Evidence map›Paper›PMID 41692816›Full record

ArticleJournal of neuroengineering and rehabilitation2026

EEG hemispheric asymmetry and behavioral responsiveness following rTMS in unresponsive wakefulness syndrome: an exploratory study.

Xiaochun Zheng, Qiuyi Xiao, Chengwei Xu, Zerong Chen, Zhanxing Yuan, Haili Zhong, Yang Bai, Xiyan Huang, Qiuyou Xie

Abstract read
In one paragraph

Article in Journal of neuroengineering and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Xiaochun ZhengJoint Research Centre for Disorders of Consciousness, Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China.
Qiuyi XiaoJoint Research Centre for Disorders of Consciousness, Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China.
Chengwei XuJoint Research Centre for Disorders of Consciousness, Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China.
Zerong ChenJoint Research Centre for Disorders of Consciousness, Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China.
Zhanxing YuanJoint Research Centre for Disorders of Consciousness, Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China.
Haili ZhongJoint Research Centre for Disorders of Consciousness, Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China.
Yang BaiAffiliated Rehabilitation Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330003, Jiangxi, China. baiyang_nanchang@163.com.
Xiyan HuangJoint Research Centre for Disorders of Consciousness, Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China. loriahuang@126.com.
Qiuyou XieJoint Research Centre for Disorders of Consciousness, Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China. xqy7180@163.com.ORCID http://orcid.org/0000-0002-8333-0165

Funding

National Natural Science Foundation of China 82371184the Key Technologies R&D Program of Guangdong Province 2023B0303020003
6 · The paper itself

Abstract

backgroundHemispheric asymmetry is a fundamental feature of large-scale brain organization, yet its relevance to disorders of consciousness (DOC) and its modulation following repetitive transcranial magnetic stimulation (rTMS) remain insufficiently studied. This study investigated pre-to-post rTMS changes in EEG hemispheric asymmetry, particularly differences between responders and non-responders and examined how these changes relate to long-term functional outcomes.

methodsThis exploratory single-arm pre–post study enrolled 20 patients with unresponsive wakefulness syndrome (UWS) who received 10-Hz rTMS for 10 consecutive days. Resting-state EEG was acquired before (T0) and after stimulation (T1) to quantify alpha-band hemispheric asymmetry indices, including frontal alpha asymmetry (FAA), parietal alpha asymmetry (PAA), frontal alpha synchrony asymmetry (FASA) and parietal alpha synchrony asymmetry (PASA). Clinical outcomes were tracked for 12 months by Disability Rating Scale.

resultsClinical improvement after rTMS was observed in a subset of patients, accompanied by changes in EEG asymmetry from pre- to post-stimulation. Changes in frontal alpha asymmetry (FAA) were associated with responder status, with responders exhibiting a greater leftward shift in FAA after stimulation. In addition, baseline frontal alpha synchrony asymmetry (FASA) and parietal alpha asymmetry (PAA) were associated with functional disability at the 12-month follow-up.

conclusionsIn this single-arm cohort, rTMS was associated with clinical improvement in a subset of patients with DOC, accompanied by changes in EEG hemispheric asymmetry, particularly FAA. FAA may serve as an exploratory marker for identifying DOC patients who respond to rTMS. Moreover, asymmetry indices were associated with long-term functional outcomes.

Indexed as

Consciousness DisordersElectroencephalographyFunctional LateralityTranscranial Magnetic StimulationAdultAlpha RhythmFemaleHumansMaleMiddle AgedTreatment OutcomeDisorder of consciousnessEEGHemispheric asymmetryLong-term prognosisRepetitive transcranial magnetic stimulation

Identifiers

PMID41692816
PMCPMC13011703

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.