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In Reply: Drs Guntheroth and Spiers argue that the medullary 5-HT abnormalities observed in the infants with SIDS in our study were due to the effects of hypoxia prior to death and were not the cause of death. We did not conclude that the abnormality of serotonin function in the brainstem is a specific cause of SIDS, rather that it is associated with SIDS. We agree that whether the serotonin abnormality is a cause or effect of any insult, including hypoxia, cannot be established with certainty in an autopsy study.

The effect of hypoxia on neurotransmitter receptor binding has been addressed in neurochemical studies of the brainstem by using a separate control population of infants who died with known chronic oxygenation disorders, eg, cyanotic congenital heart disease.¹ In these studies, the SIDS group did not demonstrate neurotransmitter binding changes in the same pattern as this chronic group, and the chronic . . . [Full Text of this Article]

David S. Paterson, PhD
david.paterson@childrens.harvard.edu
Department of Pathology
Children's Hospital
Boston, Mass

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Sudden Infant Death Syndrome and Brain Abnormalities
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