{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"bioRxiv"}],"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T22:48:59Z","timestamp":1768517339882,"version":"3.49.0"},"posted":{"date-parts":[[2024,12,16]]},"group-title":"Neuroscience","reference-count":105,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T00:00:00Z","timestamp":1734307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,3,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>Speech comprehension in noisy environments remains a significant challenge, even among individuals with clinically normal hearing and users of hearing aids and cochlear implants. While conventional assistive hearing devices address limitations in the auditory periphery, they do not directly enhance the brain\u2019s capacity to segregate speech from background noise. Because tonic vagus nerve stimulation (VNS) has demonstrated potential for rapidly improving central sensory processing, this study investigated whether tonic transcutaneous cervical VNS (tcVNS) can augment speech-in-noise intelligibility.<\/jats:p>\n                <jats:p>Two cohorts of older human adults (60-84 years) participated in a placebo-controlled, crossover study. Participants completed speech-in-noise assessments using either QuickSIN or AzBio sentences, while receiving tonic tcVNS to the neck, or placebo stimulation to the neck-shoulder junction. Speech-in-noise performance was assessed by measuring participants\u2019 accuracy in repeating sentences presented at varying signal-to-noise ratios (SNR) within background babble.<\/jats:p>\n                <jats:p>Tonic tcVNS improved speech-in-noise intelligibility compared to placebo. At the group-level, the SNR threshold for 50% speech intelligibility (SNR-50) improved by 0.76 dB in QuickSIN (p=0.016) and by 0.38 dB in AzBio (p=0.045). For individual participants, 50% demonstrated improvements that met a minimum clinically important difference (MCID) of 1 dB. Tonic tcVNS evoked progressively greater improvements as SNR increased in QuickSIN (p=0.021) and AzBio (p=0.00023), with the largest gains above 0 dB SNR. In 55% of participants, tcVNS improved intelligibility beyond an MCID benchmark of 4.9% at 5 dB SNR. While the magnitude of tcVNS-evoked improvements was inversely related to baseline speech-in-noise impairment (p=0.028), with the most impaired individuals demonstrating the largest gains, it did not correlate with hearing loss severity (p=0.97) or age (p=0.88).<\/jats:p>\n                <jats:p>Our findings indicate that tonic tcVNS can evoke immediate and clinically meaningful enhancements in speech-in-noise comprehension. This suggests tcVNS may complement conventional assistive hearing technologies and inform novel therapies for sensory processing disorders.<\/jats:p>","DOI":"10.1101\/2024.12.10.627804","type":"posted-content","created":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T12:28:17Z","timestamp":1735734497000},"source":"Crossref","is-referenced-by-count":0,"title":["Transcutaneous cervical vagus nerve stimulation improves speech comprehension in noise: A crossover, placebo-controlled study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9742-4576","authenticated-orcid":false,"given":"Michael","family":"Jigo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason B.","family":"Carmel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8656-1439","authenticated-orcid":false,"given":"Qi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8255-6699","authenticated-orcid":false,"given":"Charles","family":"Rodenkirch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025032800381333000_2024.12.10.627804v2.1","doi-asserted-by":"crossref","unstructured":"Van Hedger SC , Johnsrude IS . Speech perception under adverse listening conditions. Speech perception. Springer; 2022:141\u2013171.","DOI":"10.1007\/978-3-030-81542-4_6"},{"key":"2025032800381333000_2024.12.10.627804v2.2","unstructured":"World Health Organization. World Report on Hearing. World Health Organization; 2021:252."},{"key":"2025032800381333000_2024.12.10.627804v2.3","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000195"},{"key":"2025032800381333000_2024.12.10.627804v2.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2017.12.001"},{"key":"2025032800381333000_2024.12.10.627804v2.5","doi-asserted-by":"crossref","unstructured":"Gordon-Salant S . Hearing loss and aging: new research findings and clinical implications. Journal of Rehabilitation Research & Development. 2005;42","DOI":"10.1682\/JRRD.2005.01.0006"},{"key":"2025032800381333000_2024.12.10.627804v2.6","doi-asserted-by":"crossref","unstructured":"Pichora-Fuller MK , Alain C , Schneider BA . Older adults at the cocktail party. The auditory system at the cocktail party. 2017:227\u2013259.","DOI":"10.1007\/978-3-319-51662-2_9"},{"key":"2025032800381333000_2024.12.10.627804v2.7","doi-asserted-by":"crossref","unstructured":"Lopez-Poveda EA , Johannesen PT , P\u00e9rez-Gonz\u00e1lez P , Blanco JL , Kalluri S , Edwards B . Predictors of hearing-aid outcomes. Trends in Hearing. 2017;21","DOI":"10.1177\/2331216517730526"},{"key":"2025032800381333000_2024.12.10.627804v2.8","doi-asserted-by":"crossref","unstructured":"Zaltz Y , Bugannim Y , Zechoval D , Kishon-Rabin L , Perez R . Listening in noise remains a significant challenge for cochlear implant users: Evidence from early deafened and those with progressive hearing loss compared to peers with normal hearing. Journal of Clinical Medicine. 2020;9(5)","DOI":"10.3390\/jcm9051381"},{"issue":"11","key":"2025032800381333000_2024.12.10.627804v2.9","first-page":"18","article-title":"MarkeTrak VI: Consumers rate improvements sought in hearing instruments","volume":"9","year":"2002","journal-title":"Hearing Review"},{"key":"2025032800381333000_2024.12.10.627804v2.10","doi-asserted-by":"publisher","DOI":"10.1111\/head.12647"},{"key":"2025032800381333000_2024.12.10.627804v2.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2022.09.013"},{"key":"2025032800381333000_2024.12.10.627804v2.12","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12706"},{"key":"2025032800381333000_2024.12.10.627804v2.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2019.02.015"},{"issue":"17","key":"2025032800381333000_2024.12.10.627804v2.14","first-page":"S317","article-title":"Review of non-invasive vagus nerve stimulation (gammaCore): efficacy, safety, potential impact on comorbidities, and economic burden for episodic and chronic cluster headache","volume":"23","year":"2017","journal-title":"Am J Manag Care"},{"key":"2025032800381333000_2024.12.10.627804v2.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2018.08.010"},{"key":"2025032800381333000_2024.12.10.627804v2.16","doi-asserted-by":"publisher","DOI":"10.1038\/s41539-020-0070-0"},{"key":"2025032800381333000_2024.12.10.627804v2.17","doi-asserted-by":"publisher","DOI":"10.1162\/jocn_a_01783"},{"key":"2025032800381333000_2024.12.10.627804v2.18","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-68015-4"},{"key":"2025032800381333000_2024.12.10.627804v2.19","doi-asserted-by":"publisher","DOI":"10.1038\/s42003-021-02145-7"},{"key":"2025032800381333000_2024.12.10.627804v2.20","doi-asserted-by":"crossref","unstructured":"Zhang H , Guo Z , Qu Y , et al. Cognitive function and brain activation before and after transcutaneous cervical vagus nerve stimulation in healthy adults: A concurrent tcVNS-fMRI study. Frontiers in Psychology. 2022;13:1003411.","DOI":"10.3389\/fpsyg.2022.1003411"},{"key":"2025032800381333000_2024.12.10.627804v2.21","doi-asserted-by":"crossref","unstructured":"Rodenkirch C , Wang Q . Rapid and transient enhancement of thalamic information transmission induced by vagus nerve stimulation. Journal of Neural Engineering. 2020;17(2)","DOI":"10.1088\/1741-2552\/ab6b84"},{"key":"2025032800381333000_2024.12.10.627804v2.22","doi-asserted-by":"crossref","unstructured":"Rodenkirch C , Carmel JB , Wang Q . Rapid effects of vagus nerve stimulation on sensory processing through activation of neuromodulatory systems. Frontiers in Neuroscience. 2022;16","DOI":"10.3389\/fnins.2022.922424"},{"key":"2025032800381333000_2024.12.10.627804v2.23","doi-asserted-by":"crossref","unstructured":"Jigo M , Carmel JB , Wang Q , Rodenkirch C . Transcutaneous cervical vagus nerve stimulation improves sensory performance in humans: a randomized controlled crossover pilot study. Scientific Reports. 2024;14(1)","DOI":"10.1038\/s41598-024-54026-8"},{"key":"2025032800381333000_2024.12.10.627804v2.24","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.59.6_suppl_4.S31"},{"key":"2025032800381333000_2024.12.10.627804v2.25","first-page":"317","article-title":"Vagus nerve stimulation for epilepsy: randomized comparison of three stimulation paradigms","volume":"652","year":"2005","journal-title":"Neurology"},{"key":"2025032800381333000_2024.12.10.627804v2.26","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a034264"},{"key":"2025032800381333000_2024.12.10.627804v2.27","doi-asserted-by":"publisher","DOI":"10.1038\/nature09656"},{"key":"2025032800381333000_2024.12.10.627804v2.28","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12127"},{"key":"2025032800381333000_2024.12.10.627804v2.29","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-019-13695-0"},{"key":"2025032800381333000_2024.12.10.627804v2.30","doi-asserted-by":"publisher","DOI":"10.1002\/ctm2.397"},{"key":"2025032800381333000_2024.12.10.627804v2.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2016.12.005"},{"key":"2025032800381333000_2024.12.10.627804v2.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2016.10.008"},{"key":"2025032800381333000_2024.12.10.627804v2.33","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417717470"},{"key":"2025032800381333000_2024.12.10.627804v2.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchemneu.2010.12.002"},{"key":"2025032800381333000_2024.12.10.627804v2.35","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.08-10-03644.1988"},{"key":"2025032800381333000_2024.12.10.627804v2.36","doi-asserted-by":"publisher","DOI":"10.1038\/nn.2670"},{"key":"2025032800381333000_2024.12.10.627804v2.37","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2011.06.027"},{"key":"2025032800381333000_2024.12.10.627804v2.38","doi-asserted-by":"publisher","DOI":"10.1038\/s41593-018-0283-1"},{"key":"2025032800381333000_2024.12.10.627804v2.39","doi-asserted-by":"crossref","unstructured":"Tallal P , Miller S , Fitch RH . Neurobiological basis of speech: a case for the preeminence of temporal processing. Annals-New York Academy of Sciences. 1993;682","DOI":"10.1111\/j.1749-6632.1993.tb22957.x"},{"key":"2025032800381333000_2024.12.10.627804v2.40","doi-asserted-by":"crossref","unstructured":"Schneider BA , Pichora-Fuller MK. Age-related changes in temporal processing: implications for speech perception. Thieme Medical Publishers, Inc.; 2001:227\u2013240.","DOI":"10.1055\/s-2001-15628"},{"key":"2025032800381333000_2024.12.10.627804v2.41","doi-asserted-by":"publisher","DOI":"10.1121\/1.1784440"},{"key":"2025032800381333000_2024.12.10.627804v2.42","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0b013e31822c2549"},{"key":"2025032800381333000_2024.12.10.627804v2.43","unstructured":". Mueller HG . Signia expert series: Speech-in-noise testing for selection and fitting of hearing aids: Worth the effort. AudiologyOnline. 2016:18336."},{"key":"2025032800381333000_2024.12.10.627804v2.44","doi-asserted-by":"publisher","DOI":"10.1044\/2024_AJA-24-00008"},{"key":"2025032800381333000_2024.12.10.627804v2.45","doi-asserted-by":"crossref","unstructured":"Farmer AD , Strzelczyk A , Finisguerra A , et al. International consensus based review and recommendations for minimum reporting standards in research on transcutaneous vagus nerve stimulation (version 2020). Frontiers in human neuroscience. 2021;14:568051.","DOI":"10.3389\/fnhum.2020.568051"},{"key":"2025032800381333000_2024.12.10.627804v2.46","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.007253"},{"key":"2025032800381333000_2024.12.10.627804v2.47","doi-asserted-by":"publisher","DOI":"10.1111\/2041-210X.12504"},{"key":"2025032800381333000_2024.12.10.627804v2.48","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2023.0376"},{"key":"2025032800381333000_2024.12.10.627804v2.49","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.6905"},{"key":"2025032800381333000_2024.12.10.627804v2.50","unstructured":"QuickSIN\u2122 Speech-in-Noise Test (Version 1.3) [Audio CD and Test Manual]. 2006."},{"key":"2025032800381333000_2024.12.10.627804v2.51","unstructured":"AzBio Sentence Test v2.0. Auditory Potential LLC; 2022."},{"key":"2025032800381333000_2024.12.10.627804v2.52","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2001.113035"},{"key":"2025032800381333000_2024.12.10.627804v2.53","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2007\/059)"},{"key":"2025032800381333000_2024.12.10.627804v2.54","doi-asserted-by":"publisher","DOI":"10.3758\/BF03194551"},{"key":"2025032800381333000_2024.12.10.627804v2.55","first-page":"122","article-title":"L\u00f3pez-Moliner J. quickpsy: An R package to fit psychometric functions for multiple groups","volume":"8","year":"2016","journal-title":"The R Journal"},{"key":"2025032800381333000_2024.12.10.627804v2.56","doi-asserted-by":"publisher","DOI":"10.3758\/BF03202828"},{"key":"2025032800381333000_2024.12.10.627804v2.57","unstructured":"R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing; 2024. https:\/\/www.r-project.org\/"},{"key":"2025032800381333000_2024.12.10.627804v2.58","doi-asserted-by":"crossref","unstructured":"Kuznetsova A , Brockhoff PB , Christensen RHB . lmerTest package: tests in linear mixed effects models. Journal of Statistical Software. 2017;82(13)","DOI":"10.18637\/jss.v082.i13"},{"key":"2025032800381333000_2024.12.10.627804v2.59","doi-asserted-by":"crossref","unstructured":"Meteyard L , Davies RA . Best practice guidance for linear mixed-effects models in psychological science. Journal of Memory and Language. 2020;112:104092.","DOI":"10.1016\/j.jml.2020.104092"},{"key":"2025032800381333000_2024.12.10.627804v2.60","doi-asserted-by":"publisher","DOI":"10.2307\/2346101"},{"key":"2025032800381333000_2024.12.10.627804v2.61","doi-asserted-by":"publisher","DOI":"10.1080\/00031305.2018.1501191"},{"key":"2025032800381333000_2024.12.10.627804v2.62","article-title":"Parsimonious mixed models","year":"2015","journal-title":"arXiv preprint arXiv"},{"key":"2025032800381333000_2024.12.10.627804v2.63","doi-asserted-by":"publisher","DOI":"10.1016\/j.jml.2017.01.001"},{"key":"2025032800381333000_2024.12.10.627804v2.64","unstructured":"Westfall PH , Young SS . Resampling-based multiple testing: Examples and methods for p-value adjustment. vol 279. John Wiley & Sons; 1993."},{"key":"2025032800381333000_2024.12.10.627804v2.65","doi-asserted-by":"crossref","unstructured":"Furrow RE . Regression to the Mean in Pre\u2013Post Testing: Using Simulations and Permutations to Develop Null Expectations. CBE\u2014Life Sciences Education. 2019;18(2):le2.","DOI":"10.1187\/cbe.19-02-0034"},{"key":"2025032800381333000_2024.12.10.627804v2.66","unstructured":"U.S. Food and Drug Administration. Summary of Safety and Effectiveness Data for Nucleus 24 Cochlear Implant System. 2022. Accessed 12\/10\/2024. https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf\/P970051S205B.pdf"},{"issue":"2","key":"2025032800381333000_2024.12.10.627804v2.67","first-page":"61","article-title":"Confidence intervals from normalized data: A correction to Cousineau","volume":"4","year":"2005","journal-title":"Tutorials in Quantitative Methods for Psychology"},{"key":"2025032800381333000_2024.12.10.627804v2.68","doi-asserted-by":"publisher","DOI":"10.1121\/10.0003956"},{"key":"2025032800381333000_2024.12.10.627804v2.69","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000004319"},{"key":"2025032800381333000_2024.12.10.627804v2.70","doi-asserted-by":"publisher","DOI":"10.1121\/1.428211"},{"key":"2025032800381333000_2024.12.10.627804v2.71","doi-asserted-by":"publisher","DOI":"10.1121\/1.1610463"},{"key":"2025032800381333000_2024.12.10.627804v2.72","unstructured":"Pearsons KS , Bennett RL , Fidell SA . Speech levels in various noise environments. Office of Health and Ecological Effects; 1977."},{"key":"2025032800381333000_2024.12.10.627804v2.73","doi-asserted-by":"publisher","DOI":"10.1044\/1059-0889(1998\/012)"},{"key":"2025032800381333000_2024.12.10.627804v2.74","doi-asserted-by":"publisher","DOI":"10.3766\/jaaa.26.2.7"},{"key":"2025032800381333000_2024.12.10.627804v2.75","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000486"},{"key":"2025032800381333000_2024.12.10.627804v2.76","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainresbull.2022.07.014"},{"key":"2025032800381333000_2024.12.10.627804v2.77","doi-asserted-by":"crossref","unstructured":"Anderson S , Karawani H . Objective evidence of temporal processing deficits in older adults. Hearing Research. 2020;397","DOI":"10.1016\/j.heares.2020.108053"},{"key":"2025032800381333000_2024.12.10.627804v2.78","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2008.02.003"},{"key":"2025032800381333000_2024.12.10.627804v2.79","doi-asserted-by":"publisher","DOI":"10.1177\/1084713808325306"},{"key":"2025032800381333000_2024.12.10.627804v2.80","doi-asserted-by":"publisher","DOI":"10.1121\/1.4817926"},{"key":"2025032800381333000_2024.12.10.627804v2.81","doi-asserted-by":"publisher","DOI":"10.1097\/aud.0000000000000640"},{"key":"2025032800381333000_2024.12.10.627804v2.82","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2024.04.001"},{"key":"2025032800381333000_2024.12.10.627804v2.83","doi-asserted-by":"publisher","DOI":"10.1016\/j.conb.2015.07.004"},{"key":"2025032800381333000_2024.12.10.627804v2.84","doi-asserted-by":"publisher","DOI":"10.3758\/s13423-016-1220-5"},{"key":"2025032800381333000_2024.12.10.627804v2.85","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2016.01.001"},{"key":"2025032800381333000_2024.12.10.627804v2.86","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.1868"},{"key":"2025032800381333000_2024.12.10.627804v2.87","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-10208-8"},{"key":"2025032800381333000_2024.12.10.627804v2.88","doi-asserted-by":"publisher","DOI":"10.1037\/0278-7393.17.1.163"},{"key":"2025032800381333000_2024.12.10.627804v2.89","doi-asserted-by":"publisher","DOI":"10.1037\/0882-7974.14.3.458"},{"key":"2025032800381333000_2024.12.10.627804v2.90","doi-asserted-by":"crossref","unstructured":"Wingfield A , Tun PA . Spoken language comprehension in older adults: Interactions between sensory and cognitive change in normal aging. Copyright\u00a9 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New \u2026; 2001:287\u2013302.","DOI":"10.1055\/s-2001-15632"},{"key":"2025032800381333000_2024.12.10.627804v2.91","doi-asserted-by":"publisher","DOI":"10.1111\/ejn.14573"},{"key":"2025032800381333000_2024.12.10.627804v2.92","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2007.02.006"},{"key":"2025032800381333000_2024.12.10.627804v2.93","doi-asserted-by":"crossref","unstructured":"Lifshitz-Ben-Basat A , Taitelbaum-Swead R , Fostick L . Speech perception following transcranial direct current stimulation (tDCS) over left superior temporal gyrus (STG)(including Wernicke\u2019s area) versus inferior frontal gyrus (IFG)(including Broca\u2019s area). Neuropsychologia. 2024;202:108959.","DOI":"10.1016\/j.neuropsychologia.2024.108959"},{"key":"2025032800381333000_2024.12.10.627804v2.94","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2011.02.007"},{"key":"2025032800381333000_2024.12.10.627804v2.95","doi-asserted-by":"crossref","unstructured":"Brisson V , Tremblay P . Improving speech perception in noise in young and older adults using transcranial magnetic stimulation. Brain and Language. 2021;222:105009.","DOI":"10.1016\/j.bandl.2021.105009"},{"key":"2025032800381333000_2024.12.10.627804v2.96","doi-asserted-by":"publisher","DOI":"10.1162\/jocn_a_02224"},{"key":"2025032800381333000_2024.12.10.627804v2.97","doi-asserted-by":"crossref","unstructured":"Carroll AM , Riley JR , Borland MS , et al. Bursts of vagus nerve stimulation paired with auditory rehabilitation fail to improve speech sound perception in rats with hearing loss. iScience. 2024;27(4)","DOI":"10.1016\/j.isci.2024.109527"},{"key":"2025032800381333000_2024.12.10.627804v2.98","doi-asserted-by":"crossref","unstructured":"Gomez-Tames JD , Gonzalez J , Yu W . A simulation study: effect of the inter-electrode distance, electrode size and shape in transcutaneous electrical stimulation. IEEE; 2012:3576\u20133579.","DOI":"10.1109\/EMBC.2012.6346739"},{"key":"2025032800381333000_2024.12.10.627804v2.99","doi-asserted-by":"crossref","unstructured":"Du J , Morales A , Paknahad J , et al. Electrode spacing and current distribution in electrical stimulation of peripheral nerve: a computational modeling study using realistic nerve models. IEEE; 2021:4416\u20134419.","DOI":"10.1109\/EMBC46164.2021.9631068"},{"key":"2025032800381333000_2024.12.10.627804v2.100","doi-asserted-by":"crossref","unstructured":"Shaffer F , Ginsberg JP . An overview of heart rate variability metrics and norms. Frontiers in Public Health. 2017;5:258.","DOI":"10.3389\/fpubh.2017.00258"},{"key":"2025032800381333000_2024.12.10.627804v2.101","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2022.06.006"},{"key":"2025032800381333000_2024.12.10.627804v2.102","doi-asserted-by":"publisher","DOI":"10.1111\/ner.13313"},{"key":"2025032800381333000_2024.12.10.627804v2.103","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2023.07.025"},{"key":"2025032800381333000_2024.12.10.627804v2.104","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.13571"},{"key":"2025032800381333000_2024.12.10.627804v2.105","doi-asserted-by":"publisher","DOI":"10.1080\/0361073X.2013.779197"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2024.12.10.627804","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T07:44:08Z","timestamp":1768463048000},"score":1,"resource":{"primary":{"URL":"http:\/\/biorxiv.org\/lookup\/doi\/10.1101\/2024.12.10.627804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,16]]},"references-count":105,"URL":"https:\/\/doi.org\/10.1101\/2024.12.10.627804","relation":{"is-preprint-of":[{"id-type":"doi","id":"10.1016\/j.neurom.2025.04.007","asserted-by":"subject"}]},"subject":[],"published":{"date-parts":[[2024,12,16]]},"subtype":"preprint"}}