1363 Empirical Mode Decomposition to Assess Coupling Between Infants Cry Signals and Pain Expression Quantified by a Pain Score

Abstract

Introduction: Coupling between fundamental frequency variation and intensity contour during crying reflects the degree of maturation of the central nervous system. We recently described the use of Empirical Mode Decomposition (EMD) to quantify coupling during infant cries [1]. We subsequently wanted to evaluate if there is an association between the extent of (de)coupling and quantitative pain expression.

Methods: To assess decoupling during crying in healthy term neonates during procedural pain, 47 newborns were videotaped and crying was recorded during venous blood sampling [2]. Acoustic analysis was performed and coupling between pitch frequency and the amplitude (energy) of the cry while pain expression was quantified based on the Modified Behavioral Pain Scale (MBPS). The relation between acoustic properties and the MBPS were explored.

Results: The correlation between pitch frequency and amplitude of the cry was strong (0.69±0.1, range 0.41-0.83). On the other hand, the correlation between the coupling of the cry sounds and MBPS shows positive trend (r=0.38, p = 0.008).

Conclusions: This study shows that pitch frequency and amplitude in neonates are significantly coupled, as it has already been reported, but not quantified. In addition, the acoustic properties of the neonates' cry signal relate to the MBPS. Although significant, this correlation only to a limited extent explains the interindividual variability in coupling observed.

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