Pacifier Use May Decrease the Risk of SIDS Giovanni Andrisani 1 and Giorgia Andrisani 2 1 Andrisani Dental Clinic, Matera, Italy 2 Tandzorg Delſt Centrum, Ezelsveldlaan 2, 2611 RV Delſt, The Netherlands Corresponding author: Giovanni Andrisani, Private Pracce, Andrisani Dental Clinic, Matera, Italy, Tel: 0031644148385; E-mail: giorgia.andrisani@gmail.com Received: Jan 12, 2017; Accepted: Jan 30, 2017; Published: Feb 02, 2017 Citaon: Andrisani G, Andrisani G. Pacifier Use May Decrease the Risk of SIDS. J Neurol Neurosci. 2017, 8:1. Abstract The purpose of this review arcle is to explain how pacifier use might prevent sudden infant death syndrome (SIDS). Aſter describing the mesencephalic trigeminal nucleus descripon, we will discuss the effect of sleep during the non-rapid eye movement (NREM) stage. We hypothesize that during NREM sleep, intense inhibitory neurotransmission by gamma-aminobutyric acid (GABA) and galanin from the ventrolateral preopc hypothalamic nucleus (VLPO) and median preopc nucleus (MNPO) to the brainstem acvates the mesencephalic trigeminal nucleus (Me5). In response, glutamate is released to overcome the inhibitory effect of GABA and galanin on the ascending recular acvang system (ARAS) nuclei. Infants lack teeth, which means the Me5 cannot opmally exercise its funcon, and GABA signaling is unopposed. This excess of GABA can lead to extreme "brainstem system" weakness, and many cells of the cerebral stem nuclei do not work properly. For this reason, some infants have high "sensivity" to numerous non-lethal factors due to momentary weakness of the system (e.g. long QT and trivial infecons). Perhaps most importantly, there is "weight" on the respiratory system due to the imbalance of certain neurotransmiers, most notably serotonin. Keywords: SIDS; Me5; Hippocampus; Sleep phases; SIUDS; Pacifier; SUDC Introducon Pacifier use and non-nutrive sucking Non-nutrive sucking is a normal fetal and neonate behavior. Pacifiers (also known as dummies) have been used to fulfill this innate desire for over 2000 years [1]. These mock nipples can soothe or calm infants and are also useful during minor medical procedures [2]. For example, pacifier sucking was shown to reduce crying in young infants undergoing venipuncture [3]. In 1979, it was postulated that pacifier use might decrease the risk of sudden infant death syndrome (SIDS) at a me when SIDS was associated with sleep apnea. Although this relaonship has been disproven, there is strong and consistent evidence that fewer infants with SIDS use a pacifier during nighme sleep than age-matched control infants [4]. The mechanisms whereby pacifiers provide protecon against SIDS remain unclear, though two mechanisms have been proposed. Firstly, protecon may be related to effects on autonomic control [5]. Secondly, pacifiers may increase arousability from sleep [6,7]. The Me5 The object of our research is the mesencephalic trigeminal nucleus (Me5), a unique nerve formaon in the central nervous system (CNS) as it is the only site of intra-neuraxial ganglions. That is, it contains the cell bodies of primary afferent sensory neurons. This narrow band of cells passes immediately next to the periaqueductal gray (PAG) and extends from the border between the pons Varolii and midbrain to the superior colliculus (upper limit of the midbrain). Its lower limit is rostral to the motor trigeminal nucleus (Mo5). Next to Me5, a more medially and in front of the fourth ventricle is the locus coeruleus, the main source of noradrenergic fibers in the nervous system. The LC and Me5 are inmately related in early development; the LC is important in the differenaon of Me5 neurons that are necessary for proper LC funcon [8,9]. The Me5 is completely surrounded by the recular formaon (RF), and its caudal poron is its core consisng of small, mulpolar, fusiform gamma-aminobutyric acid (GABA)ergic cells that are rostral to the Mo5 and which we denote as Me5c (caudal poron of the mesencephalic trigeminal nucleus) [10]. Conversely, the rostral poron sits in the midbrain and is comprised of large pseudo-unipolar glutamatergic cells without dendrites [11-15]. Me5 cells have gap juncons that form somato-somac synapses among small groups of neurons [16,17]. Each neuron is almost enrely covered with processes that radiate from two or more astrocytes (usually astrocytes cover more neurons) [17]. The peripheral branches of mesencephalic trigeminal nucleus neurons mainly innervate mechanoreceptors in the periodontal ligament. These receptors are remarkably sensive to movement of elevator muscles in the jaw; they are acvated by a simple touch of the teeth, only a very small force is needed (1N and 4N in the Review Article iMedPub Journals http://www.imedpub.com/ DOI: 10.21767/2171-6625.1000170 JOURNAL OF NEUROLOGY AND NEUROSCIENCE ISSN 2171-6625 Vol.8 No.1:170 2017 © Copyright iMedPub | This article is available from: http://www.jneuro.com 1