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. 2024 Feb 13:12:1365767.
doi: 10.3389/fped.2024.1365767. eCollection 2024.

Pairing taVNS and CIMT is feasible and may improve upper extremity function in infants

Kelly McGloon  1 , Elizabeth Humanitzki  2 , Julia Brennan  2 , Philip Summers  3 , Alyssa Brennan  4 , Mark S George  3   5 , Bashar W Badran  3 , Anne R Cribb  6 , Dorothea Jenkins  4 , Patricia Coker-Bolt  1
Affiliations

Pairing taVNS and CIMT is feasible and may improve upper extremity function in infants

Kelly McGloon et al. Front Pediatr. .

Abstract

In this study we combined non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) with 40 h of constraint induced movement therapy (CIMT) in infants. All infants completed the full intervention with no adverse events. Therapists were able to maintain high treatment fidelity and reported high ratings for ease of use and child tolerance. Preliminary results show promising gains on motor outcomes: Mean QUEST increase 19.17 (minimal clinically important difference, MCID 4.89); Mean GMFM increase 13.33 (MCID 1%-3%). Infants also exceeded expectations on Goal Attainment Scores (+1). Early data is promising that taVNS paired with intensive motor CIMT is feasible, reliable, and safe in young infants with hemiplegia, and may help harness activity-dependent plasticity to enhance functional movement.

Keywords: auricular nerve stimulation; cerebral palsy; motor rehabilitation; neuromodulation; taVNS; vagus nerve.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
The custom taVNS set-up consisted of a taVNS unit (Soterix Medical, New York, NY) and adhesive hydrogel ear electrodes (Neotech, Valencia, CA) placed in front of the tragus and at the cymbae conchae (A) stimulation was triggered manually by the therapist to reinforce proper movements using a trigger button strapped to the hand (B,C). The taVNS unit was secured on the infant's back using a Velcro cummerbund but could be removed and placed on the mat for activities like rolling. The set-up is shown in treatment context (D).
Figure 2
Figure 2
Fidelity and ease of use results.
Figure 3
Figure 3
Motor outcome measures. GMFM—Gross Motor Function Measure—88 Interpreted in % value.; DAYC-2—Developmental Assessment of Young Children—2nd edition—standard scores shown; QUEST—Quality of Upper Extremity Skills Test—Summary Scores.
Figure 4
Figure 4
GAS outcomes.
See this image and copyright information in PMC

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