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Auricular Neurostimulation: A Novel Therapy for Abdominal Pain-Related Disorders of Gut-Brain Interaction
Lauren Hagenstein1, Katja Karrento2
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
Insights
Percutaneous electrical nerve field stimulation (PENFS) shows promise for treating pediatric disorders of gut-brain interaction (DGBI). This noninvasive therapy targets vagal pathways, offering a safe and effective option for children with autonomic dysregulation.
Area of Science:
- Pediatric Gastroenterology
- Neurogastroenterology
- Autonomic Nervous System Research
Background:
- Disorders of Gut-Brain Interaction (DGBI) are common in children, presenting heterogeneous symptoms and multifactorial causes.
- Autonomic nervous system alterations are increasingly recognized in pediatric DGBI, complicating diagnosis and treatment.
- Current therapies for pediatric DGBI lack specificity and effectiveness, highlighting the need for novel approaches.
Purpose of the Study:
- To evaluate the efficacy and safety of Percutaneous Electrical Nerve Field Stimulation (PENFS) for pediatric DGBI.
- To explore PENFS as a targeted, nonpharmacologic therapy for children with DGBI and autonomic dysregulation.
Main Methods:
- Utilized PENFS, a nonpharmacologic neurostimulation device targeting vagal pathways via the external auricle.
- Administered four-week cycles of PENFS therapy in pediatric patients with abdominal pain-related DGBI.
Main Results:
- PENFS demonstrated efficacy in treating various abdominal pain-related DGBI in children.
- PENFS exhibited a high safety profile with minimal side effects in large cohort studies.
Conclusions:
- Auricular PENFS is a promising, noninvasive therapy for pediatric DGBI, particularly those with underlying autonomic dysregulation.
- Despite access challenges, PENFS offers a targeted and safe treatment option, addressing the unmet need for effective pediatric DGBI therapies.
Abstract:
Disorders of gut-brain interaction (DGBI) are highly prevalent in the pediatric population. DGBI are heterogeneous disorders with presumed multifactorial pathophysiology. Emerging studies document autonomic nervous system alterations in at least a subset. There is significant symptom overlap among the most common DGBI categories and suboptimal clinical characterization. Extraintestinal comorbidities are frequent and contribute to a rising health care burden. Most therapies are either gut-directed or empirically aimed at desensitizing brain-gut signals. There are a lack of targeted, safe, and effective therapies. Percutaneous electrical nerve field stimulation (PENFS) is a nonpharmacologic neurostimulation device that targets vagal pathways via the external auricle. Four-week cycles of PENFS therapy have demonstrated efficacy for various abdominal pain-related DGBI in children. PENFS has a high safety profile with minimal side effects in large cohort studies. Although access remains challenging because of the need for device placements by certified clinicians along with limited reimbursement, auricular PENFS is a promising, noninvasive, and targeted therapy for pediatric DGBI with underlying autonomic dysregulation.
