ArticleTherapeutic advances in neurological disorders2026
Implantable vagus nerve stimulation for the treatment of disorders of consciousness with epilepsy: a retrospective propensity score-matched clinical study.
Article in Therapeutic advances in neurological disorders, 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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Abstract
Background: Disorders of consciousness (DoC) have limited effective therapies. Implantable vagus nerve stimulation (VNS) is established for epilepsy but remains underexplored for DoC with comorbid epilepsy. Objectives: To evaluate whether VNS is associated with improved consciousness recovery in DoC patients with epilepsy and to explore factors related to response. Design: Retrospective propensity score-matched cohort study. Methods: Ninety DoC patients with epilepsy received implantable VNS or conservative management. The primary outcome was clinically meaningful improvement at 1 year (Coma Recovery Scale-Revised (CRS-R) increase ⩾3 points). Propensity score matching (1:1) balanced baseline characteristics (23 per group). Longitudinal CRS-R trajectories were assessed using linear mixed-effects models with Type III ANOVA. Logistic regression within the VNS cohort explored factors associated with responder status; adverse events were extracted from operative and follow-up records. Results: The 1-year responder rate was higher with VNS than with conservative management (34.78% vs 4.35%; two-sided Fisher's exact test, Conclusion: Implantable VNS was associated with higher 1-year clinically meaningful improvement and greater longitudinal CRS-R gains than conservative management in DoC patients with epilepsy. Prospective controlled studies are warranted.
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