AQHA Magazine July/August 2015 | Page 38

While larger studies are underway, the researchers have presented their results at national and international meetings of equine veterinarians, and many veterinarians and clinics are treating maladjusted foals with the squeeze procedure — now called the Madigan Foal Squeeze Procedure. Madigan cautions that, in spite of the strong observational effects, a larger, controlled clinical trial of national and international scope is now needed to reproduce those observed results and provide a better understanding of the processes that occur in the foals. ‘A strong tactile stimulation’ “We don’t fully understand the mechanisms that are at work here, but it appears that the rope restraint provides strong tactile stimulation, similar to what the foal should experience during labor and passage through the birth canal,” he said. Using brain-wave studies conducted by Monica Aleman, the researchers have confirmed that the foals truly go into slowwave sleep with the squeeze procedure, and endocrine changes also occur with the squeeze. "We have the unique ability to obtain brain wave data to determine the nature of some of the brain changes with the neurosteroids in the neonatal horse," Aleman said. Mirrors ‘kangaroo care’ for human babies Madigan says the findings are not without precedent in human medicine, citing anecdotal evidence that tactile pressure appears to also be important for infants. In the second stage of labour, an important signal tells the foal to quit producing the sedative neurosteroids and ‘wake up.’ “There are reports of very sick newborn babies, determined unlikely to survive, making seemingly miraculous, spontaneous recoveries after being placed in the arms of a grieving parent for a last embrace,” Madigan said. “Perhaps those babies benefited from some form of squeeze-induced stimulation or neuroactivation – similar to what we’re seeing in the foals.” He noted that many hospitals are making newborn “kangaroo care” — immediate skin-to-skin contact with the mother as well as swaddling in a light blanket — standard procedures right after birth. Premature infant survival is dramatically improved when kangaroo care is implemented, he said. Baby feels like it’s in the womb “Kangaroo care makes babies feel like they are in the womb,” said Mark Underwood, chief of paediatric neonatology at the UC Davis Children’s Hospital.  “In newborn babies that have received kangaroo care, we see their heart rates stabilise, their sleep deepen and agitation decrease.” Underwood and Madigan have discussed the neonatal maladjusted syndrome in foals as well as some of the similarities between human and horse babies. Labour affects steroid levels “In human babies, we don’t yet know what it is about the kangaroo care type of holding that is effective,” Underwood said. “We do know, however, that in babies, labour brings interesting changes in steroid levels.” Madigan adds that earlier medical studies that have found concentrations of neurosteroids, similar to those found in neonatal foals are present after birth and then rapidly decline in both full-term and early-term human babies. However after 12 hours, the preterm infants have significantly higher levels of those neurosteroids than do the full-term infants, mirroring what is seen in foals with the maladjustment syndrome. Link to Autism? The early findings by Madigan and colleagues have compelling implications for the health of newborn foals, but have also caused the researchers to explore possible links to autism in children. Autism, or autism spectrum disorder, refers to a group of complex brain-development disorders. While the symptoms vary, the disorder generally is marked by difficulties with social interactions, verbal and nonverbal communication, and repetitive behaviours. Page Page 38 38 •• The The Australian Australian Quarter Quarter Horse Horse Magazine Magazine •• July July •• August August 2015 2015 There is a long history in medical and veterinary medical research, including at UC Davis, of looking for similar symptoms and disorders in a variety of animal species — an approach that has come to be known as One Health. When Madigan decided to examine possible links between the foal disorder and childhood autism, he approached Pessah with videos of foals affected by the maladjustment syndrome. Foal Behaviours Resemble Autism ‘There are thousands of potential causes for autism, but the one thing that all autistic children have in common is that they are detached.’ — Isaac Pessah “The concept that a disruption in the transition of foetal consciousness may be related to children with autism is intriguing,” said Pessah, confirming that the behaviours seen in the maladjusted foal syndrome truly are reminiscent of those in autistic children. He notes that some children with autism do outgrow autistic behaviours by the time they reach their teen years. Could this be a parallel to the recovery of the foals with the maladjustment syndrome? Investigating possible links A new group called the Comparative Neurology Research Group, consisting of veterinarians, physicians, epidemiologists and basic-science researchers, has formed to pursue further studies in this area. Madigan is working with researchers at the Stanford School of Medicine, exploring the mechanisms of post-birth transitions of consciousness related to kangaroo care of infants. Using data from the foal research, Pessah, Madigan and Aleman are working with environmental epidemiologist Irva Hertz-Picciotto at the UC Davis MIND Institute to investigate neurosteroids in children with varying degrees of autism, ranging from some developmental delay to full-spectrum autism. The researchers are exploring whether abnormal regulation of neurosteroids during the time around childbirth could be one of many factors that might contribute to autism and related neurodevelopment disorders. H