{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T10:14:52Z","timestamp":1769768092300,"version":"3.49.0"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"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. Nutr."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>This paper presents a preliminary study on whether repetitive transcranial magnetic stimulation (rTMS) can modulate the nutritional status of persistent vegetative state (PVS) patients (the primary endpoint) by regulating the intestinal flora and the metabolites, with the correlation between them also investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy-six patients with PVS were selected and divided into the observation group (<jats:italic>n<\/jats:italic>\u2009=\u200938) and the control group (<jats:italic>n<\/jats:italic>\u2009=\u200938) by random numerical grouping. All subjects\u2019 stool samples were examined for metabolites and analyzed regarding the short-chain fatty acids (SCFAs) content. All subjects\u2019 serum albumin, prealbumin, and hemoglobin levels were measured before and after the treatment. Nutrition risk screening 2002 was performed on all the subjects before and after the treatment and on the 30th and 90th days of the follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>(1) Intestinal flora structure: the Chao index, Ace index, and Shannon index of the observation group and the control group were significantly higher (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05), while the Simpson index was significantly lower (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05) following the treatment. (2) Metabolites of the intestinal flora: the observation group had significantly higher levels of acetic acid, butyric acid, and valeric acid (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05), as well as lower levels of propionic acid (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05) following the treatment. (3) Nutritional status (the primary endpoint): following the treatment, the above serum nutritional indices were significantly higher in both groups (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05), while the indices of the observation group were significantly higher than those of the control group (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The rTMS method may improve the nutritional status of patients with PVS by regulating the structure of the intestinal flora and affecting the level of SCFAs through the microbiota\u2013gut\u2013brain axis. The possible mechanism involves how high-frequency rTMS can cause increased excitation in the frontal lobe of the right side of the brain, thus regulating the 5-hydroxytryptamine and norepinephrine levels.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2023.924260","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T06:07:37Z","timestamp":1679551657000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of high-frequency repetitive transcranial magnetic stimulation on the nutritional status of patients in a persistent vegetative state: A pilot study"],"prefix":"10.3389","volume":"10","author":[{"given":"Xuan-Wei","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na-Na","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Pang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiong","family":"Wen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke-Xue","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan-Ning","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia-Min","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Long","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai-Bo","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/S0140-6736(97)06447-7","article-title":"Persistent vegetative state","volume":"350","author":"Zeman","year":"1997","journal-title":"Lancet"},{"key":"ref2","first-page":"49","article-title":"Provision of renal care for patients with end stage kidney disease in persistent vegetative state, in United Arab Emirates: a national survey of renal physicians","volume":"13","author":"Ebrahim","year":"2018","journal-title":"Libyan J Med"},{"key":"ref3","article-title":"Internet of things (IoT) and cloud computing based persistent vegetative state patient monitoring system: a remote assessment and management","author":"Bharat","year":"2019"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1177\/0953946818808140","article-title":"Still human: a Thomistic analysis of \u2018persistent vegetative state\u2019","volume":"32","author":"Clem","year":"2019","journal-title":"Soc Stud Christ Ethic"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1590\/0004-282X20160088","article-title":"Prevalence and predictors of post stroke depression among elderly stroke survivors","volume":"74","author":"Dos","year":"2016","journal-title":"Arq Neuropsiquiatr"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"105","DOI":"10.15912\/j.cnki.gocm.2014.31.075","article-title":"To analyze the effect of different enteral nutrition methods in patients with persistent vegetative state during perioperative period","volume":"12","author":"Liang","year":"2014","journal-title":"Guide China Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/978-3-319-39546-3_4","article-title":"Recovery from chronic dseases ofconsciousness diseases of consciousness.: state of the art in neuromodulation for persistent vegetative state and minimally conscious state","volume":"124","author":"Mattogno","year":"2017","journal-title":"Acta Neurochir Suppl"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1007\/s40263-016-0370-3","article-title":"May the force be with you: the light and dark sides of the microbiota\u2013gut\u2013brain Axis in neuropsychiatry","volume":"30","author":"Sherwin","year":"2016","journal-title":"CNS Drugs"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1017\/S0029665114001700","article-title":"Gut microbiota and energy balance: role in obesity","volume":"74","author":"Blaut","year":"2015","journal-title":"Proc Nutr Soc"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.bbrc.2004.12.009","article-title":"Modulation of monoamine transporter expression and function by repetitive transcranial magnetic stimulation","volume":"327","author":"Ikeda","year":"2005","journal-title":"Biochem Biophys Res Commun"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1486","DOI":"10.1053\/j.gastro.2020.10.066","article-title":"The microbiota-gut-brain Axis: from motility to mood","volume":"160","author":"Margolis","year":"2021","journal-title":"Gastroenterology"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/s0261-5614(02)00214-5","article-title":"Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials","volume":"22","author":"Kondrup","year":"2003","journal-title":"Clin Nutr"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1097\/PSY.0000000000000495","article-title":"Gut microbiota and the gut-brain axis: new insights in the pathophysi-ology of metabolic syndrome","volume":"79","author":"De Clercq","year":"2017","journal-title":"Psychosom Med"},{"key":"ref14","first-page":"123","article-title":"Comparing the adequacy of the MNA-SF, NRS-2002 and MUST nutritional tools in assessing malnutrition in hip fracture operated elderly patients","volume":"19","author":"Tamar","year":"2016","journal-title":"Clin Nutr"},{"key":"ref15","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4614-7836-2_145","volume-title":"Bioethical and Medico-legal Implications of Withdrawing Artificial Nutrition and Hydration from Adults in Critical Care","author":"Moreschi","year":"2015"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1016\/j.clnu.2017.01.017","article-title":"Comparing the adequacy of the MNA-SF, NRS-2002 and MUST nutritional tools in assessing malnutrition in hip fracture operated elderly patients","volume":"36","author":"Ozsurekci","year":"2017","journal-title":"Clin Nutr"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"5408","DOI":"10.26355\/eurrev_201712_13928","article-title":"Research on the nutrition and cognition of high-risk stroke groups in community and the relevant factors","volume":"21","author":"Zhao","year":"2017","journal-title":"Eur Rev Med Pharmacol Sci"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2023.924260\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T06:07:44Z","timestamp":1679551664000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2023.924260\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,23]]},"references-count":17,"alternative-id":["10.3389\/fnut.2023.924260"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2023.924260","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,23]]},"article-number":"924260"}}