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Trigeminal nerve stimulation (TNS) has recently emerged as a promising neuromodulatory intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Mechanisms and Current Evidence<\/jats:title>\n                    <jats:p>The trigeminal nuclei send efferent fibers to the thalamus and the ascending reticular system, which then broadly innervate multiple brain areas via the ascending reticular activating system (ARAS) through both direct and indirect pathways. Capitalizing on the trigeminal nerve's distinctive anatomy, TNS has been hypothesized to potentially promote consciousness recovery in preclinical models by activating specific pathways, modulating the release of key neurotransmitters (e.g., hypocretin, dopamine, and norepinephrine), and influencing cerebral hemodynamics. Furthermore, randomized controlled trials (RCTs) involving both external TNS (eTNS) and acoustic\u2010electric TNS have highlighted a possible direction for its application as a novel therapy for DoC; the findings appear to suggest potential clinical relevance, although current evidence remains constrained by small samples, patient heterogeneity, variable stimulation protocols, and limited long\u2010term follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Challenges<\/jats:title>\n                    <jats:p>The clinical translation of TNS, however, faces pressing obstacles, including uncertainty regarding optimal stimulation targets and parameters, insufficient long\u2010term safety and efficacy data, incompletely elucidated mechanisms of action, and a lack of suitable preclinical models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TNS may represent a promising therapeutic approach for DoC, but further high\u2010quality studies are needed to establish its mechanisms, safety, efficacy, and optimal stimulation strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns.71148","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T06:17:32Z","timestamp":1792563452000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trigeminal Nerve Stimulation for Disorders of Consciousness: A Narrative Review of Potential Mechanisms, Clinical Evidence, and Future Perspectives"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4690-6799","authenticated-orcid":false,"given":"Haodong","family":"Niu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Beijing Tiantan Hospital, Capital Medical 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