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However, the identification of optimal stimulation frequencies remains a subject of ongoing debate. Although previous electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) studies have suggested the therapeutic efficacy of 5- and 70-Hz, respectively, the integrative neurovascular mechanisms and frequency-specific network dynamics underlying these effects remain to be elucidated.\n                    <jats:bold>Objective and Impact Statement:<\/jats:bold>\n                    This study aims to characterize frequency-dependent network reconfiguration in DoC using simultaneous EEG-fNIRS recordings and graph theoretical analysis. By delineating distinct neurophysiological and hemodynamic signatures, our findings establish a mechanistic framework for the optimization of SCS parameters, thereby advancing personalized neuromodulation strategies for the promotion of consciousness recovery.\n                    <jats:bold>Methods:<\/jats:bold>\n                    This prospective trial used simultaneous EEG\u2013fNIRS and graph theory in 16 patients with DoC undergoing multifrequency SCS at 5, 20, 70, and 100 Hz to decode frequency-specific network dynamics. Our integrated EEG\u2013fNIRS analysis revealed 3 principal advances. First, multimodal cortical mapping via a unified anatomical atlas quantified frequency-dependent network reconfiguration, generating graph-theoretical metrics (global and nodal efficiency, characteristic path length, and clustering coefficients) from source-localized EEG (delta\u2013gamma bands) and fNIRS (oxyhemoglobin and deoxygenated) data. Second, we identified frequency-dependent neurophysiological profiles.\n                    <jats:bold>Results:<\/jats:bold>\n                    Five-hertz stimulation produced acute enhancement of theta-band global network efficiency coupled with elevated gamma-band nodal efficiency in the right cingulate motor area, indicating immediate frontolimbic engagement. Conversely, 70-Hz stimulation selectively evoked delayed hemodynamic responses in the visual cortices and increased occipital hemoglobin oxygenation without concomitant EEG alterations, suggesting preferential retinotopic pathway recruitment.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Multimodal EEG\u2013fNIRS analysis elucidates frequency-specific SCS mechanisms, where 5-Hz stimulation optimizes local information integration through theta and gamma modulation, while 70-Hz enhances long-range connectivity, exposing frequency-specific neural plasticity mechanisms.\n                  <\/jats:p>","DOI":"10.34133\/cbsystems.0539","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T12:56:52Z","timestamp":1770123412000},"update-policy":"https:\/\/doi.org\/10.34133\/aaas_crossmark_01","source":"Crossref","is-referenced-by-count":0,"title":["Graph-Theoretical Signature from Neural and Vascular Signals Reveals Spinal Cord Stimulation Frequency-Specific Brain Network in Disorders of Consciousness Patients"],"prefix":"10.34133","volume":"7","author":[{"given":"Nan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, \rCapital Medical University, Beijing 100070, China."},{"name":"Department of Neurosurgery, Peking Union Medical College Hospital, \rChinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoke","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, \rCapital Medical University, Beijing 100070, China."},{"name":"China National Clinical Research Center for Neurological Diseases","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifang","family":"He","sequence":"additional","affiliation":[{"name":"School of Instrumentation Science and Opto-Electronics Engineering, \rBeijing Information Science and Technology University, Beijing 102206, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiuxiang","family":"Song","sequence":"additional","affiliation":[{"name":"School of Advanced Manufacturing, \rNanchang University, Nanchang, Jiangxi 330031, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianqing","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, \rAviation General Hospital, Beijing 100012, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiheng","family":"He","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, \rCapital Medical University, Beijing 100070, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sipeng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, \rCapital Medical University, Beijing 100070, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yitong","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, \rCapital Medical University, Beijing 100070, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juanning","family":"Si","sequence":"additional","affiliation":[{"name":"School of Instrumentation Science and Opto-Electronics Engineering, \rBeijing Information Science and Technology University, Beijing 102206, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, \rCapital Medical University, Beijing 100070, China."},{"name":"China National Clinical Research Center for Neurological Diseases","place":["China"]},{"name":"Brain Computer Interface Transitional Research Center, Beijing Tiantan Hospital, \rCapital Medical University, Beijing 100070, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jizong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, \rCapital Medical University, Beijing 100070, China."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"221","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"issue":"10","key":"e_1_3_4_2_2","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1212\/WNL.0000000000005926","article-title":"Practice guideline update recommendations summary: Disorders of consciousness","volume":"91","author":"Giacino JT","year":"2018","unstructured":"Giacino JT, Katz DI, Schiff ND, Whyte J, Ashman EJ, Ashwal S, Barbano R, Hammond FM, Laureys S, Ling GSF, et al. 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