{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:57:27Z","timestamp":1792403847561,"version":"4.4.0"},"reference-count":126,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01HD045935"],"award-info":[{"award-number":["U01HD045935"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute of Health","award":["U01HD055155"],"award-info":[{"award-number":["U01HD055155"]}]},{"name":"National Institute of Health","award":["U01HD045991"],"award-info":[{"award-number":["U01HD045991"]}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U01AA016501"],"award-info":[{"award-number":["U01AA016501"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    The Sudden Infant Death Syndrome (SIDS) is a major global health problem, with increased risk among socioeconomically disadvantaged populations. We propose SIDS, or a subset, is due to a defect in the brainstem serotonin system mediating cardiorespiratory integration and arousal. This defect impinges on homeostasis during a critical developmental period in infancy, especially in populations experiencing maternal and infantile stress, resulting in sleep-related sudden death. In the socially disadvantaged cohort of the\n                    <jats:italic>prospective<\/jats:italic>\n                    Safe Passage Study from Cape Town, South Africa, and the Northern Plains of the United States, we tested the hypothesis that: 1) serotonin (5-HT) receptor 1A binding is reduced within the brainstem of SIDS infants compared to controls; and 2) reduced 5-HT\n                    <jats:sub>1A<\/jats:sub>\n                    binding in SIDS is associated with maternal drinking and\/or smoking during pregnancy. Using receptor ligand autoradiography for the 5-HT\n                    <jats:sub>1A<\/jats:sub>\n                    receptor,\n                    <jats:sup>3<\/jats:sup>\n                    H-8-OH-DPAT binding was measured in brainstem nuclei in infants dying of SIDS (n\u2009=\u200914) and controls dying of known causes (n\u2009=\u200910). We found a brainstem serotonin defect in SIDS infants, that is strongly driven by preterm birth, and that likely underlies the pathogenesis of sleep-related sudden death in response to homeostatic stress. The findings replicate studies of US low-to-middle income SIDS cohorts, with key differences related to prematurity, including increased 5-HT\n                    <jats:sub>1A<\/jats:sub>\n                    binding in premature SIDS compared to premature controls. The relationship of the serotonin defect to prenatal smoking and drinking is unclear, owing to the high exposure rates in SIDS cases\n                    <jats:italic>and<\/jats:italic>\n                    controls. SIDS was significantly associated with lack of a phone (proxy for poverty) (p\u2009=\u20090.024) and overcrowded housing (p\u2009=\u20090.047). These data support the concept of a serotonin defect in brainstem nuclei mediating cardiorespiratory control and arousal in SIDS infants. Maternal and\/or fetal stress, along with premature birth, may underlie a deflection of normal development of the serotonergic system.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0330940","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T17:32:13Z","timestamp":1757525533000},"page":"e0330940","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Serotonergic receptor binding in the brainstem in the Sudden Infant Death Syndrome in a high-risk population"],"prefix":"10.1371","volume":"20","author":[{"given":"Hannah C.","family":"Kinney","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca D.","family":"Folkerth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan 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