PURPOSE: Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive neuromodulation technique that may improve oromotor skills when paired with feeding in at-risk infants, but effects on other motor function and how motor function relates to white matter (WM) microstructure are unknown. METHODS: In this prospective study, infants failing oral feeds and slated for gastrostomy tube (G-tube) placement received taVNS paired with bottle feeding daily for 2-3 weeks. The effects of taVNS-paired feeding on general and specific head movements were investigated using the Specific Test of Early infant motor Performance (STEP) and diffusion MRI obtained before and after taVNS treatment. Scores between and within groups (taVNS responders, attained full oral feeds; non-responders, received G-tubes) were compared. RESULTS: Performance on head movement items improved significantly in responders but not in non-responders (p < 0.05). Total STEP scores were significantly higher in responders after taVNS treatment than non-responders (p = 0.04). One STEP item, rolling by arm, was associated with significantly greater change in WM tract microstructure (p < 0.05) in the responders. CONCLUSION: These results suggest that pairing feeding with taVNS may affect specific head and neck movements to a greater extent in infants who are able to attain full oral feeds.
Date Presented 03/27/20
STEP is a novel infant motor skills test that is an efficient developmental assessment for preterm infants. STEP scores are related to MRS metabolite N-acetylaspartate (NAA) and multiple white matter (WM) tract fractional anisotropy (FA) values. Neuroimaging data in a model with STEP scores strongly predict 12-month Bayley outcomes. Performance on the STEP relates to CNS structural and metabolic integrity, and combining neuroimaging with STEP assessment can predict long-term motor development.
Primary Author and Speaker: Patty Coker-Bolt
Additional Authors and Speakers: Hannah Haskins, Hunter Moss, Shelby Davis, Amy Reiner, Dorothea Jenkins
Date Presented 03/27/20
A noninvasive application of vagal nerve stimulation, taVNS, stimulates the auricular branch of the vagal nerve. In a first-in-neonates application, infants who received taVNS for oral feeding dysfunction also showed improvements in head control and brain neuroimaging of major white-matter tracts. These exploratory results are promising and promote future studies of taVNS to improve motor abilities in infants with feeding difficulties or motor disorders.
Primary Author and Speaker: Shelby Davis
Additional Authors and Speakers: Amy Reiner, Hannah Haskin, Patty Coker-Bolt, Turki Aljuhani
Contributing Authors: Mark George, Bashar Badran, Dorthea Jenkins
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