CClinicalTrials.gg
Active, not recruitingNCT05129020SPROUTUpdated Jun 2, 2026

Neurostimulation to Improve NOWS Outcomes

An interventional study of Sparrow Fledging Therapy System and Sham Sparrow Fledging Therapy System in Neonatal Opioid Withdrawal Syndrome and Neonatal Abstinence Syndrome, sponsored by Spark Biomedical, Inc.. Active, not recruiting at 3 sites in United States. Open to participants aged 33 Weeks to 1 Year. Per ClinicalTrials.gov, last updated 2026-06-02.

Sponsored by Spark Biomedical, Inc. · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
52
Allocation
Randomized
Ages
33 Weeks to 1 Year
Sex
All
01

Study summary

The objective of this study is to determine if tAN therapy can reduce the median number of days of oral morphine administered to an infant after start of treatment.

Read the detailed description

This study is designed as a randomized, double-blind, sham-controlled, multi-center, clinical trial in which neonates diagnosed with Neonatal Opioid Withdrawal Syndrome (NOWS) will be randomized 1:1 into one of two treatment groups:

  1. Group 1: Active tAN + Morphine
  2. Group 2: Sham tAN + Morphine

Morphine dosing for all infants will be managed by using the Finnegan Neonatal Abstinence Scoring System (FNASS), recorded every three hours.

After the participant exits the inpatient treatment phase of the study, they will enter the neurodevelopmental follow-up phase. The participant's parent or legal guardian will be contacted at 3, 9, 18, and 24 months of age to complete the Ages and Stages Questionnaire (ASQ-3) and the Sensory Profile 2 (SP-2). At 24 months, participants who fail in any sub-domain will be referred to their primary care physician for further neurodevelopmental assessment using the Bayley Scale of Infant and Toddler Development III (BSID-III) or other neurodevelopmental assessment.

02

Conditions studied

  • Neonatal Opioid Withdrawal Syndrome
  • Neonatal Abstinence Syndrome

Keywords

  • auricular neurostimulation
  • vagus nerve stimulation
  • transcutaneous
  • withdrawal symptoms
03

Who can participate

Ages eligible
33 Weeks to 1 Year
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Neonates or infants >33 weeks gestational age with NOWS who have withdrawal scores requiring morphine replacement therapy
  2. Clinically stable without respiratory support (exception for nasal cannula)
  3. Congenital syndromes may be included if the infants do not have major, unrepaired anomalies

Exclusion criteria

Exclusion Criteria

  1. Unstable infants
  2. Repeated episodes of autonomic instability (apnea or bradycardia) which are not self-resolving
  3. Major unrepaired congenital anomalies impacting respiratory or cardiovascular system
  4. Cardiomyopathy
  5. Abnormal ear anatomy preventing the device to fit
  6. Infants diagnosed with iatrogenic NOWS
  7. Infants two weeks of age or older (after birth)
  8. Neonates who have received more than 6 methadone doses or 24 hours of methadone dosing
  9. Infants who are wards of the state
  10. Participant has any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
52 participants (actual)

Study arms

  • Experimental
    Active tAN + Morphine

    Device: Sparrow Fledging Therapy System

  • Sham comparator
    Sham tAN + Morphine

    Device: Sham Sparrow Fledging Therapy System

Interventions

  • DeviceSparrow Fledging Therapy System

    tAN sessions will be administered up to four times per day for up to 20 days total. Active tAN will be set to run for 30 minutes one hour prior to each planned morphine dose. When the 30-minute tAN session is complete, the system will be turned off and unplugged.

  • DeviceSham Sparrow Fledging Therapy System

    Participants randomized to the sham group will have the device earpiece applied at the same timepoints and for the same duration as the active group, but stimulation will not be turned on. tAN sessions will be administered up to four times per day for up to 20 days total. Sham tAN will be set to run for 30 minutes one hour prior to each planned morphine dose. When the 30-minute tAN session is complete, the system will be turned off and unplugged.

05

What researchers measure

Primary outcomes

  1. Median number of days of oral morphine medication administered to the infant after start of active or sham tAN treatment.

    Time frame: Duration of morphine administration

  2. Finnegan Neonatal Abstinence Scoring System (FNASS)

    Finnegan Neonatal Abstinence Scoring System (FNASS) is a validated assessment tool designed to measure 21 signs of withdrawal in infants. The tool provides a means to rate severity of withdrawal symptoms every three hours after feeding using a standard format.

    Time frame: Day 1 - Day 30 (or day of discharge)

Secondary outcomes

  1. Median length of hospital stay due to NOWS

    Defined as the number of calendar days from first q3h opioid administration through the 48-hour observation period

    Time frame: Through inpatient treatment phase completion, an average of one month

  2. Median length of hospital stay secondary to NOWS

    Defined as the number of calendar days from date of birth through date of discharge

    Time frame: Through inpatient treatment phase completion, an average of one month

  3. Neonatal Neurobehavioral Scale (NNNS-II)

    The NNNS is a comprehensive and systematic assessment of an infant's response to a variety of items including handling, spontaneous behavior, motor activity and self-soothing as indicators of neurobehavioral performance. The NNNS examines neurobehavioral organization, neurological reflexes, motor development, active and passive tone, and signs of stress and withdrawal of the at-risk and drug-exposed infant. The NNNS document the range of withdrawal and stress behavior likely to be observed in intervention with substance-exposed infants. The scale consists of 13 domains: habituation, attention, arousal, regulation, handling procedures, quality of movement, excitability, lethargy, nonoptimal reflexes, asymmetric reflexes, hypertonicity, hypotonicity, and stress/abstinence scale. Summary scores are calculated and compared with percentile scores to determine how an infant compares with an at-risk sample. The NNNS has good psychometric properties and reliability.

    Time frame: Baseline, Day 7, Day 15, and Day 30 (or day of discharge)

  4. Mean number of days of oral morphine medication administered

    Time frame: Day 1 - Day 30 (or day of discharge)

  5. Mean number of days from birth to medical readiness for discharge

    Defined as the date where all of the following criteria are met: age of at least 96 hours, a period of at least 48 hours without receipt of an opioid, at least 24 hours without respiratory support and with 100% oral feeding, at least 24 hours from initiation of maximum caloric density

    Time frame: From day of birth through discharge, an average of one month

Other outcomes

  1. Median length of time to reach oral morphine control dose

    Time frame: Day 1 - Day 30 (or day of discharge)

  2. Mean total oral morphine delivered

    Time frame: Day 1 - Day 30 (or day of discharge)

  3. Proportion of infants with episode(s) of bradycardia

    Time frame: Day 1 - Day 30 (or day of discharge)

  4. Proportion of infants with episode(s) of apnea related to tAN

    Time frame: Day 1 - Day 30 (or day of discharge)

  5. Proportion of infants with episode(s) of laryngospasms related to tAN

    Time frame: Day 1 - Day 30 (or day of discharge)

  6. Neonatal Infant Pain Scale (NIPS)

    The Neonatal Infant Pain Scale (NIPS) is a validated pain scale utilized in the NICU. There are six components to the NIPS: facial expression, crying, breathing patterns, arm and leg movements, and state of arousal. The NIPS scale scoring ranges from 0-7, with scores greater than 3 indicating discomfort. A score of 3 is similar to the pain level associated with a heel stick procedure to obtain blood and the maximum score of 6 is similar to a circumcision procedure without analgesia. This measure will be taken immediately prior to, during, and after tAN therapy.

    Time frame: Day 1 - Day 30 (or day of discharge)

  7. Number of infants with an Ages and Stages Questionnaire-3 (ASQ-3) Score greater than 2 standard deviations below the mean for any domain

    The ASQ-3 is a parent-completed developmental screening tool that pinpoints developmental progress in children between the ages of one month to 5 ½ years. The ASQ-3 is a series of 19 age-specific questionnaires screening communication, gross motor, fine motor, problem-solving, and personal adaptive skills; results in a pass/fail score for domains.

    Time frame: At 3, 9, 18, and 24 months of age

  8. Number of infants who have scores outside of "typical performance", as calculated by a score greater than 1 standard deviation away from the mean, on the Sensory Profile 2 (SP-2)

    The SP-2 is a set of norm-referenced, parent and teacher questionnaires designed to assess the sensory processing patterns of children from birth through 14 years, 11 months. Information obtained from the Sensory Profile 2 helps identify ways sensory processing may be contributing to or interfering with a child's participation in home, school, and community. There are five different forms selected based on age: 1) Infant Sensory Profile 2 - Birth to 6 months; 2) Toddler Sensory Profile - 7 to 35 months; 3) Child Sensory Profile 2 - 3 to 15 years; 4) Short Sensory Profile 2 - 3 to 15 years; and 5) School Companion Sensory Profile 2 - 3 to 15 years. Each of the forms includes some combination of Sensory System, Behavioral, and Sensory Pattern scores.

    Time frame: At 3, 9, 18, and 24 months of age

  9. Proportion of participants who do not meet criteria for normal neurodevelopment as measured by the Bayley Scale of Infant and Toddler Development III (BSID-III) or other neurodevelopmental assessment

    The BSID-III is an extensive formal developmental assessment tool for diagnosing developmental delays in early childhood. The BSID-III has three main subtests; the Cognitive Scale, the Language Scale, and the Motor Scale.

    Time frame: At 24 months of age

06

Study locations

3 sites
  • Medical University of South Carolina - Shawn Jenkins Children's Hospital
    Charleston, South Carolina 29425, United States
  • UT Southwestern Medical Center / Parkland Memorial Hospital
    Dallas, Texas 75235, United States
  • University of Texas Health Science Center San Antonio
    San Antonio, Texas 78229, United States
07

References and documents

Study documents

  • Informed consent form · Feb 7, 2024

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No — There is no plan to share participant data.

08

Registry details

Key details

Study ID
NCT05129020
Lead sponsor
Spark Biomedical, Inc.
Collaborators
Medical University of South Carolina, University of Texas Southwestern Medical Center, The University of Texas Health Science Center at San Antonio, National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH)
Responsible party
Sponsor
First posted
Nov 22, 2021
Start date
Jul 27, 2022
Primary completion
Jan 31, 2025
Completion
Jan 31, 2027 (estimated)
Last update
Jun 2, 2026

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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