Transcutaneous auricular vagus nerve stimulation (taVNS) given for poor feeding in at-risk infants also improves their motor abilities

Article type: Research Article

Authors: Aljuhani, Turki^{a; b} | Haskin, Hannah^c | Davis, Shelby^c | Reiner, Amy^c | Moss, Hunter G.^{d; h} | Badran, Bashar W.^e | George, Mark S.^{e; f; h} | Jenkins, Dorothea^g | Coker-Bolt, Patricia^{c; *}

Affiliations: [a] Division of Health Science and Research, Medical University of South Carolina, Charleston, SC, USA | [b] Department of Occupational Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia | [c] Division of Occupational Therapy, Medical University of South Carolina, Charleston, SC, USA | [d] Graduate Studies, Neuroscience, Medical University of South Carolina, Charleston, SC, USA | [e] Neuro-X Lab, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA | [f] Ralph H. Johnson VA Medical Center, Charleston, SC, USA | [g] College of Medicine, Pediatrics, Medical University of South Carolina, Charleston, SC, USA | [h] Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, USA

Correspondence: [*] Corresponding author: Patricia Coker-Bolt, Division of Occupational Therapy, Medical University of South Carolina, Charleston, SC, USA. E-mail: [email protected].

Abstract: 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.

Keywords: Early motor movement, Oral-feed, STEP, Diffusion MRI, taVNS, infant development

DOI: 10.3233/PRM-210090

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 15, no. 3, pp. 447-457, 2022