N-acetylcysteine (NAC) facilitates motor learning in infants of diabetic mothers (IDM) failing oral feeds treated with transcutaneous auricular vagus nerve stimulation (taVNS)

Abstract Introduction: taVNS improves oral feeding in newborns who are failing feeds but is ineffective Infants of Diabetic Mothers (IDM) with lower CNS glutathione(GSH) concentrations a prior trial. We hypothesized that mitigating oxidative stress N-acetylcysteine(NAC) to would enhance motor learning IDM and achieve full feeds. measured PK GSH changes NAC. Methods: Following informed consent, we enrolled 8 slated receive gastrotomy tubes. received NAC 75 (n=4) or 100mg/kg/dose q6h via nasogastric tube for 4 days alone, then up 14 days. obtained magnetic resonance spectroscopy (MRS) before NAC, after 4d the end treatment, along steady-state serum estimates around day MRS. Feeding volumes were compared between treated NAC+taVNS (n=8) alone (prior trial, n=12). Results: Mean (SD) postmenstrual age was 41±1wks, attempting po 39±8d, 50% infants had bleeds infarcts due birth asphyxia. The increase daily over 2 weeks significantly greater during (+2.6ml/kg/d) than treatment (0.5ml/kg/d, p<0.001) (+1.5ml/kg/d, p<0.001). 62% reached NAC+taVNS, 25% alone. parameters included t½ = 1.8±0.4hours, AUC= 58.7±26.3 mcg-hr/mL, CL= 1107±257mL/hr/kg. MRS showed increased [GSH] basal ganglia all at 1.5-2h ng well tolerated. Conclusions: improved antioxidant status facilitated effects on have largely did not respond This approach may neuromodulation other neuroinflammatory conditions. Research Category Technology Methods Translational Research: 12. Vagus Nerve Stimulation (VNS); Keywords: taVNS, stress, diabetic mothers