{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:45:02Z","timestamp":1793371502283,"version":"4.5.0"},"reference-count":65,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T00:00:00Z","timestamp":1702512000000},"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. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a potentially effective neuromodulation technique for addressing neurological disorders, including disorders of consciousness. Expanding upon our prior clinical study, which demonstrated the superior effectiveness of a 4-week taVNS treatment in patients with minimally conscious state (MCS) compared to those in a vegetative state\/unresponsive wakefulness state, the aim of this investigation was to evaluate the safety and therapeutic efficacy of taVNS in individuals with MCS through a sham-controlled randomized double-blind clinical trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cohort of 50 adult patients (male\u2009=\u200933, female\u2009=\u200917) diagnosed with a MCS were randomly assigned to either the active taVNS (\n                      <jats:italic>N<\/jats:italic>\n                      =\u200925) or sham taVNS (\n                      <jats:italic>N<\/jats:italic>\n                      =\u200925) groups. The treatment period lasted for 4 weeks, followed by an 8-week follow-up period. The Coma Recovery Scale-Revised (CRS-R) and Glasgow Coma Scale (GCS) were administered at baseline and weekly during the initial 4 weeks. Additionally, the Disability Rating Scale (DRS) was used to assess the patients\u2019 functional abilities via telephone at week 12. Furthermore, various neurophysiological measures, including electroencephalogram (EEG), upper-limb somatosensory evoked potentials (USEP), brainstem auditory evoked potentials (BAEP), and P300 event-related potentials (P300), were employed to monitor changes in brain activity and neural conduction pathways.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The scores for the active taVNS group in the CRS-R and GCS showed greater improvement over time compared to the sham taVNS group (CRS-R: 1-week, Z\u2009=\u2009\u22121.248,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.212; 2-week, Z\u2009=\u2009\u22121.090,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.276; 3-week, Z\u2009=\u2009\u22122.017,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.044; 4-week, Z\u2009=\u2009\u22122.267,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.023. GCS: 1-week, Z\u2009=\u2009\u22121.325,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.185; 2-week, Z\u2009=\u2009\u22121.245,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.213; 3-week, Z\u2009=\u2009\u22121.848,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.065; 4-week, Z\u2009=\u2009\u22121.990,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.047). Additionally, the EEG, USEP, BAEP, and P300 also demonstrated significant improvement in the active taVNS group compared to the sham taVNS group at week 4 (EEG, Z\u2009=\u2009\u22122.086,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.037; USEP, Z\u2009=\u2009\u22122.014,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.044; BAEP, Z\u2009=\u2009\u22122.298,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.022; P300 amplitude, Z\u2009=\u2009\u22121.974,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.049; P300 latency, t\u2009=\u20092.275,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.027). Subgroup analysis revealed that patients with MCS derived greater benefits from receiving taVNS treatment earlier (CRS-R, Disease duration \u2264 1-month, mean difference\u2009=\u20098.50, 95% CI\u2009=\u2009[2.22, 14.78],\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.027; GCS, Disease duration \u2264 1-month, mean difference\u2009=\u20093.58, 95% CI\u2009=\u2009[0.14, 7.03],\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.044). By week 12, the active taVNS group exhibited lower Disability Rating Scale (DRS) scores compared to the sham taVNS group (Z\u2009=\u2009\u22122.105,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.035), indicating a more favorable prognosis for MCS patients who underwent taVNS. Furthermore, no significant adverse events related to taVNS were observed during treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings of this study suggest that taVNS may serve as a potentially effective and safe intervention for facilitating the restoration of consciousness in individuals diagnosed with MCS. This therapeutic approach appears to enhance cerebral functioning and optimize neural conduction pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>http:\/\/www.chictr.org.cn<\/jats:ext-link>\n                      , Identifier ChiCTR2200066629.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnins.2023.1323079","type":"journal-article","created":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T09:04:19Z","timestamp":1702544659000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":25,"title":["The efficacy and safety of transcutaneous auricular vagus nerve stimulation for patients with minimally conscious state: a sham-controlled randomized double-blind clinical trial"],"prefix":"10.3389","volume":"17","author":[{"given":"Yifan","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yejing","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junwei","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunliang","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyang","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"790943","DOI":"10.3389\/fnins.2021.790943","article-title":"How is the norepinephrine system involved in the antiepileptic effects of Vagus nerve stimulation?","volume":"15","author":"Berger","year":"2021","journal-title":"Front. Neurosci."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1016\/j.apmr.2015.08.422","article-title":"Sensitivity and specificity of the coma recovery scale--revised Total score in detection of conscious awareness","volume":"97","author":"Bodien","year":"2016","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e14456","DOI":"10.1111\/nmo.14456","article-title":"Anti-inflammatory effects of vagal nerve stimulation with a special attention to intestinal barrier dysfunction","volume":"34","author":"Bonaz","year":"2022","journal-title":"Neurogastroenterol. Motil."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"933","DOI":"10.3389\/fneur.2020.00933","article-title":"Transcutaneous auricular vagal nerve stimulation and disorders of consciousness: a hypothesis for mechanisms of action","volume":"11","author":"Briand","year":"2020","journal-title":"Front. Neurol."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1402","DOI":"10.3390\/ijerph20021402","article-title":"Transcutaneous auricular Vagus nerve stimulation facilitates cortical arousal and alertness","volume":"20","author":"Chen","year":"2023","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"4140","DOI":"10.2174\/13816128113196660656","article-title":"Disorders of consciousness and pharmaceuticals that act on oxygen based amino acid and monoamine neurotransmitter pathways of the brain","volume":"20","author":"Clauss","year":"2014","journal-title":"Curr. Pharm. Des."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"E27","DOI":"10.1097\/HTR.0000000000000264","article-title":"P300 event-related potentials differentiate better performing individuals with traumatic brain injury: a preliminary study of semantic processing","volume":"32","author":"Davis","year":"2017","journal-title":"J. Head Trauma Rehabil."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1481","DOI":"10.1089\/neu.2022.0153","article-title":"Non-invasive Vagus nerve stimulation improves brain lesion volume and neurobehavioral outcomes in a rat model of traumatic brain injury","volume":"40","author":"Divani","year":"2023","journal-title":"J. Neurotrauma"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"244","DOI":"10.4103\/1673-5374.226395","article-title":"Wake-promoting effects of vagus nerve stimulation after traumatic brain injury: upregulation of orexin-a and orexin receptor type 1 expression in the prefrontal cortex","volume":"13","author":"Dong","year":"2018","journal-title":"Neural Regen. Res."},{"key":"ref10","first-page":"4742","article-title":"Vagus nerve stimulation causes wake-promotion by affecting neurotransmitters via orexins pathway in traumatic brain injury induced comatose rats","volume":"11","author":"Dong","year":"2018","journal-title":"Int. J. Clin. Exp. Med."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1257378","DOI":"10.3389\/fnins.2023.1257378","article-title":"Stimulation of vagus nerve for patients with disorders of consciousness: a systematic review","volume":"17","author":"Dong","year":"2023","journal-title":"Front. Neurosci."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.pmr.2016.12.003","article-title":"Disorders of consciousness","volume":"28","author":"Eapen","year":"2017","journal-title":"Phys. Med. Rehabil. Clin. N. Am."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1097\/WNP.0000000000000576","article-title":"Transcutaneous Auricular Vagus Nerve Stimulation","volume":"36","author":"Ellrich","year":"2019","journal-title":"J. Clin. Neurophysiol."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1177\/02692155221089455","article-title":"Repetitive transcranial magnetic stimulation improves consciousness in some patients with disorders of consciousness","volume":"36","author":"Fan","year":"2022","journal-title":"Clin. Rehabil."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"8367","DOI":"10.1523\/JNEUROSCI.1720-20.2020","article-title":"Enhanced retrieval of taste associative memory by Chemogenetic activation of locus coeruleus norepinephrine neurons","volume":"40","author":"Fukabori","year":"2020","journal-title":"J. Neurosci."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1212\/wnl.58.3.349","article-title":"The minimally conscious state: definition and diagnostic criteria","volume":"58","author":"Giacino","year":"2002","journal-title":"Neurology"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1016\/j.apmr.2004.02.033","article-title":"The JFK coma recovery scale-revised: measurement characteristics and diagnostic utility","volume":"85","author":"Giacino","year":"2004","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1212\/WNL.0000000000005926","article-title":"Practice guideline update recommendations summary: disorders of consciousness: report of the guideline development, dissemination, and implementation Subcommittee of the American Academy of neurology; the American congress of rehabilitation medicine; and the National Institute on Disability, Independent Living, and Rehabilitation Research","volume":"91","author":"Giacino","year":"2018","journal-title":"Neurology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1089\/neu.2019.6429","article-title":"Behavioral recovery and early decision making in patients with prolonged disturbance in consciousness after traumatic brain injury","volume":"37","author":"Giacino","year":"2020","journal-title":"J. Neurotrauma"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1056\/NEJMoa1102609","article-title":"Placebo-controlled trial of amantadine for severe traumatic brain injury","volume":"366","author":"Giacino","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"247","DOI":"10.3390\/biomedicines10020247","article-title":"Different transcutaneous auricular Vagus nerve stimulation parameters modulate the anti-inflammatory effects on lipopolysaccharide-induced acute inflammation in mice","volume":"10","author":"Go","year":"2022","journal-title":"Biomedicine"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"150","DOI":"10.3171\/jns.1977.47.2.0150","article-title":"Evaluation of brain function in severe human head trauma with multimodality evoked potentials. Part 1: evoked brain-injury potentials, methods, and analysis","volume":"47","author":"Greenberg","year":"1977","journal-title":"J. Neurosurg."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1111\/ner.13148","article-title":"Transcutaneous Vagus nerve stimulation in patients with severe traumatic brain injury: a feasibility trial","volume":"23","author":"Hakon","year":"2020","journal-title":"Neuromodulation"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"15","DOI":"10.32641\/andespediatr.v92i1.2502","article-title":"Prolonged disorder of consciousness in children, an update","volume":"92","author":"Hernandez","year":"2021","journal-title":"Andes Pediatr"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1016\/0013-4694(65)90075-1","article-title":"Electroencephalographic changes in acute cerebral anoxia from cardiac or respiratory arrest","volume":"18","author":"Hockaday","year":"1965","journal-title":"Electroencephalogr. Clin. Neurophysiol."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"112975","DOI":"10.1016\/j.expneurol.2019.112975","article-title":"Norepinephrine and serotonin are required for vagus nerve stimulation directed cortical plasticity","volume":"320","author":"Hulsey","year":"2019","journal-title":"Exp. Neurol."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1016\/j.neuropharm.2011.08.047","article-title":"Arousal effects of orexin a on acute alcohol intoxication-induced coma in rats","volume":"62","author":"Jia","year":"2012","journal-title":"Neuropharmacology"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1111\/ene.14151","article-title":"European academy of neurology guideline on the diagnosis of coma and other disorders of consciousness","volume":"27","author":"Kondziella","year":"2020","journal-title":"Eur. J. Neurol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1001\/jamaneurol.2021.0084","article-title":"Recovery of consciousness and functional outcome in moderate and severe traumatic brain injury","volume":"78","author":"Kowalski","year":"2021","journal-title":"JAMA Neurol."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1584","DOI":"10.1089\/neu.2014.3768","article-title":"Right median nerve electrical stimulation for acute traumatic coma patients","volume":"32","author":"Lei","year":"2015","journal-title":"J. Neurotrauma"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1186\/s12883-016-0666-4","article-title":"Early consciousness disorder in acute ischemic stroke: incidence, risk factors and outcome","volume":"16","author":"Li","year":"2016","journal-title":"BMC Neurol."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s12974-020-01732-5","article-title":"Neural networks and the anti-inflammatory effect of transcutaneous auricular vagus nerve stimulation in depression","volume":"17","author":"Liu","year":"2020","journal-title":"J. Neuroinflammation"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1016\/j.brs.2023.05.002","article-title":"Trigeminal nerve stimulation for prolonged disorders of consciousness: a randomized double-blind sham-controlled study","volume":"16","author":"Ma","year":"2023","journal-title":"Brain Stimul."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1001\/jamaneurol.2021.2043","article-title":"Functional outcomes over the first year after moderate to severe traumatic brain injury in the prospective, Longitudinal TRACK-TBI Study","volume":"78","author":"McCrea","year":"2021","journal-title":"JAMA Neurol."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"l1296","DOI":"10.1136\/bmj.l1296","article-title":"Glasgow coma scale explained","volume":"365","author":"Mehta","year":"2019","journal-title":"BMJ"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"c3765","DOI":"10.1136\/bmj.c3765","article-title":"The vegetative state","volume":"341","author":"Monti","year":"2010","journal-title":"BMJ"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/j.brs.2019.12.005","article-title":"Feasibility, safety and efficacy of transauricular vagus nerve stimulation in a cohort of patients with disorders of consciousness","volume":"13","author":"Noe","year":"2020","journal-title":"Brain Stimul."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"2104880","DOI":"10.1155\/2022\/2104880","article-title":"Predictive power of cognitive biomarkers in neurodegenerative disease drug development: utility of the P300 event-related potential","volume":"2022","author":"Olichney","year":"2022","journal-title":"Neural Plast."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"834507","DOI":"10.3389\/fnins.2022.834507","article-title":"Non-invasive Vagus nerve stimulation in treatment of disorders of consciousness\u2014longitudinal case study","volume":"16","author":"Osinska","year":"2022","journal-title":"Front. Neurosci."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.heares.2017.12.003","article-title":"Transauricular vagus nerve stimulation at auricular acupoints Kindey (CO10), Yidan (CO11), liver (CO12) and Shenmen (TF4) can induce auditory and limbic cortices activation measured by fMRI","volume":"359","author":"Peng","year":"2018","journal-title":"Hear. Res."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1080\/09602011.2022.2042330","article-title":"Being a caregiver of a relative with a prolonged disorder of consciousness living at home: a scoping review","volume":"33","author":"Proia-Lelouey","year":"2023","journal-title":"Neuropsychol. Rehabil."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1037\/neu0000735","article-title":"The effects of transcutaneous auricular vagal nerve stimulation on cognition in healthy individuals: a meta-analysis","volume":"35","author":"Ridgewell","year":"2021","journal-title":"Neuropsychology"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"2019","DOI":"10.1007\/s00213-020-05515-x","article-title":"Dopaminergic and noradrenergic manipulation of anticipatory reward and probability event-related potentials","volume":"237","author":"Schutte","year":"2020","journal-title":"Psychopharmacology (Berl)"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1055\/s-0038-1667384","article-title":"Disorders of consciousness: ethical issues of diagnosis, treatment, and prognostication","volume":"38","author":"Septien","year":"2018","journal-title":"Semin. Neurol."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1016\/s0887-8994(00)00194-6","article-title":"Life expectancy of children in vegetative and minimally conscious states","volume":"23","author":"Strauss","year":"2000","journal-title":"Pediatr. Neurol."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1177\/1545968320948065","article-title":"Vagus nerve stimulation attenuates early traumatic brain injury by regulating the NF-kappaB\/NLRP3 Signaling pathway","volume":"34","author":"Tang","year":"2020","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"4208","DOI":"10.2174\/1381612825666191029101830","article-title":"Neurophysiology and treatment of disorders of consciousness induced by traumatic brain injury: orexin Signaling as a potential therapeutic target","volume":"25","author":"Tang","year":"2019","journal-title":"Curr. Pharm. Des."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1007\/s00415-019-09628-y","article-title":"Minimally conscious state \"plus\": diagnostic criteria and relation to functional recovery","volume":"267","author":"Thibaut","year":"2020","journal-title":"J. Neurol."},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1212\/WNL.0000000000000260","article-title":"tDCS in patients with disorders of consciousness: sham-controlled randomized double-blind study","volume":"82","author":"Thibaut","year":"2014","journal-title":"Neurology"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1016\/S1474-4422(19)30031-6","article-title":"Therapeutic interventions in patients with prolonged disorders of consciousness","volume":"18","author":"Thibaut","year":"2019","journal-title":"Lancet Neurol."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"102840","DOI":"10.1016\/j.autneu.2021.102840","article-title":"Transcutaneous vagus nerve stimulation in the treatment of drug-resistant epilepsy","volume":"235","author":"von Wrede","year":"2021","journal-title":"Auton. Neurosci."},{"key":"ref54","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1007\/s12264-020-00619-y","article-title":"Transcutaneous auricular Vagus nerve stimulation: from concept to application","volume":"37","author":"Wang","year":"","journal-title":"Neurosci. Bull."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.neubiorev.2021.04.018","article-title":"Vagus nerve stimulation in brain diseases: therapeutic applications and biological mechanisms","volume":"127","author":"Wang","year":"","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref56","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1186\/s12974-021-02341-6","article-title":"Mechanisms underlying antidepressant effect of transcutaneous auricular vagus nerve stimulation on CUMS model rats based on hippocampal alpha7nAchR\/NF-kappaB signal pathway","volume":"18","author":"Wang","year":"2021","journal-title":"J. Neuroinflammation"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1007\/s00134-023-07072-1","article-title":"Acute traumatic coma awakening by right median nerve electrical stimulation: a randomised controlled trial","volume":"49","author":"Wu","year":"2023","journal-title":"Intensive Care Med."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1097\/CM9.0000000000001377","article-title":"Neuromodulatory therapies for patients with prolonged disorders of consciousness","volume":"134","author":"Wu","year":"2021","journal-title":"Chin Med J (Engl)"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"7089543","DOI":"10.1155\/2019\/7089543","article-title":"Efficiency of repetitive transcranial direct current stimulation of the dorsolateral prefrontal cortex in disorders of consciousness: a randomized sham-controlled study","volume":"2019","author":"Wu","year":"2019","journal-title":"Neural Plast."},{"key":"ref60","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1007\/s12264-018-0244-4","article-title":"Current status of Neuromodulatory therapies for disorders of consciousness","volume":"34","author":"Xia","year":"2018","journal-title":"Neurosci. Bull."},{"key":"ref61","doi-asserted-by":"publisher","first-page":"463","DOI":"10.19852\/j.cnki.jtcm.2022.03.012","article-title":"Transcutaneous auricular vague nerve stimulation improved brain connection activity on patients of disorders of consciousness: a pilot study","volume":"42","author":"Yifei","year":"2022","journal-title":"J. Tradit. Chin. Med."},{"key":"ref62","doi-asserted-by":"publisher","first-page":"684791","DOI":"10.3389\/fneur.2021.684791","article-title":"Cerebral hemodynamic correlates of transcutaneous auricular vagal nerve stimulation in consciousness restoration: an open-label pilot study","volume":"12","author":"Yu","year":"2021","journal-title":"Front. Neurol."},{"key":"ref63","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1016\/j.brs.2016.12.004","article-title":"Transcutaneous auricular vagus nerve stimulation in disorders of consciousness monitored by fMRI: the first case report","volume":"10","author":"Yu","year":"2017","journal-title":"Brain Stimul."},{"key":"ref64","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1080\/02699052.2019.1566832","article-title":"Validation of the Chinese version of the coma recovery scale-revised (CRS-R)","volume":"33","author":"Zhang","year":"2019","journal-title":"Brain Inj."},{"key":"ref65","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1007\/s12264-018-0263-1","article-title":"Disorders of consciousness in China","volume":"34","author":"Zhao","year":"2018","journal-title":"Neurosci. Bull."},{"key":"ref66","doi-asserted-by":"publisher","first-page":"627023","DOI":"10.1155\/2012\/627023","article-title":"Transcutaneous auricular vagus nerve stimulation protects endotoxemic rat from lipopolysaccharide-induced inflammation","volume":"2012","author":"Zhao","year":"2012","journal-title":"Evid. Based Complement. Alternat. Med."},{"key":"ref67","doi-asserted-by":"publisher","first-page":"1133893","DOI":"10.3389\/fneur.2023.1133893","article-title":"Transauricular vagus nerve stimulation for patients with disorders of consciousness: a randomized controlled clinical trial","volume":"14","author":"Zhou","year":"2023","journal-title":"Front. 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