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Santucci NR, Sahay R, El-Chammas KI, Graham K, Wheatley M, Vandenbrink M, Hardy J, Fei L. Percutaneous electrical nerve field stimulation compared to standard medical therapy in adolescents with functional abdominal pain disorders. Front Pain Res (Lausanne) 2023; 4:1251932. [PMID: 37795388 PMCID: PMC10545961 DOI: 10.3389/fpain.2023.1251932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/06/2023] [Indexed: 10/06/2023] Open
Abstract
Introduction Standard medical therapy (SMT) in children with functional abdominal pain disorders (FAPD) includes cyproheptadine and amitriptyline. While percutaneous electrical nerve field stimulation (PENFS) has shown benefit, no study has compared outcomes of PENFS to SMT. We aimed to examine changes in abdominal pain, nausea and disability before and after treatment and compare outcomes between treatments. Methods The records of FAPD patients ages 11-21 years, treated with 4 weeks of PENFS, cyproheptadine or amitriptyline were reviewed. Outcomes were evaluated using validated questionnaires [Abdominal Pain Index (API), Nausea Severity Scale (NSS), and the Functional Disability Inventory (FDI)] at baseline and follow-up within 3 months (FU). Result Of 101 patients, 48% received PENFS, 31% cyproheptadine and 21% received amitriptyline. Median ages were 17 (15-19), 16 (15-18) and 15 (11-16) years respectively and the majority were females (75%, 90% and 52% respectively). In the PENFS group, API (p = 0.001), NSS (p = 0.059) and FDI (p = 0.048) were significantly lower at FU. API (p = 0.034) but not NSS and FDI (p > 0.05) decreased significantly at FU in the amitriptyline group. API, NSS and FDI did not change significantly with cyproheptadine at FU (p > 0.05). FU API scores were lower in PENFS vs. cyproheptadine (p = 0.04) but not vs. amitriptyline (p = 0.64). The FDI scores were significantly lower in the amitriptyline vs. cyproheptadine group (p = 0.03). Conclusion Therapy with PENFS showed improvements in abdominal pain, nausea and disability while amitriptyline showed improvements in abdominal pain within 3 months of treatment. PENFS was more effective than cyproheptadine in improving abdominal pain. Amitriptyline improved disability scores more than cyproheptadine and showed promise for treatment. PENFS may be a good non-pharmacologic alternative for FAPD.
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Affiliation(s)
- Neha R. Santucci
- Gastroenterology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Pediatrics, University of Cincinnati, Cincinnati, OH, United States
| | - Rashmi Sahay
- Biostatistics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Khalil I. El-Chammas
- Gastroenterology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Pediatrics, University of Cincinnati, Cincinnati, OH, United States
| | - Kahleb Graham
- Gastroenterology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Pediatrics, University of Cincinnati, Cincinnati, OH, United States
| | - Mikaela Wheatley
- Gastroenterology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Pediatrics, University of Cincinnati, Cincinnati, OH, United States
| | | | - Jennifer Hardy
- Gastroenterology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Lin Fei
- Biostatistics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
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Roossien DH, Sadis BV, Yan Y, Webb JM, Min LY, Dizaji AS, Bogart LJ, Mazuski C, Huth RS, Stecher JS, Akula S, Shen F, Li Y, Xiao T, Vandenbrink M, Lichtman JW, Hensch TK, Herzog ED, Cai D. Multispectral tracing in densely labeled mouse brain with nTracer. Bioinformatics 2020; 35:3544-3546. [PMID: 30715234 PMCID: PMC6748755 DOI: 10.1093/bioinformatics/btz084] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 01/08/2019] [Accepted: 02/02/2019] [Indexed: 11/12/2022] Open
Abstract
SUMMARY This note describes nTracer, an ImageJ plug-in for user-guided, semi-automated tracing of multispectral fluorescent tissue samples. This approach allows for rapid and accurate reconstruction of whole cell morphology of large neuronal populations in densely labeled brains. AVAILABILITY AND IMPLEMENTATION nTracer was written as a plug-in for the open source image processing software ImageJ. The software, instructional documentation, tutorial videos, sample image and sample tracing results are available at https://www.cai-lab.org/ntracer-tutorial. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Douglas H Roossien
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Benjamin V Sadis
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Yan Yan
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - John M Webb
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | - Lia Y Min
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA.,Life Sciences Institute, University of Michigan, Ann Arbor, MI, USA.,School of Art and Design, University of Michigan, Ann Arbor, MI, USA
| | - Aslan S Dizaji
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Luke J Bogart
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Cristina Mazuski
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | - Robert S Huth
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Johanna S Stecher
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Sriakhila Akula
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Fred Shen
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ye Li
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Tingxin Xiao
- Department of Biology, University of Toronto, Toronto, ON, Canada
| | - Madeleine Vandenbrink
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jeff W Lichtman
- Department of Molecular and Cellular Biology Cambridge, MA, USA.,Center for Brain Science, Harvard University, Cambridge, MA, USA
| | - Takao K Hensch
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Molecular and Cellular Biology Cambridge, MA, USA.,Center for Brain Science, Harvard University, Cambridge, MA, USA
| | - Erik D Herzog
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | - Dawen Cai
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI, USA
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