Case report: Monitoring consciousness with fNIRS in a patient with prolonged reduced consciousness following hemorrhagic stroke undergoing adjunct taVNS therapy
Disorders of consciousness (DoC) resulting from severe brain injury present substantial challenges in rehabilitation due to disruptions in brain network connectivity, particularly within the frontal-parietal network critical for awareness. Transcutaneous auricular vagus nerve stimulation (taVNS) has...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2025.1519939/full |
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| author | Fei Gao Likai Wang Likai Wang Zhan Wang Yaru Tian Jingyi Wu Mengchun Wang Litong Wang |
| author_facet | Fei Gao Likai Wang Likai Wang Zhan Wang Yaru Tian Jingyi Wu Mengchun Wang Litong Wang |
| author_sort | Fei Gao |
| collection | DOAJ |
| description | Disorders of consciousness (DoC) resulting from severe brain injury present substantial challenges in rehabilitation due to disruptions in brain network connectivity, particularly within the frontal-parietal network critical for awareness. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising non-invasive intervention; however, the precise mechanisms through which it influences cortical function in DoC patients remain unclear. This study describes the effects of taVNS on fronto-parietal network connectivity and arousal in a 77-year-old female patient with unresponsive wakefulness syndrome (UWS). The patient received bilateral taVNS for 1 h daily over 3 months, with functional connectivity (FC) in the frontoparietal network assessed using functional near-infrared spectroscopy (fNIRS) and behavioral responsiveness evaluated through the Coma Recovery Scale-Revised (CRS-R). After taVNS intervention, mean FC was enhanced from 0.06 (SD = 0.31) to 0.33 (SD = 0.28) in the frontal-parietal network. The frontal-parietal were subdivided into 12 regions of interest (ROIs) and it was determined that the FC between the left dorsolateral prefrontal cortex (DLPFC) and the left prefrontal ROIs was 0.06 ± 0.41 before the intervention and 0.55 ± 0.24 after the intervention. Behavioral improvements were evidenced by an increase in CRS-R scores from 2 to 14, marking the patient's transition from UWS to minimally conscious state plus (MCS+). Additionally, regions associated with auditory and sensory processing showed increased cortical engagement, supporting the positive impact of taVNS on cortical responsiveness. This suggests its value as a non-invasive adjunctive therapy in the rehabilitation of DoC patients. Further studies are necessary to confirm these effects in a wider patient population and to refine the strategy for clinical application of taVNS. |
| format | Article |
| id | doaj-art-a0a8f29f9e8c492c90ceceffc330e48f |
| institution | Kabale University |
| issn | 1662-453X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neuroscience |
| spelling | doaj-art-a0a8f29f9e8c492c90ceceffc330e48f2025-02-04T06:31:52ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2025-02-011910.3389/fnins.2025.15199391519939Case report: Monitoring consciousness with fNIRS in a patient with prolonged reduced consciousness following hemorrhagic stroke undergoing adjunct taVNS therapyFei Gao0Likai Wang1Likai Wang2Zhan Wang3Yaru Tian4Jingyi Wu5Mengchun Wang6Litong Wang7Department of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, ChinaRehabilitation Center, Qilu Hospital of Shandong University, Jinan, ChinaUniversity of Health and Rehabilitation Sciences, Qingdao, ChinaDepartment of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, ChinaDepartment of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, ChinaDepartment of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, ChinaDepartment of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, ChinaDepartment of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, ChinaDisorders of consciousness (DoC) resulting from severe brain injury present substantial challenges in rehabilitation due to disruptions in brain network connectivity, particularly within the frontal-parietal network critical for awareness. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising non-invasive intervention; however, the precise mechanisms through which it influences cortical function in DoC patients remain unclear. This study describes the effects of taVNS on fronto-parietal network connectivity and arousal in a 77-year-old female patient with unresponsive wakefulness syndrome (UWS). The patient received bilateral taVNS for 1 h daily over 3 months, with functional connectivity (FC) in the frontoparietal network assessed using functional near-infrared spectroscopy (fNIRS) and behavioral responsiveness evaluated through the Coma Recovery Scale-Revised (CRS-R). After taVNS intervention, mean FC was enhanced from 0.06 (SD = 0.31) to 0.33 (SD = 0.28) in the frontal-parietal network. The frontal-parietal were subdivided into 12 regions of interest (ROIs) and it was determined that the FC between the left dorsolateral prefrontal cortex (DLPFC) and the left prefrontal ROIs was 0.06 ± 0.41 before the intervention and 0.55 ± 0.24 after the intervention. Behavioral improvements were evidenced by an increase in CRS-R scores from 2 to 14, marking the patient's transition from UWS to minimally conscious state plus (MCS+). Additionally, regions associated with auditory and sensory processing showed increased cortical engagement, supporting the positive impact of taVNS on cortical responsiveness. This suggests its value as a non-invasive adjunctive therapy in the rehabilitation of DoC patients. Further studies are necessary to confirm these effects in a wider patient population and to refine the strategy for clinical application of taVNS.https://www.frontiersin.org/articles/10.3389/fnins.2025.1519939/fulldisorders of consciousnesstranscutaneous auricular vagal nerve stimulationfunctional connectivityfunctional near-infrared spectroscopystroke |
| spellingShingle | Fei Gao Likai Wang Likai Wang Zhan Wang Yaru Tian Jingyi Wu Mengchun Wang Litong Wang Case report: Monitoring consciousness with fNIRS in a patient with prolonged reduced consciousness following hemorrhagic stroke undergoing adjunct taVNS therapy Frontiers in Neuroscience disorders of consciousness transcutaneous auricular vagal nerve stimulation functional connectivity functional near-infrared spectroscopy stroke |
| title | Case report: Monitoring consciousness with fNIRS in a patient with prolonged reduced consciousness following hemorrhagic stroke undergoing adjunct taVNS therapy |
| title_full | Case report: Monitoring consciousness with fNIRS in a patient with prolonged reduced consciousness following hemorrhagic stroke undergoing adjunct taVNS therapy |
| title_fullStr | Case report: Monitoring consciousness with fNIRS in a patient with prolonged reduced consciousness following hemorrhagic stroke undergoing adjunct taVNS therapy |
| title_full_unstemmed | Case report: Monitoring consciousness with fNIRS in a patient with prolonged reduced consciousness following hemorrhagic stroke undergoing adjunct taVNS therapy |
| title_short | Case report: Monitoring consciousness with fNIRS in a patient with prolonged reduced consciousness following hemorrhagic stroke undergoing adjunct taVNS therapy |
| title_sort | case report monitoring consciousness with fnirs in a patient with prolonged reduced consciousness following hemorrhagic stroke undergoing adjunct tavns therapy |
| topic | disorders of consciousness transcutaneous auricular vagal nerve stimulation functional connectivity functional near-infrared spectroscopy stroke |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2025.1519939/full |
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