Trial reportIntensive care medicine2023
Acute traumatic coma awakening by right median nerve electrical stimulation: a randomised controlled trial.
Trial report in Intensive care medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07077135 (Transcutaneous Vagal Nerve Stimulation to Treat Disorders of Consciousness), which is not on this map. Cited by 30 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Transcutaneous Vagal Nerve Stimulation to Treat Disorders of Consciousness
Who cites it
30 citing papers in PubMed, 5 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Noninvasive neuromodulation for disorders of consciousness: an updated systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Acute Traumatic Coma Awakening Induced by Median Nerve Electrical Stimulation: A Systematic Review and Meta-Analysis.Neurocritical care · 2025Pooled it
- Pooled it
- The effect of acupuncture combined with hyperbaric oxygenation compared with hyperbaric oxygenation alone for patients with traumatic brain injury: a systematic review and meta-analysis.Frontiers in neurology · 2025Pooled it
- Efficacy and safety of neuromodulation and multimodal therapies for traumatic brain injury-induced disorders of consciousness: an updated umbrella review.Frontiers in neurologyPooled it
- Promoting Consciousness Recovery in Patients with Acquired Brain Injury Through Multimodal Sensory Stimulation: A Randomized Controlled Trial of Median Nerve and Auricular Stimulation.Neurocritical care · 2026Trial
- Repeated tDCS of the left dorsolateral prefrontal cortex for acute DoC: a pilot randomized controlled trial.Scientific reports · 2026Trial
- Neural Circuit Mechanisms of Disorders of Consciousness and Potential Therapeutic Targets of Brain Stimulation.CNS neuroscience & therapeutics · 2026Review
- A Meta-epidemiologic Analysis of Differences in Treatment-Effect Estimates According to Outcome Scale (GOS vs. GOSE) in Moderate-to-Severe Traumatic Brain Injury Trials.Neurocritical care · 2026Article
- Feasibility, Safety, and Preliminary Efficacy of Median Nerve Stimulation for Cognitive Dysfunction in Patients With Acute Traumatic Brain Injury: Study Protocol for a Pilot Randomized Controlled Trial.JMIR research protocols · 2026Article
- Non-invasive neuroregulation techniques applied to patients with consciousness disorders: a narrative review.Frontiers in human neuroscience · 2026Review
- Disorders of consciousness diagnosis, interventions, and prognostication for the intensivist: Report of the 2025 ISICEM roundtable.Intensive care medicine · 2026Review
- Median nerve electrical stimulation promotes myelin regeneration through regulating miR-1-3p/BDNF/TrkB-MAPK pathway in a transient cerebral ischemia rat model.Frontiers in behavioral neuroscience · 2026Article
- Advances in understanding and treating disorders of consciousness caused by brainstem injury.Chinese neurosurgical journal · 2025Review
- Neuromodulation techniques in traumatic brain injury: a narrative review of the current state.Acta neurologica Belgica · 2025Review
- Reduce electrical overload via threaded Chinese acupuncture in nerve electrical therapy.Bioactive materials · 2025Article
- Statistical Practice of Ordinal Outcome Analysis in Neurologic Trials: A Literature Review.Neurology · 2025Review
- Impact of transcranial direct current stimulation combined with median nerve stimulation on CRS-R in patients with prolonged disorders of consciousness after cerebral hemorrhage: protocol for a randomized controlled trial.Frontiers in neurology · 2025Article
- Review
- Article
Corrections and comments
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Authors and funding
31 authors at 20 institutions in 3 countries.
Funding
Abstract
purposeSevere traumatic brain injury (TBI) leads to acute coma and may result in prolonged disorder of consciousness (pDOC). We aimed to determine whether right median nerve electrical stimulation is a safe and effective treatment for accelerating emergence from coma after TBI.
methodsThis randomised controlled trial was performed in 22 centres in China. Participants with acute coma at 7-14 days after TBI were randomly assigned (1:1) to either routine therapy and right median nerve electrical stimulation (RMNS group) or routine treatment (control group). The RMNS group received 20 mA, 300 μs, 40 Hz stimulation pulses, lasting 20 s per minutes, 8 h per day, for 2 weeks. The primary outcome was the proportion of patients who regained consciousness 6 months post-injury. The secondary endpoints were Glasgow Coma Scale (GCS), Full Outline of Unresponsiveness scale (FOUR), Coma Recovery Scale-Revised (CRS-R), Disability Rating Scale (DRS) and Glasgow Outcome Scale Extended (GOSE) scores reported as medians on day 28, 3 months and 6 months after injury, and GCS and FOUR scores on day 1 and day 7 during stimulation. Primary analyses were based on the intention-to-treat set.
resultsBetween March 26, 2016, and October 18, 2020, 329 participants were recruited, of whom 167 were randomised to the RMNS group and 162 to the control group. At 6 months post-injury, a higher proportion of patients in the RMNS group regained consciousness compared with the control group (72.5%, n = 121, 95% confidence interval (CI) 65.2-78.7% vs. 56.8%, n = 92, 95% CI 49.1-64.2%, p = 0.004). GOSE at 3 months and 6 months (5 [interquartile range (IQR) 3-7] vs. 4 [IQR 2-6], p = 0.002; 6 [IQR 3-7] vs. 4 [IQR 2-7], p = 0.0005) and FOUR at 28 days (15 [IQR 13-16] vs. 13 [interquartile range (IQR) 11-16], p = 0.002) were significantly increased in the RMNS group compared with the control group. Trajectory analysis showed that significantly more patients in the RMNS group had faster GCS, CRS-R and DRS improvement (p = 0.01, 0.004 and 0.04, respectively). Adverse events were similar in both groups. No serious adverse events were associated with the stimulation device.
conclusionRight median nerve electrical stimulation is a possible effective treatment for patients with acute traumatic coma, that will require validation in a confirmatory trial.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.