{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:31:36Z","timestamp":1788355896708,"version":"build-2803163510"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vocal cord paralysis combined with dysphagia following brain injury is a severe complication associated with aspiration pneumonia, asphyxiation, and malnutrition, for which traditional rehabilitation yields limited efficacy. Non-invasive vagus nerve magnetic stimulation (nVNMS) is an emerging neuromodulation technology; however, systematic clinical studies addressing this specific dual-deficit population remain lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective case series study was conducted at Guangdong Sanjiu Brain Hospital (June 2024\u2013May 2025), consecutively enrolling 38 inpatients with brain injury\u2013related vocal cord paralysis and dysphagia. All patients received a 21-day combined protocol comprising left mastoid nVNMS (5\u202fHz, 20\u202fmin\/session, once daily), low-frequency pulse electrical stimulation for swallowing (20\u202fmin\/session, once daily), and manual swallowing training (30\u202fmin\/session, once daily). Outcomes were assessed at baseline and post-treatment using the Standardized Swallowing Assessment (SSA), Food Intake Level Scale (FILS), Penetration-Aspiration Scale (PAS), and laryngoscopy, with adverse events recorded throughout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After treatment, SSA scores decreased from 36.92\u202f\u00b1\u202f4.71 to 32.63\u202f\u00b1\u202f7.10 (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001, Cohen\u2019s d\u202f=\u202f0.72, large effect), FILS scores increased from 2 (2\u20132) to 3 (2\u20133) (p\u202f&amp;lt;\u202f0.001, representing transition from total tube-feeding dependence to eligibility for supervised minimal oral intake), and PAS scores decreased from 6 (4\u20136) to 4 (4\u20134) (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001,\n                      <jats:italic>r<\/jats:italic>\n                      =\u202f0.64, large effect, representing restoration of functional airway protective response). The incidence of vocal cord paralysis decreased from 100 to 63.2% (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001), tracheostomy cannula retention rate decreased from 55.3 to 26.3% (\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.001), with 11 patients achieving decannulation and thereby regaining airway independence; nasogastric tube retention rate decreased from 100 to 68.4% (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001), with 12 patients recovering oral feeding ability. No serious adverse events occurred during treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>As a preliminary case series without a control group, nVNMS combined with rehabilitation training may improve swallowing safety and vocal cord function and reduce airway management requirements in patients following brain injury, with favorable short-term safety. Owing to the lack of a control group, the specific effect of nVNMS and the impact of natural recovery cannot be differentiated; thus, multicenter randomized controlled trials are required for further validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1807577","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:26:28Z","timestamp":1782908788000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Non-invasive vagus nerve magnetic stimulation combined with rehabilitation training for vocal cord paralysis and dysphagia following brain injury: a prospective case series study"],"prefix":"10.3389","volume":"17","author":[{"given":"Shujuan","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanbo","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caixia","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huimin","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weifeng","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lirong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1016\/j.jvoice.2017.02.003","article-title":"Relationship between laryngeal 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