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External neurostimulation reduces pain scores in children with IBS
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A non-invasive device that delivers neurostimulation to the external ear reduced pain scores and improved overall well-being in children with irritable bowel syndrome, according to study results.
Katja Kovacic, MD, of the division of gastroenterology and hepatology at the Medical College of Wisconsin, and colleagues wrote that auricular neurostimulation therapy delivered through percutaneous electrical nerve field stimulation (PENFS) has gained some attention as a potential therapy for functional abdominal pain disorders.
“PENFS therapy is thought to stimulate branches of several cranial nerves that project to the brainstem,” they wrote. “Because of the dual effects on visceromotor response and ascending ventral pathways, we hypothesized that PENFS is an effective treatment for IBS.”
Researchers analyzed data from children with IBS who were taking part in a double-blind trial at a tertiary care center from 2015 to 2016. They randomly assigned patients into groups that underwent either PENFS (n = 27) or sham stimulation (n = 23) 5 days a week for 4 weeks.
The primary endpoint of the study was the number of patients with a reduction of at least 30% in worst abdominal pain severity after 3 weeks. Secondary endpoints included reduction in composite abdominal pain severity score, reduction in usual abdominal pain severity and improvement in global symptoms based on symptoms response scale from –7 to 7 with 0 being “no change.”
Investigators found that more patients in the PENFS group achieved a 30% or greater reduction in worst abdominal pain scores compared with patients in the control group (59% vs. 26%; P = .024). They also achieved lower mean composite pain (7.5 vs. 14.4; P = .026) and usual pain (3 vs. 5; P = .029) compared with the sham group. More patients in the PENFS group also achieved a symptom response scale score of at least 2 (82% vs. 26%; P .001).
Kovacic and colleagues wrote that the good safety profile and efficacy of PENFS means that the novel therapy could also be considered in adults.
“Future studies should focus on characterizing short and long-term responses to PENFS in different IBS subtypes and other functional GI disorders, finding the optimal duration of therapy while also assessing changes in stool pattern,” they wrote. “Further mechanistic studies are also needed to help target this therapy to the most appropriate patient population, including adults.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.
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