller in the SIDS infants, and therefore the neuronal density was increased. These values suggest differences in the development of these nuclei between SIDS and control infants. ( J Child Neurol 1992;7:44-49).

Get full access to this article

View all access options for this article.

References

Southall DP : Role of apnea in the sudden infant death syndrome: A personal view . Pediatrics 1988;81:73-84.

Henderson-Smart DJ : Regulation of breathing rhythm in the newborn. The role of brainstem immaturity and inhibition. J Dev Physiol 1984;6:83-92.

Brooks JG : Apnea of infancy and sudden infant death syndrome. Am J Dis Child 1982;136:1012-1013.

Thach BT : Sleep apnea in infancy and childhood. Med Clin North Am 1985;69:1289-1315.

Sterman MB , Hodgman J. : The role of sleep and arousal in SIDS. Ann NY Acad Sci 1988;533:48-61.

Gould JB , Austin Fsl , Morelock S. : The relationship between sleep and SIDS. Ann NY Acad Sci 1988;533:63-77.

Naeye RL : Brainstem and adrenal abnormalities in the sudden infant death syndrome . Am J Clin Pathol 1976;66:526-530.

Naeye R. , Drage J. : Sudden infant death syndrome, a prospective study. Pediatr Res 1975;9:298.

Leech RW , Alvord EC : Anoxic-ischemic encephalopathy in the human neonatal period. Arch Neurol 1977;34:109-113.

10.

Gadson DR , Emery JL : Fatty change in the brain in perinatal and unexpected death. Arch Dis Child 1976;51:42-48.

11.

Takashima S. , Armstrong D. , Becker L. , Huber J. : Cerebral white matter lesions in sudden infant death syndrome. Pediatrics 1978;62:155-159.

12.

Brand MM , Bignami A. : The effects of chronic hypoxia on the neonatal and infantile brain . Brain 1969;92:233-254.

13.

Summers CG , Parker JC : The brainstem in sudden infant death syndrome. A postmortem survey . Am J Med Pathol 1981;12:121-127.

14.

Atkinson JB , Evans OB , Ellison RS , Netsky MG : Ischemia of the brain stem: A cause of sudden infant death syndrome. Arch Pathol Lab Med 1984;108:341-342.

15.

Sachis P. , Armstrong D. , Becker L. , Bryan C. : The vagus nerve and sudden infant death syndrome: A morphometric study . J Pediatr 1981;98:278-280.

16.

Baba N. , Quattrochi JJ , Reiner CB , et al: Possible role of the brain stem in sudden infant death syndrome . JAMA 1983;249:2789-2791.

17.

Quattrachi J. , Batsa N. , Liss L. , et al. Sudden infant death syndrome. A preliminary study of reticular dendritic spines in infants with sudden infant death syndrome . Brain Res 1980;181:245-249.

18.

Takashima S. , Becker LE : Developmental abnormalities of medullary "respiratory centres" in SIDS. Exp Neurol 1985; 90:580-587.

19.

DeCock M. : Nervus hypoglossus (n.XII). Acta Otorhinolaryngol Belg 1986;40:259-280.

20.

Brodal A. : Neurological Anatomy in Relation to Clinical Medicine. New York, Oxford University Press, 1981, pp 460-470.

21.

Abercrombie M. : Estimation of nuclear population from microtome sections. Anat Rec 1946;94:239-247.

22.

Hays WL : Statistics. 4th ed. New York , Holt Rinehart & Winston, 1988 .

23.

Huck SW , Cormier WH , Bounds WG : Reading Statistics and Research. New York, Harper & Row, 1974.

24.

Huttenlocher PR : Morphometric study of human cerebral cortex development. Neuropsychologia 1990;28:517-527.

25.

Marin-Padilla M. : Prenatal and early postnatal ontogenesis of the human motor cortex: A Golgi study. I. The sequential development of the cortical layers. Brain Res 1970;23:167-183.

26.

Paldino AM , Purpura DP : Quantitative analysis of the spatial distribution of axonal and dendritic terminals of hippocampal pyramidal neurons in immature human brain. Exp Neurol 1979;64:604-619.

27.

Lewis P. : Report on the occurrence of sudden infant death syndrome in the Blacktown Local Government Area—January to October 1990. Sydney , Western Sector Public Health Unit, 1990.

28.

Golding J. , Limerick S. , Macfarlane A. : Sudden infant death— Patterns, puzzles and problems. Somerset, England , Open Books, 1985, pp 22-43.

29.

Denorey L. , Gay N. , Gilly R. , et al: Catecholamines synthesizing enzyme activity in brainstem areas from victims of SIDS. Neuropediatrics 1987 ;18:187-190.

30.

Naeye RL , Olsson JM , Combs JW : New brain stem and bone marrow abnormalities in victims of sudden infant death syndrome. J Perinatol 1989;9:180-183.

31.

Hwang Ji-Chuu , St John Walker M. : Alterations of hypoglossal motorneuronal activities during pulmonary inflations. Exp Neurol 1987;97:615-625.

32.

Kuna ST : Inhibition of inspiratory upper airway motorneurone activity by phasic volume feedback. J Appl Physiol 1986;60:1373-1379.

33.

van Lunteren E. , Kingman S. : The muscles of the upper airways . Clin Chest Med 1986;7:171-188.

34.

Johnson P. : Airway reflexes and the control of breathing in postnatal life. Ann NY Acad Sci 1988;533:262-275.

35.

Mellins RB , Haddad GG : Cardiorespiratory control in sudden infant death syndrome. Hypoxia, Exercise and Altitude: Proceedings of the Third Banff International Hypoxia Symposium . New York, Liss, 1983, pp 51-56.

36.

Harper RM , Leake B. , Hodgman JE , Hoppenbrouwers T. : Developmental patterns of heart rate and heart rate variability during sleep and waking in normal infants and infants at risk for the sudden infant death syndrome. Sleep 1982;5:28-38.

37.

Zhang JS , Harper RM , Frysinger RC : Respiratory modulation of neuronal discharge in the central nucleus of the amygdala during sleep and waking states. Exp Neurol 1986;91:193-207.

38.

Frysinger RC , Frostig RD , Schechtman VL , et al: Characterization of neuronal discharge in medial frontal cortex with spontaneous changes in cardiorespiratory parameters across sleep-waking states. Soc Neurosci Abstr 1985;11:825.

39.

Peterson PR , Benson EA , Fischer LO : Postnatal growth and SIDS. Am J Epidemiol 1974;99:389.

40.

Johnson P. : Environmental temperature and the development of breathing, in Harper RM, Hoffman HF (eds): Sudden Infant Death Syndrome: Risk Factors and Basic Mechanisms. New York, Spectrum, 1988, pp 233-248.

41.

Parmeggiani PL : Temperature regulation during sleep: A study in homeostasis, in Orem J , Barnes CD (eds): Physiology in Sleep. New York, Academic Press, 1980, pp 98-143.

42.

Stanton AN : Overheating and cot death. Lancet 1984; 2:1199-1201.

43.

Guilleminault C. , Peraita R. , Souquet M. , Dement WC : Apneas during sleep in infants: Possible relationship with sudden infant death syndrome . Science 1975;190:677-679.

44.

Guilleminault C. , Ariajgnos R. , Korobkin R. : Sleep parameters and respiratory variables in near miss SIDS infants. Pediatrics 1981 ;50:1313-1317.

45.

Hillman L. , Hoffman HF , Jones M. , et al: Relationships of prenatal and neonatal factors to SIDS: Preliminary results of the NICHD co-operative epidemiological study of sudden infant death syndrome (SIDS) risk factors. Pediatr Res 1982;16:291A.