{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T15:10:36Z","timestamp":1778339436819,"version":"3.51.4"},"reference-count":0,"publisher":"Pakistan Journal of Medical Sciences","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pak J Med Sci"],"abstract":"<jats:p>Objective: To evaluate the clinical efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of moderate-to-severe depression.\nMethodology: This was a retrospective study. A total of 180 patients diagnosed with moderate-to-severe depression and admitted to Hebei Provincial Mental Health Center between July 2023 to March 2025 were enrolled and randomized into three groups(n= 60 each) using a random number table: the taVNS group (Group-A), the rTMS group (Group-R) and the taVNS\u202f+\u202frTMS group (Group-C). All patients underwent a 4-week treatment course. Clinical outcomes, changes in depression severity, sleep quality and incidence of adverse events were assessed post-treatment. All outcome assessments were conducted under blinded conditions using standardized rating scales.\nResults: The overall response rate was 85% in Group-C, significantly higher than the 70% in Group-A and the 66% in Group-R (p= 0.02). Additionally, patients in Group-C showed significantly greater reductions in both Clinical Global Impression and Pittsburgh Sleep Quality Index scores compared with Groups A and R (both p= 0.00). No statistically significant differences were observed among the three groups in the incidence of adverse events(p= 0.60).\nConclusion: The combination of taVNS and rTMS demonstrates a synergistic effect in the treatment of moderate-to-severe depression, which is considered a safe and effective therapeutic strategy as it can significantly improve clinical symptoms and sleep quality without increasing adverse effects.<\/jats:p>","DOI":"10.12669\/pjms.42.3.13028","type":"journal-article","created":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T06:05:04Z","timestamp":1773468304000},"page":"660-665","source":"Crossref","is-referenced-by-count":0,"title":["A clinical study on the augmented therapeutic effects of transcutaneous auricular vagus nerve stimulation combined with repetitive transcranial magnetic stimulation in the treatment of moderate-to-severe depression"],"prefix":"10.12669","volume":"42","author":[{"given":"Shuhui","family":"Gao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun","family":"Mi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haizhu","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengxue","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4935","published-online":{"date-parts":[[2026,3,5]]},"container-title":["Pakistan Journal of Medical Sciences"],"original-title":[],"link":[{"URL":"https:\/\/pjms.org.pk\/index.php\/pjms\/article\/download\/13028\/3268","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/pjms.org.pk\/index.php\/pjms\/article\/download\/13028\/3268","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T14:39:55Z","timestamp":1778337595000},"score":1,"resource":{"primary":{"URL":"https:\/\/pjms.org.pk\/index.php\/pjms\/article\/view\/13028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,5]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,5]]}},"URL":"https:\/\/doi.org\/10.12669\/pjms.42.3.13028","relation":{},"ISSN":["1681-715X","1682-024X"],"issn-type":[{"value":"1681-715X","type":"electronic"},{"value":"1682-024X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3,5]]}}}