A perspective on SIDS pathogenesis. The hypotheses: plausibility and evidence

Several theories of the underlying mechanisms of Sudden Infant Death Syndrome (SIDS) have been proposed. These theories have born relatively narrow beach-head research programs attracting generous research funding sustained for many years at expense to the public purse. This perspective endeavors to critically examine the evidence and bases of these theories and determine their plausibility; and questions whether or not a safe and reasoned hypothesis lies at their foundation. The Opinion sets specific criteria by asking the following questions: 1. Does the hypothesis take into account the key pathological findings in SIDS? 2. Is the hypothesis congruent with the key epidemiological risk factors? 3. Does it link 1 and 2? Falling short of any one of these answers, by inference, would imply insufficient grounds for a sustainable hypothesis. Some of the hypotheses overlap, for instance, notional respiratory failure may encompass apnea, prone sleep position, and asphyxia which may be seen to be linked to co-sleeping. For the purposes of this paper, each element will be assessed on the above criteria

Comparison of the septal areas in New Guinean and European brains

In 1966, septal nuclei of unusual size in brains of kuru-diseased Fore people from the Eastern Highlands of New Guinea were reported (Beck and Gajdusek, 1966). Microscopic investigation which did not reveal any pathological changes in these nuclei led to the question of whether their large size could be a characteristic feature of the Fore (and perhaps also of other ethnic groups of New Guinea), rather than a consequence of the disease. We had at our disposal brains from patients of coastal areas of New Guinea who did not suffer from kuru. The septal areas of eight cases were investigated by serial sections and compared to those of nine European brains. No difference in size comparable to that reported in the earlier study could be detected. We conclude that a possible pecularity in the size of the septal nuclei of Fore people cannot be generalized to the entire population of New Guinea