Effect of percutaneous electrical nerve field stimulation on mechanosensitivity, sleep, and psychological comorbidities in adolescents with functional abdominal pain disorders. Issue 8 (16th March 2022)

• Record Type: Journal Article
• Authors: Santucci, Neha R; King, Christopher; El‐Chammas, Khalil I.; Wongteerasut, Anundorn; Damrongmanee, Alisara; Graham, Kahleb; Fei, Lin; Sahay, Rashmi; Jones, Cheryl; Cunningham, Natoshia R.; Coghill, Robert C
• Is Part Of: Neurogastroenterology & motility. Volume 34:Issue 8(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-03-16
• Subjects: functional abdominal pain -- irritable bowel syndrome -- nerve stimulation -- pediatrics -- sleep; Gastrointestinal system -- Motility -- Periodicals; Gastrointestinal system -- Innervation -- Periodicals; 616.33
• DOI: 10.1111/nmo.14358
• Languages: English
• ISSNs: 1350-1925

Abstract

Abstract: Background: Percutaneous electrical nerve field stimulation (PENFS) improves symptoms in adolescents with functional abdominal pain disorders (FAPDs). However, little is known about its impact on sleep and psychological functioning. We evaluated the effects of PENFS on resting and evoked pain and nausea, sleep and psychological functioning, and long‐term outcomes. Methods: Patient ages 11–19 years with FAPD requiring PENFS as standard care were recruited. Evoked pain was elicited by a Water Load Symptom Provocation Task (WL‐SPT) before and after four weeks of treatment. Pain, gastrointestinal symptoms, sleep, somatic symptoms, and physical and psychological functioning were assessed. Actigraphy was used to measure daily sleep–wake patterns. Key Results: Twenty patients (14.3 ± 2.2 years old) with FAPD were enrolled. Most patients were females (70%) and white (95%). During pain evoked by WL‐SPT, visual analog scale (VAS) pain intensity and nausea were lower following PENFS compared with baseline ( p = 0.004 and p = 0.02, respectively). After PENFS, resting VAS pain unpleasantness ( p = 0.03), abdominal pain ( p < 0.0001), pain catastrophizing ( p = 0.0004), somatic complaints (0.01), functional disability ( p = 0.04), and anxiety ( p = 0.02) exhibited significant improvements, and some were sustained long‐term. Self‐reported sleep improved after PENFS ( p 's < 0.05) as well as actigraphy‐derived sleep onset latency ( p = 0.03). Conclusions and Inferences: We demonstrated improvements in resting and evoked pain and nausea, sleep, disability, pain catastrophizing, somatic complaints, and anxiety after four weeks of PENFS therapy. Some effects were sustained at 6–12 months post‐treatment. This suggests that PENFS is a suitable alternative to pharmacologic therapy. Abstract : We aimed to establish the effect of percutaneous electrical nerve field stimulation (PENFS) on resting and evoked pain and nausea, changes in sleep and psychological functioning as well as long term outcomes in patients with functional abdominal pain disorders. Participants performed a waterload symptom provocation task with pre and post pain and nausea visual analog scales at baseline and after PENFS, wore an actigraphy watch to determine sleep changes and filled questionnaires pertaining to GI symptoms, sleep and psychological functioning during PENFS. Abdominal pain, nausea, gastric mechanosensitivity, sleep, disability, pain catastrophizing, somatization and anxiety improved after PENFS with some effects sustained 6‐12 months later, showing promising outcomes.