Awakening effect of taVNS combined with high-frequency rTMS on patients with coma after brain injury

CHEN Tianling; MO Yanling; CHEN Hanbo; FAN Yuling; LIU Churong

doi:10.3969/j.issn.1002-266X.2025.11.004

Abstract：Objective To observe the awakening effect of transcutaneous auricular vagus nerve stimulation(taVNS)combined with high-frequency repetitive transcranial magnetic stimulation(rTMS)on patients with coma after brain inju-ry.Methods Forty-eight patients with coma after brain injury were selected and randomly divided into the observation group and control group using a random number table,with 24 patients in each group.Both groups received conventional awakening therapy.The control group received high-frequency rTMS treatment,while the observation group received taVNS combined with high-frequency rTMS treatment.Both groups underwent continuous treatment for 4 weeks.The level of consciousness was assessed using the Glasgow coma scale(GCS)score before and after treatment,the degree of con-sciousness impairment was assessed using the Coma Recovery Scale-Revised(CRS-R)score,the vegetative state was as-sessed using the persistent vegetative state(PVS)score,and the depth of coma was assessed using electroencephalography(EEG)grading.Results After treatment,the GCS,CRS-R,and PVS scores of both groups were significantly higher than those before treatment(all P<0.05).Furthermore,the observation group had significantly higher GCS,CRS-R,and PVS scores than the control group(all P<0.05).After treatment,the EEG grading of both groups improved significantly in comparison with that before treatment(P<0.05),and the improvement in the observation group was superior to that in the control group(P<0.05).Conclusion Compared with high-frequency rTMS alone,taVNS combined with high-fre-quency rTMS can more effectively enhance the level of consciousness,improve consciousness impairment and vegetative state,and reduce the depth of coma in patients with coma after brain injury.