AUTHOR=Karrento Katja , Zhang Liyun , Conley William , Qazi Zeeshan , Venkatesan Thangam , Simpson Pippa , Li B U.K. 

TITLE=Percutaneous electrical nerve field stimulation improves comorbidities in children with cyclic vomiting syndrome

JOURNAL=Frontiers in Pain Research

VOLUME=Volume 4 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2023.1203541

DOI=10.3389/fpain.2023.1203541

ISSN=2673-561X

ABSTRACT=Introduction: Children with cyclic vomiting syndrome (CVS) frequently suffer from disabling abdominal pain and comorbidities that impair quality of life. A non-invasive, auricular percutaneous electrical nerve field stimulation (PENFS) device is shown effective for abdominal pain in children with disorders of gut-brain interaction. We aimed to determine the effects of PENFS on pain, common comorbidities and quality of life in pediatric CVS. 
Methods: Children ages 8-18 years with drug-refractory CVS were enrolled in a prospective, open-label study receiving 6 consecutive weeks of PENFS. Subjects completed the following surveys at baseline, during/after therapy (week 6) and at extended follow-up approximately 4-6 month later: Abdominal Pain Index (API), State-Trait Anxiety Inventory for Children (STAI-C), Pittsburgh Sleep Quality Index (PSQI) and PROMIS Pediatric Profile-37.  
Results: 30 subjects were included. Median (IQR) age was 10.5 (8.5,15.5) years; 60% were female. Median (IQR) API scores decreased from baseline to week 6 (p=0.003) and to extended follow-up (p<0.0001). State anxiety scores decreased from baseline to week 6 (p<0.0001) and to extended follow-up (p<0.0001). There were short-term improvement in sleep at 6 weeks (p=0.031) but not at extended follow-up (p=0.22). Quality of life measures of physical function, anxiety, fatigue and pain interference improved short-term, while there were long-term benefits for anxiety. No serious side effects were reported. 
Conclusions: This is the first study to demonstrate efficacy of auricular neurostimulation using PENFS for pain and several disabling comorbidities in pediatric CVS. PENFS improves anxiety, sleep and several aspects of quality of life with long-term benefits for anxiety.