ArticleFrontiers in neuroscience2026
Retrospective
Article in Frontiers in neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
4 authors.
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Abstract
Introduction: Persistent symptoms following mild traumatic brain injury (mTBI) remain a major clinical challenge. Patients with comorbid post-traumatic stress disorder (mTBI + PTSD) typically exhibit greater symptom burden and poorer outcome. Overlapping pathology-dysfunction in central autonomic, limbic, and cognitive networks-suggests a potential role for neuromodulatory interventions. Non-invasive vagus nerve stimulation (nVNS) has shown promise as a treatment for both neurotraumatic and psychiatric conditions, but its real-world impact in patients with chronic mTBI and comorbid PTSD has not been well characterized. Methods: This study represents a post-hoc subgroup analysis of a previously published retrospective observational cohort in adults with chronic mTBI symptoms treated with adjunctive nVNS. Symptom severity was assessed using the Neurobehavioral Symptom Inventory (NSI) at baseline and after 3-4 months of treatment. A post-hoc PTSD-enriched subgroup was identified using the PTSD Checklist for DSM-5 (PCL-5; score ≥31). Changes in total NSI scores, symptom domains, and item-level responses were evaluated for improvement. Multivariate analyses were used to characterize baseline concussion symptom profiles with (PTSD+) and without PTSD. Results: Among PTSD+ patients, adjunctive nVNS was associated with a significant reduction in overall symptom burden, with mean total NSI scores decreasing from 2.50 ± 0.60 at baseline to 2.03 ± 0.46 at follow-up (FDR-corrected, Conclusion: Adjunctive nVNS was well tolerated and associated with symptom improvement in patients with mTBI + PTSD, a population often considered refractory to treatment. These findings support the feasibility of vagal neuromodulation and highlight a high-symptom-burden subgroup with distinct symptom patterns that may retain treatment responsiveness, warranting further prospective evaluation.
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