{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T07:12:08Z","timestamp":1788505928536,"version":"build-2803163510"},"reference-count":60,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC2401203"],"award-info":[{"award-number":["2021YFC2401203"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Disorders of consciousness (DoC) have limited effective therapies. Implantable vagus nerve stimulation (VNS) is established for epilepsy but remains underexplored for DoC with comorbid epilepsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate whether VNS is associated with improved consciousness recovery in DoC patients with epilepsy and to explore factors related to response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective propensity score-matched cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Ninety DoC patients with epilepsy received implantable VNS or conservative management. The primary outcome was clinically meaningful improvement at 1\u2009year (Coma Recovery Scale-Revised (CRS-R) increase \u2a7e3\u2009points). Propensity score matching (1:1) balanced baseline characteristics (23 per group). Longitudinal CRS-R trajectories were assessed using linear mixed-effects models with Type III ANOVA. Logistic regression within the VNS cohort explored factors associated with responder status; adverse events were extracted from operative and follow-up records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The 1-year responder rate was higher with VNS than with conservative management (34.78% vs 4.35%; two-sided Fisher\u2019s exact test,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.022). Longitudinal analyses showed a significant group\u2009\u00d7\u2009time interaction (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200943.535,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) with greater CRS-R gains from 3\u2009months onward in the VNS group. Within the VNS cohort, responder status was associated with baseline minimally conscious state (aOR\u2009=\u20099.750, 95% confidence interval (CI) 1.592\u201359.695;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.014) and better seizure control (McHugh classification; aOR\u2009=\u200922.667, 95% CI 3.140\u2013163.629;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.002). Traumatic etiology was not associated with 12-month net CRS-R improvement after adjustment for baseline CRS-R (\u03b2\u2009=\u20090.893, 95% CI \u22121.583 to 3.369;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.466). Five patients reported stimulation-related hoarseness\/dysphonia, and two had surgical-site complications; no device removal occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Implantable VNS was associated with higher 1-year clinically meaningful improvement and greater longitudinal CRS-R gains than conservative management in DoC patients with epilepsy. Prospective controlled studies are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562864261452312","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:48:52Z","timestamp":1788176932000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Implantable vagus nerve stimulation for the treatment of disorders of consciousness with epilepsy: a retrospective propensity score-matched clinical study"],"prefix":"10.1177","volume":"19","author":[{"given":"Jinyi","family":"Zuo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiqiang","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, 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