{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T21:23:43Z","timestamp":1789507423492,"version":"build-2803163510"},"reference-count":50,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Current Research Funds 2024, Ministry of Health, Italy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Touch, particularly affective touch mediated by C-tactile fibers, plays a key role in emotional regulation and therapeutic interventions. However, tactile stimulation is underutilized in sensory stimulation (SS) protocols for brain injury patients, despite its potential to enhance consciousness and promote recovery through neural and autonomic regulation. Tools like the Neurowave enable advanced multisensory stimulation, including audio-visual and emotional inputs, but lack tactile components. Integrating gentle touch stimulation with such systems could further enhance neuroplasticity, improve heart rate regulation, and support recovery in patients with disorders of consciousness. In this study, twenty patients affected by minimally conscious state (MCS) were divided into two groups: an experimental group (EG n.10) and a control group (CG n.10). Both groups underwent standard neurorehabilitation, including conventional physiotherapy and speech therapy. The key difference was in the type of sensory stimulation. The EG received advanced sensory stimulation with the Neurowave system (which provides audio-visual and emotional sensory stimulation) in addition to gentle touch stimulation. The CG received conventional sensory stimulation without the Neurowave and neutral gentle touch stimulation. Each patient was evaluated by a multidisciplinary rehabilitation team, using clinical scales such as coma recovery scale\u2014revised (CSR-R), level of cognitive functioning (LCF), before (T0) and after (T1) treatment. Additionally, heart rate (HR) and neurophysiological outcomes (P300) were also recorded for both groups (EG and CG). The MANOVA model revealed a significant interaction effect between group and phase on P300 latency (F (1, 18) = 10.23, p &lt; 0.001, \u03b72 = 0.09), indicating that the intervention involving gentle touch stimulation significantly influenced the P300 latency in the EG. The findings of this study contribute to our understanding of the therapeutic potential of emotional multisensory stimulation, which also includes gentle touch stimulation, in MCS rehabilitation. By demonstrating significant effects on both neurophysiological and functional measures, our results support the integration of tactile interventions into comprehensive neurorehabilitation programs.<\/jats:p>","DOI":"10.3390\/life15020280","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T11:01:08Z","timestamp":1739271668000},"page":"280","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of Gentle Touch Stimulation Combined with Advanced Sensory Stimulation in Patients in a Minimally Conscious State: A Quasi-Randomized Clinical Trial"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3284-9741","authenticated-orcid":false,"given":"Mirjam","family":"Bonanno","sequence":"first","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, Cda Casazza, SS 113, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Gangemi","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, Cda Casazza, SS 113, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7065-1528","authenticated-orcid":false,"given":"Rosa Angela","family":"Fabio","sequence":"additional","affiliation":[{"name":"Department of Cognitive Science, University of Messina, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6034-0638","authenticated-orcid":false,"given":"Marco","family":"Tramontano","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, 40138 Bologna, Italy"},{"name":"Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0757-2389","authenticated-orcid":false,"given":"Maria Grazia","family":"Maggio","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, Cda Casazza, SS 113, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1348-9442","authenticated-orcid":false,"given":"Federica","family":"Impellizzeri","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, Cda Casazza, SS 113, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Manuli","sequence":"additional","affiliation":[{"name":"A.O.U. Policlinico \u201cG. Martino\u201d, Via Consolare Valeria, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Tripoli","sequence":"additional","affiliation":[{"name":"A.O. Papardo, 98158 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Quartarone","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, Cda Casazza, SS 113, 98124 Messina, Italy"},{"name":"Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98122 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9503-4366","authenticated-orcid":false,"given":"Rosaria","family":"De Luca","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, Cda Casazza, SS 113, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8566-3166","authenticated-orcid":false,"given":"Rocco Salvatore","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, Cda Casazza, SS 113, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.neuron.2014.05.001","article-title":"Discriminative and affective touch: Sensing and feeling","volume":"82","author":"McGlone","year":"2014","journal-title":"Neuron"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.cobeha.2021.08.012","article-title":"C-tactile (CT) afferents: Evidence of their function from microneurography studies in humans","volume":"43","author":"Ackerley","year":"2022","journal-title":"Curr. 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