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DiabetesPENFSNCT06783504

Effect Of Percutaneous Electrical Nerve Field Stimulation on Symptom Control/Nervous System Activity in Patients w/Diabetes Types 1/2

A study testing PERCUTANEOUS ELECTRICAL FIELD NERVE STIMULATION in people with Diabetes and Gastroparesis, run by Indiana University at 1 site in United States.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

The purpose of this study is to evaluate whether stimulation of the vagus nerve can improve nausea and vomiting in diabetic gastroparetic patients. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Diabetes, Gastroparesis
What is being tested?
PERCUTANEOUS ELECTRICAL FIELD NERVE STIMULATION
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
60 participants
Where
1 siteUnited States
Study dates
10 Feb 2027to Feb 2029
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Wiling to have one teaspoon (5 ml) of blood drawn.
  • Willing to have electrodes placed in the external ear.
  • Diagnosed with gastroparesis for twelve months or longer
  • Diagnosed with diabetes either Type 1 or Type 2
  • Documented delayed gastric emptying (>10% retention of the test meal at four hours) on a standardized scrambled-egg scintigraphy gastric emptying test performed in the last two years.
  • Upper GI endoscopy indicating no mechanical obstruction performed in the last five years.
  • Symptoms of nausea and vomiting consistent with clinical diagnosis of gastroparesis (as opposed to other causes of nausea and vomiting such as mechanical obstruction, acute viral illness, chemotherapy, psychogenic vomiting.
  • Documented Hb A1c within three months of screening or at the time of screening (<=8.0)

Who cannot join

  • Unable to provide consent
  • Pregnant females
  • Medical records indicate intestinal pseudo-obstruction
  • Diagnosed with cardiac arrhythmia
  • History of prior gastric surgery
  • History of vagotomy
Show all 17Show fewer
  • History of organ transplantation
  • History of seizures
  • Diagnosed with primary swallowing disorders
  • Subjects who are dependent on drugs like Marinol for their condition
  • Those diagnosed with psychogenic vomiting and not related to gastroparesis
  • Medically unstable subjects
  • Those at high surgical risk
  • Subjects taking narcotic analgesics daily.
  • Those with poorly controlled diabetes mellitus (Hgb A1c>8) within three months of screening or at the time of screening.
  • Subjects diagnosed with hemophilia, psoriasis vulgaris are excluded
  • Those having a cardiac pacemaker will be excluded from the study.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Maureen Schilling, BS contact

317-278-2064

maschi@iu.edu

United States1 site
  • Indiana University Hospital

    Indianapolis, Indiana, 46202

    Maureen Schilling, BS, 3172782064, maschi@iu.edu

    Thomas V Nowak, MD

Other trials in United States

About this study

Official title: Effect Of Percutaneous Electrical Nerve Field Stimulation (PENFS) On Symptom Control And Autonomic Nervous System Activity In Patients With Diabetes Mellitus

The purpose of this study is to evaluate whether stimulation of the vagus nerve can improve nausea and vomiting in diabetic gastroparetic patients.

Read the detailed description

The vagus nerve is one of the main determinants of gastrointestinal motility and gastric emptying. It has been speculated that neuropathy of the vagus nerve is the cause of the delay in gastric emptying in gastroparesis, the symptoms of which include nausea, vomiting, weight loss, early satiety, abdominal pain and bloating.

Percutaneous Electrical Nerve Field Stimulation (PENFS) has been approved by the FDA to treat adolescents with functional abdominal pain associated with irritable bowel syndrome. In this study, the impact of PENFS on gastroparesis symptoms will be evaluated.

After informed consent is obtained, participant eligibility will be assessed at a Screening Visit. A Hemoglobin A1C level (HgbA1c) will be drawn for this purpose. Eligible participants will then return for 5 Study Visits at which, they will:

  • Complete will complete 4 questionnaires
  • Lie in a supine position and have ECG electrodes applied to the chest and/or arms, palmar skin electrodes placed on the fingers of the non-dominant hand to measure galvanic skin response (GSR) and sympathetic nerve activity, and a chest strap to record respiratory activity. Once the equipment is placed, electrocardiogram (ECG) and GSR will be recorded for 20 minutes in the supine position. After the 20 minutes, participants will be asked to sit while ECG and GSR are recorded for 2 additional minutes. Participants will then stand for an additional 2 minutes of ECG and GSR recordings.
  • Have a PENFS device applied to the left ear (the device will be applied at the first four study visits, and not at the fifth). The device will remain in place for 5 days after each visit.

Each participant will have a PENFS device applied at the study visits, however, participants are randomized to whether they will receive active stimulation during the study. The device will remain in place for 5 days after each visit. On the morning of Day 6 after each study visit, the participants will remove the PENFS device and return it at the next study visit.

Participants will also complete a daily diary to document symptoms over the previous 24 hours. Prior to each study visit, participants will be asked to refrain from caffeine on the day of the visit and to refrain from nicotine use for 24 hours prior to the visit.

Being tested
PERCUTANEOUS ELECTRICAL FIELD NERVE STIMULATION, Sham percutaneous electrical nerve field stimulation
Medical subject headings
Diabetes Mellitus, Gastroparesis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PERCUTANEOUS ELECTRICAL FIELD NERVE STIMULATIONDevice

    Also called IB-STIM

    The IB-Stim is a percutaneous electrical nerve field stimulator (PENFS) system intended to be used in patients 11-18 years of age with functional abdominal pain associated with irritable bowel syndrome (IBS). The IB-Stim is intended to be used for 120 hours per week up to 3 consecutive weeks, through application to branches of Cranial Nerves V, VII, IX and X, and the occipital nerves identified by transillumination, as an aid in the reduction of pain when combined with other therapies for IBS.

  • Sham percutaneous electrical nerve field stimulationDevice

    SHAM (no electrical charge)

Study groups in NCT06783504
Study groupRoleWhat they receive
ACTIVE (electrical charge)Active comparatorThe PENFS device is placed behind the patient's left ear and connected to stimulation needles on the auricle. The appliance transmits low-frequency electrical impulses throughout the auricle.
Receives: Device: PERCUTANEOUS ELECTRICAL FIELD NERVE STIMULATION
Sham percutaneous electrical nerve field stimulation (no electrical charge)Sham comparatorThe PENFS device is placed behind the patient's left ear and connected to stimulation needles on the auricle. The appliance will not transmit any electrical impulses.
Receives: Device: Sham percutaneous electrical nerve field stimulation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Gastroparesis Cardinal Symptom Index Daily Dairy

    A modified version of the GASTROPARESIS CARDINAL SYMPTOM INDEX - DAILY DIARY (GCSI-DD) will be used. The questionnaire evaluates 4 gastroparesis symptoms (nausea, early satiety, postprandial fullness, upper abdominal pain) and asks participants to rate the severity of symptoms over the past 24 hours on a scale from 0 (none) to 4 (very severe). Additionally, vomiting episodes are reported (0 for none, 1 for one episode, 2 for two episodes, 3 for three episodes, or 4 for four or more episodes). Lower total scores indicate fewer or less severe symptoms.

    Measured: Baseline, Week 5

  2. Change in Patient Assessment of Upper Gastrointestinal Disorder Symptoms

    Scores are calculated by averaging the scores for each item in the subscale, with scores ranging from 0 (none or absent) to 5 (very severe). Optimal outcome would be a score of zero, no episodes/symptoms.

    Measured: Baseline, Week 5

Secondary outcomes (5)
  1. Change in Heart Rate Variability

    Heart Rate Variability is reported on a 0-100 scale.

    Measured: Baseline, Week 5

  2. Change in Anxiety

    The General Anxiety Disorder (GAD)-7 scale is from 0-21, where 0= no anxiety and 21=severe anxiety

    Measured: Baseline, Week 5

  3. Change in the measure of depression

    Patient Health Questionnaire (PHQ)-8 is a questionnaire that measures self-reported depressive systems. PHQ-8 uses a range from 0-24, where 0=no depressive symptoms and 24=severe symptoms.

    Measured: Baseline, Week 5

  4. Change in Patient Assessment of Upper Gastrointestinal Disorder Symptoms by Diabetes Type

    Scores are calculated by averaging the scores for each item in the subscale, with scores ranging from 0 (none or absent) to 5 (very severe). Optimal outcome would be a score of zero, no episodes/symptoms.

    Measured: Baseline, Week 5

  5. Change in Gastroparesis Cardinal Symptom Index Daily Diary by Diabetes Type

    A modified version of the GASTROPARESIS CARDINAL SYMPTOM INDEX - DAILY DIARY (GCSI-DD) will be used. The questionnaire evaluates 4 gastroparesis symptoms (nausea, early satiety, postprandial fullness, upper abdominal pain) and asks participants to rate the severity of symptoms over the past 24 hours on a scale from 0 (none) to 4 (very severe). Additionally, vomiting episodes are reported (0 for none, 1 for one episode, 2 for two episodes, 3 for three episodes, or 4 for four or more episodes). Lower total scores indicate fewer or less severe symptoms.

    Measured: Baseline, Week 5

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Jan 2025
  2. Study start10 Feb 2027 (estimated)
  3. Primary completionFeb 2029 (estimated)
  4. Study completionFeb 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a double blind, randomized, sham controlled study. A total of 60 subjects will be enrolled with 30 subjects in each arm (PENFS device or Sham (no electrical charge).
Masking
Single blind
Who is masked
Participant
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06783504
Sponsor's protocol ID
18260
Acronym
PENFS
Status last verified
Sep 2026
First submitted
9 Sep 2024
Last updated
1 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No: All data and devices will be stored containing only the study subject number and dates of device usage. Sharing this data will not involve any IPD.

Publications

  • Revicki DA, Speck RM, Lavoie S, Puelles J, Kuo B, Camilleri M, Almansa C, Parkman HP. The American neurogastroenterology and motility society gastroparesis cardinal symptom index-daily diary (ANMS GCSI-DD): Psychometric evaluation in patients with idiopathic or diabetic gastroparesis. Neurogastroenterol Motil. 2019 Apr;31(4):e13553. doi: 10.1111/nmo.13553. Epub 2019 Feb 7.

    PubMed 30734412
  • Kovacic K, Kolacz J, Lewis GF, Porges SW. Impaired Vagal Efficiency Predicts Auricular Neurostimulation Response in Adolescent Functional Abdominal Pain Disorders. Am J Gastroenterol. 2020 Sep;115(9):1534-1538. doi: 10.14309/ajg.0000000000000753.

    PubMed 32732620
  • Berntson GG, Bigger JT Jr, Eckberg DL, Grossman P, Kaufmann PG, Malik M, Nagaraja HN, Porges SW, Saul JP, Stone PH, van der Molen MW. Heart rate variability: origins, methods, and interpretive caveats. Psychophysiology. 1997 Nov;34(6):623-48. doi: 10.1111/j.1469-8986.1997.tb02140.x.

    PubMed 9401419
  • Lewis GF, Furman SA, McCool MF, Porges SW. Statistical strategies to quantify respiratory sinus arrhythmia: are commonly used metrics equivalent? Biol Psychol. 2012 Feb;89(2):349-64. doi: 10.1016/j.biopsycho.2011.11.009. Epub 2011 Dec 3.

    PubMed 22138367
  • Porges SW. Method and apparatus for evaluating rhythmic oscillations in aperiodic physiological response systems. US4510944A, 1985 cited 2020 Aug 4.

  • Asahina M, Poudel A, Hirano S. Sweating on the palm and sole: physiological and clinical relevance. Clin Auton Res. 2015 Jun;25(3):153-9. doi: 10.1007/s10286-015-0282-1. Epub 2015 Apr 17.

    PubMed 25894655
  • 11. Dawson ME, Schell AM, Filion DL. The electrodermal system. In: Handbook of Physiology. 3rd ed. New York: Cambridge University Press; 2007. p. 159-81.

  • Woodbury A, Krishnamurthy V, Gebre M, Napadow V, Bicknese C, Liu M, Lukemire J, Kalangara J, Cui X, Guo Y, Sniecinski R, Crosson B. Feasibility of Auricular Field Stimulation in Fibromyalgia: Evaluation by Functional Magnetic Resonance Imaging, Randomized Trial. Pain Med. 2021 Mar 18;22(3):715-726. doi: 10.1093/pm/pnaa317.

    PubMed 33164085
  • Krasaelap A, Sood MR, Li BUK, Unteutsch R, Yan K, Nugent M, Simpson P, Kovacic K. Efficacy of Auricular Neurostimulation in Adolescents With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial. Clin Gastroenterol Hepatol. 2020 Aug;18(9):1987-1994.e2. doi: 10.1016/j.cgh.2019.10.012. Epub 2019 Oct 14.

    PubMed 31622740
  • Santucci NR, King C, El-Chammas KI, Wongteerasut A, Damrongmanee A, Graham K, Fei L, Sahay R, Jones C, Cunningham NR, Coghill RC. Effect of percutaneous electrical nerve field stimulation on mechanosensitivity, sleep, and psychological comorbidities in adolescents with functional abdominal pain disorders. Neurogastroenterol Motil. 2022 Aug;34(8):e14358. doi: 10.1111/nmo.14358. Epub 2022 Mar 16.

    PubMed 35293081
  • Kovacic K, Hainsworth K, Sood M, Chelimsky G, Unteutsch R, Nugent M, Simpson P, Miranda A. Neurostimulation for abdominal pain-related functional gastrointestinal disorders in adolescents: a randomised, double-blind, sham-controlled trial. Lancet Gastroenterol Hepatol. 2017 Oct;2(10):727-737. doi: 10.1016/S2468-1253(17)30253-4. Epub 2017 Aug 18.

    PubMed 28826627
  • Ward MP, Gupta A, Wo JM, Rajwa B, Furness JB, Powley TL, Nowak TV. An emerging method to noninvasively measure and identify vagal response markers to enable bioelectronic control of gastroparesis symptoms with gastric electrical stimulation. J Neurosci Methods. 2020 Apr 15;336:108631. doi: 10.1016/j.jneumeth.2020.108631. Epub 2020 Feb 20.

    PubMed 32087238
  • Frangos E, Ellrich J, Komisaruk BR. Non-invasive Access to the Vagus Nerve Central Projections via Electrical Stimulation of the External Ear: fMRI Evidence in Humans. Brain Stimul. 2015 May-Jun;8(3):624-36. doi: 10.1016/j.brs.2014.11.018. Epub 2014 Dec 6.

    PubMed 25573069
  • Garcia RG, Lin RL, Lee J, Kim J, Barbieri R, Sclocco R, Wasan AD, Edwards RR, Rosen BR, Hadjikhani N, Napadow V. Modulation of brainstem activity and connectivity by respiratory-gated auricular vagal afferent nerve stimulation in migraine patients. Pain. 2017 Aug;158(8):1461-1472. doi: 10.1097/j.pain.0000000000000930.

    PubMed 28541256
  • Abell T, McCallum R, Hocking M, Koch K, Abrahamsson H, Leblanc I, Lindberg G, Konturek J, Nowak T, Quigley EM, Tougas G, Starkebaum W. Gastric electrical stimulation for medically refractory gastroparesis. Gastroenterology. 2003 Aug;125(2):421-8. doi: 10.1016/s0016-5085(03)00878-3.

    PubMed 12891544

Questions about this trial

What is this clinical trial studying?

A study testing PERCUTANEOUS ELECTRICAL FIELD NERVE STIMULATION in people with Diabetes and Gastroparesis, run by Indiana University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 1 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Maureen Schilling, BS (317-278-2064, maschi@iu.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Gastroparesis Cardinal Symptom Index Daily Dairy (time frame: Baseline, Week 5). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06783504, which also lists 15 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Oct 2026.

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