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CASE REPORT article

Front. Neurosci.
Sec. Neural Technology
Volume 19 - 2025 | doi: 10.3389/fnins.2025.1519939

Monitoring Consciousness with fNIRS in a Patient with Prolonged Reduced Consciousness Following Hemorrhagic Stroke Undergoing Adjunct taVNS Therapy

Provisionally accepted
Fei Gao Fei Gao 1Likai Wang Likai Wang 2,3,4Zhan Wang Zhan Wang 1Yaru Tian Yaru Tian 1JingYi Wu JingYi Wu 1Mengchun Wang Mengchun Wang 1Wang Litong Wang Litong 1*
  • 1 Department of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, Liaoning Province, China
  • 2 Department of Rehabilitation Medicine, Qilu Hospital of Shandong University, Ji'nan, Shandong Province, China
  • 3 University of Health and Rehabilitation Sciences, Qingdao, China
  • 4 Research Center for Basic Medical Sciences, Jinan, China

The final, formatted version of the article will be published soon.

    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 frontoparietal network connectivity and arousal in a 77-year-old female patient with unresponsive wakefulness syndrome (UWS). The patient received bilateral taVNS for one hour daily over three 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 frontalparietal 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.

    Keywords: disorders of consciousness, Transcutaneous auricular vagal nerve stimulation, Lateral frontoparietal network, functional connectivity, functional near-infrared spectroscopy, Stroke

    Received: 30 Oct 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Gao, Wang, Wang, Tian, Wu, Wang and Litong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Wang Litong, Department of Rehabilitation Medicine, The Second Hospital of Dalian Medical University, Dalian, Liaoning Province, China

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