Percutaneous electric nerve field stimulation alters cortical thickness in a pilot study of veterans with fibromyalgia

Woodbury, Anna; Krishnamurthy, Lisa C.; Bohsali, Anastasia; Krishnamurthy, Vivek; Smith, Jeremy L; Gebre, Melat; Tyler, Kari C.; Vernon, Mark; Crosson, Bruce; Kalangara, Jerry P.; Napadow, Vitaly; Allen, Jason W.; Harper, Daniel

doi:10.1016/j.ynpai.2022.100093

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…While the exact mechanism for the therapeutic effect of these drugs is not known, some have suggested different central pathways for PENFS and SMT. A recent study investigated connectivity differences between PENFS and standard medical therapy in adults with fibromyalgia ( 41 ). In that study, PENFS increased connectivity post-treatment from the right posterior insula to the right middle occipital gyrus, left midbrain, left anterior insula, and right lobule IX of the cerebellum that was associated with decreased pain scores.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous electrical nerve field stimulation compared to standard medical therapy in adolescents with functional abdominal pain disorders

Santucci,

Sahay,

El-Chammas

et al. 2023

Front. Pain Res.

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IntroductionStandard medical therapy (SMT) in children with functional abdominal pain disorders (FAPD) includes cyproheptadine and amitriptyline. While percutaneous electrical nerve field stimulation (PENFS) has shown benefit, no study has compared outcomes of PENFS to SMT. We aimed to examine changes in abdominal pain, nausea and disability before and after treatment and compare outcomes between treatments.MethodsThe records of FAPD patients ages 11–21 years, treated with 4 weeks of PENFS, cyproheptadine or amitriptyline were reviewed. Outcomes were evaluated using validated questionnaires [Abdominal Pain Index (API), Nausea Severity Scale (NSS), and the Functional Disability Inventory (FDI)] at baseline and follow-up within 3 months (FU).ResultOf 101 patients, 48% received PENFS, 31% cyproheptadine and 21% received amitriptyline. Median ages were 17 (15–19), 16 (15–18) and 15 (11–16) years respectively and the majority were females (75%, 90% and 52% respectively). In the PENFS group, API (p = 0.001), NSS (p = 0.059) and FDI (p = 0.048) were significantly lower at FU. API (p = 0.034) but not NSS and FDI (p > 0.05) decreased significantly at FU in the amitriptyline group. API, NSS and FDI did not change significantly with cyproheptadine at FU (p > 0.05). FU API scores were lower in PENFS vs. cyproheptadine (p = 0.04) but not vs. amitriptyline (p = 0.64). The FDI scores were significantly lower in the amitriptyline vs. cyproheptadine group (p = 0.03).ConclusionTherapy with PENFS showed improvements in abdominal pain, nausea and disability while amitriptyline showed improvements in abdominal pain within 3 months of treatment. PENFS was more effective than cyproheptadine in improving abdominal pain. Amitriptyline improved disability scores more than cyproheptadine and showed promise for treatment. PENFS may be a good non-pharmacologic alternative for FAPD.

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Section: Discussionmentioning

confidence: 99%

Percutaneous electrical nerve field stimulation compared to standard medical therapy in adolescents with functional abdominal pain disorders

Santucci,

Sahay,

El-Chammas

et al. 2023

Front. Pain Res.

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“…PENFS likely stimulates the auricular branch of the vagus nerve via the external ear. Brain functional magnetic resonance imaging (MRI) studies have demonstrated that auricular neurostimulation therapies, including PENFS, activate cerebral vagal afferents and central networks, thus holding promise as a VNS intervention 47–49 . To date, there have been few studies on the direct effect of auricular VNS on the composition of the gut microbiota.…”

Section: Introductionmentioning

confidence: 99%

Impact of auricular percutaneous electrical nerve field stimulation on gut microbiome in adolescents with irritable bowel syndrome: A pilot study

Bora

Atkinson

Pan

et al. 2023

J of Digest Diseases

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ObjectivesPercutaneous electrical nerve field stimulation (PENFS) has documented efficacy for irritable bowel syndrome (IBS) via plausible vagal neuromodulation effects. The vagus nerve may affect gut microbiome composition via brain–gut–microbiome signaling. We aimed to investigate gut microbiome alterations by PENFS therapy in adolescent IBS patients.MethodsA prospective study of females with IBS aged 11–18 years receiving PENFS therapy for 4 weeks with pre‐ and post‐intervention stool sampling was conducted. Outcome surveys completed pre‐therapy, weekly, and post‐therapy included IBS‐Severity Scoring System (IBS‐SSS), Visceral Sensitivity Index (VSI), Functional Disability Inventory (FDI), and the global symptom response scale (SRS). Bacterial DNA was extracted from stool samples followed by 16S rRNA amplification and sequencing. QIIME 2 (version 2022.2) was used for analyses of α and β diversity and differential abundance by group.ResultsTwenty females aged 15.6 ± 1.62 years were included. IBS‐SSS, VSI, and FDI scores decreased significantly after PENFS therapy (P < 0.0001, P = 0.0003, P = 0.0004, respectively). No intra‐ or interindividual microbiome changes were noted pre‐ versus post‐therapy or between responders and non‐responders. When response was defined by 50‐point IBS‐SSS score reduction, α diversity was higher in responders compared with non‐responders at week 4 (P = 0.033). There was higher abundance of Blautia in excellent responders versus non‐responders.ConclusionsThere were no substantial microbial diversity alterations with PENFS. Subjects with excellent therapeutic response showed an enrichment of relative abundance of Blautia, which may indicate that patients with specific microbial signature have a more favorable response to PENFS.

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Altered brain activity and functional connectivity in migraine without aura during and outside attack

Zhang

et al. 2023

Neurological Research

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Percutaneous electric nerve field stimulation alters cortical thickness in a pilot study of veterans with fibromyalgia

Cited by 3 publications

References 30 publications

Percutaneous electrical nerve field stimulation compared to standard medical therapy in adolescents with functional abdominal pain disorders

Percutaneous electrical nerve field stimulation compared to standard medical therapy in adolescents with functional abdominal pain disorders

Impact of auricular percutaneous electrical nerve field stimulation on gut microbiome in adolescents with irritable bowel syndrome: A pilot study

Altered brain activity and functional connectivity in migraine without aura during and outside attack

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