{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:02:17Z","timestamp":1777942937149,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82302845"],"award-info":[{"award-number":["82302845"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurorehabil Neural Repair"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post-brain injury autonomic dysfunction, mediated by frontal\u2013vagal network (FVN) dysregulation, lacks noninvasive tools for functional mapping and targeted neuromodulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize autonomic impairment after brain injury, testify left dorsolateral prefrontal cortex (DLPFC) as an FVN hub, and validate a closed-loop intermittent theta-burst stimulation coupled with heart rate variability monitoring (iTBS\u2013HRV) paradigm for FVN assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This exploratory, secondary analysis integrated data from 3 coordinated investigations conducted using a dual-modality platform that combined structural magnetic resonance imaging (MRI)-guided optical neuronavigation with real-time HRV biofeedback: (1) autonomic profiling through HRV analysis comparing 59 brain-injured patients with 30 healthy controls; (2) A randomized crossover trial using MRI-neuronavigation iTBS to compare left versus right DLPFC stimulation effects on HRV in 15 participants; and (3) a translation study applied closed-loop iTBS\u2013HRV intervention in 17 patients to quantify FVN responsivity. Key HRV metrics: root-mean-square of successive RR intervals differences ([RMSSD]; vagal tone), (high-frequency [HF]), low-frequency (LF)\/HF (sympathovagal balance), and standard deviation of RR intervals ([SDNN]; global variability).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients showed severe autonomic dysfunction with reduced vagal tone (RMSSD: 18.6\u2009ms vs 36.7\u2009ms,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and global variability (SDNN: 21.3\u2009ms vs 50.9\u2009ms,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Left frontal lesions exacerbate sympathovagal imbalance (LF\/HF \u21912.40,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05). Left DLPFC iTBS selectively enhanced vagal modulation (\u0394HF%: +2.73,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01; \u0394LF\/HF: \u22121.60,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), confirming lateralized hub function, while patients exhibited attenuated HRV responses (\u0394RMSSD: 0.50\u2009ms vs 3.34\u2009ms in controls,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The dual-modality iTBS\u2013HRV framework provides an effective approach for mapping FVN dysfunction and targeting the left DLPFC hub for neuromodulation after brain injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15459683251399131","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T11:02:52Z","timestamp":1767610972000},"page":"61-74","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Left DLPFC as a Frontal\u2013Vagal Hub in Post-Brain Injury Dysregulation: iTBS Evidence From Dual-Modality Neuronavigation"],"prefix":"10.1177","volume":"40","author":[{"given":"Tingting","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, P.R. China"},{"name":"Guangzhou Sport University, Guangzhou, Guangdong Province, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jimin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, P.R. 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