{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T14:14:02Z","timestamp":1779804842274,"version":"3.53.1"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100013058","name":"Jiangsu Provincial Key Research and Development Program","doi-asserted-by":"publisher","award":["BE2021618"],"award-info":[{"award-number":["BE2021618"]}],"id":[{"id":"10.13039\/501100013058","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Respiratory variability (RV) reflects the dynamic modulation of breathing patterns by the central nervous system and may serve as a physiological marker of consciousness. However, its predictive value in disorders of consciousness (DOC) remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the relationship between RV and the level of consciousness, and to evaluate the potential of RV\u2010based analysis for predicting clinical outcomes in DOC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with disorders of consciousness and healthy controls were assessed using inertial measurement unit (IMU) sensors to record triaxial acceleration signals. RV indicators were extracted from respiratory waveforms. A generalized additive model (GAM) was applied to adjust for confounding variables. Group differences were evaluated using Bootstrap resampling and the Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test. Machine learning models\u2014including random forest, elastic net, support vector machine, and partial least squares regression\u2014were employed to predict Coma Recovery Scale\u2013Revised (CRS\u2010R) scores and clinical outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant differences in multiple RV indicators were observed between patient and control groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), indicating an association between RV and the pathophysiology of consciousness disorders. Among the tested models, the random forest algorithm achieved the best predictive performance for CRS\u2010R scores (mean squared error\u2009=\u20093.76,\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.76) and for clinical outcomes (AUC\u2009=\u20090.74, sensitivity\u2009=\u20090.86), outperforming other models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Respiratory variability, particularly when analyzed via random forest modeling, shows strong potential for prognostic assessment and clinical decision support in disorders of consciousness. RV may represent a non\u2010invasive biomarker reflecting the neural control of respiration and consciousness state.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns.70812","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T13:17:03Z","timestamp":1778591823000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Respiratory Variability in Disorders of Consciousness: Relationship and Clinical Applications"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7584-282X","authenticated-orcid":false,"given":"Yongli","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine The First People's Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology  Foshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaping","family":"Pan","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Center Suzhou Kowloon Hospital Shanghai Jiao Tong University School of Medicine  Suzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Feng","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Center Jiangning Hospital Affiliated to Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanjuan","family":"Fu","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Center Jiangning Hospital Affiliated to Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqing","family":"Han","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Center Jiangning Hospital Affiliated to Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(06)68508\u20105"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215518777285"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awaa056"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0079\u20106123(09)17704\u2010X"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2019.00530"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.1740\u201020.2021"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2008.10.020"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.36303\/SAJAA.2020.26.6.S3.2557"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1970.00310080117020"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1475\u2010097x.2002.00438.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.00303"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325\u2010021\u201002403\u20102"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12576\u2010022\u201000847\u2010z"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010021\u201003716\u20100"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010003\u20102073\u20108"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.5.1043"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199405263302107"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.02.033"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/data9080095"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181d5df0d"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14151"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/NEN.0b013e3182588293"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010neuro\u2010090121\u2010014424"},{"key":"e_1_2_9_25_1","volume-title":"StatPearls","author":"S\u00e1nchez\u2010Manso J. 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