Preliminary Study of Vagus Nerve Magnetic Modulation in Patients with Prolonged Disorders of Consciousness

Lingling Wang1– 3*, Qing Wu1 *, Zhenglei Yang,1,2 Yuxuan Yang,2,4 Yaomin Luo,1,2 Yuhong Cao,1,2 Li Wu,1,2 Yulei Xie,1,5 Yinxu Wang1,3 1Department of Rehabilitation Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China; 2Department of Clinical Medicine, North Sichuan Medical College, Nanchong, People’s Republic of China; 3Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 4Nanchong Central Hospital, Nanchong, People’s Republic of China; 5School of Rehabilitation, Capital Medical University, China Rehabilitation Research Center, Beijing city, Beijing province, China (mainland)*These authors contributed equally to this workCorrespondence: Yulei Xie; Yinxu Wang, Email xieyulei123@foxmail.com; 1920688477@qq.comBackground: The number of patients with prolonged disorders of consciousness (pDOC) is increasing. However, its clinical treatment remains challenging. To date, no studies have reported the effect of vagus nerve modulation (VNM) using repetitive transcranial magnetic stimulation (rTMS) in patients with pDOC. We aimed to evaluate the effect of vagus nerve magnetic modulation (VNMM) on pDOC patients.Methods: We performed VNMM in 17 pDOC patients. The Revised Coma Recovery Scale (CRS-R), Glasgow scale (GCS), somatosensory evoked potentials (SEP) and brainstem auditory evoked potentials (BAEP) were assessed before and after treatment.Results: Both CRS-R and GCS results showed significant improvement in p DOC patients after VNMM treatment. The CRS-R improved from 7.88 ± 2.93 to 11.53 ± 4.94. The GCS score also improved from 7.65 ± 1.9 to 9.18 ± 2.65. The number of BAEP grades I increased from 3 to 5 after treatment. The number of BAEP grades I increased from 3 to 5, grade II increased by 1, and grade III decreased from 4 to 1.Conclusion: This study provides a preliminary indication of the potential of VNMM in the rehabilitation of pDOC patients. It provides the basis for a Phase 2 or Phase 3 study of VNMM in patients with pDOC.Keywords: prolonged disorders of consciousness, vagus nerve modulation, evoked potentials, neuromodulation, transcranial magnetic stimulation