{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T05:28:23Z","timestamp":1786512503843,"version":"build-2736575974"},"reference-count":99,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"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>Transcutaneous auricular vagus nerve stimulation (taVNS) is a promising noninvasive intervention for mild cognitive impairment (MCI), but its clinical efficacy and network-level mechanisms remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, randomized, sham-controlled, parallel-group trial, 60 patients with MCI were assigned 1:1 to 12-week taVNS or sham taVNS. The primary outcome was the between-group difference in change from baseline to week 12 on the Montreal Cognitive Assessment-Basic (MoCA-B). Secondary outcomes included AVLT-H, STT-A\/B, AFT, BNT, HAMD-17, and HAMA scores. Twenty-eight healthy controls underwent baseline rs-fMRI as a non-randomized reference cohort. Functional connectivity (FC) identified MCI-related abnormal regions, which together with theory-driven regions served as seeds for Granger causality analysis (GCA) to characterize intervention-related effective connectivity changes. Imaging-behavior associations were examined using Pearson correlations. The final per-protocol analysis included 52 randomized patients with complete clinical and imaging data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After 12\u202fweeks, the taVNS group showed significant within-group improvements in global cognition and multiple secondary outcomes, whereas the sham group did not. The between-group difference in MoCA-B change was significant (mean difference\u202f=\u202f2.91, 95% CI: 0.79 to 5.03, Cohen\u2019s d\u202f=\u202f0.59), indicating a moderate-to-large effect. Baseline FC abnormalities in MCI mainly involved the insula, medial frontal cortex, precuneus, temporal cortex, thalamus, cingulate cortex, and parieto-occipital regions. Following taVNS, effective connectivity was selectively reconfigured within a distributed network centered on the insula, anterior cingulate cortex, temporal cortex, and precuneus. Changes in directed connectivity correlated with changes in MoCA-B, AFT, and HAMA scores. No serious adverse events occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.chictr.org.cn\/showproj.html?proj=131823<\/jats:ext-link>\n                      , identifier (ChiCTR2100049940).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1891440","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T04:44:32Z","timestamp":1786509872000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rs-fMRI reveals that taVNS improves cognitive and emotional function in mild cognitive impairment by reconfiguration of \u201csensory relay-salience-default\u201d cross-network effective connectivity: a randomized, double-blind, sham-controlled trial"],"prefix":"10.3389","volume":"17","author":[{"given":"Tianjiao","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Radiology, Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlei","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiudong","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyv","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiazheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuncheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Acupuncture, Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Asset Management Section Medical Engineering, Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiliang","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Guang\u2019anmen Hospital, China Academy of Chinese Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1212\/WNL.0000000000004826","article-title":"Practice guideline update summary: mild cognitive impairment [RETIRED]: report of the guideline development, dissemination, and implementation Subcommittee of the American Academy of 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