Evidence mapPaperPMID 41714857Full record

ArticleAnnals of clinical and translational neurology2026

Efficacy of Intermittent Theta-Burst Stimulation for Prolonged Disorders of Consciousness: A Prospective, Randomized, Controlled Trial.

Chuan Xu, Jun Hu, Qianqian Wu, Min Wu, Yamei Yu, Hangcheng Li, Jian Gao, Jingqi Li, Nai Ding, Jie Yu and 1 more

Registry-linked trialAbstract read
In one paragraph

Article in Annals of clinical and translational neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03385278 (Effects of Repetitive Transcranial Magnetic Stimulation on the Disorders of Consciousness), which is not on this map. Not yet cited in PubMed.

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0citing 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.

NCT03385278 naunknown statusnot on this map

Effects of Repetitive Transcranial Magnetic Stimulation on the Disorders of Consciousness

TypeinterventionalSponsorFirst Affiliated Hospital of Zhejiang UniversityRan2015 to 2018Enrolled10ConditionsDisorder of ConsciousnessArmsrTMS
3 · Its place in the literature

Who cites it

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4 · The record

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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

11 authors.

Chuan XuDepartment of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.ORCID https://orcid.org/0009-0009-7351-8728
Jun HuDepartment of Neurology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Qianqian WuSir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Min WuDepartment of Neurology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Yamei YuDepartment of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Hangcheng LiDepartment of Rehabilitation, Hangzhou Mingzhou Brain Rehabilitation Hospital, Hangzhou, China.
Jian GaoDepartment of Rehabilitation, Hangzhou Mingzhou Brain Rehabilitation Hospital, Hangzhou, China.
Jingqi LiDepartment of Rehabilitation, Hangzhou Mingzhou Brain Rehabilitation Hospital, Hangzhou, China.
Nai DingKey Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Sciences, Zhejiang University, Hangzhou, China.
Jie YuDepartment of Neurology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.ORCID https://orcid.org/0000-0003-4488-6010
Benyan LuoDepartment of Neurology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Funding

the China Postdoctoral Science Foundation 2024M752878the National Natural Science Foundation of China 8250050433the National Natural Science Foundation of China U22A20293the Natural Science Foundation of Zhejiang Province QN25H090004the Natural Science Foundation of Zhejiang Province QN25H090042the Science and Technology Innovation 2030 - "Brain Science and Brain-like Research" Key Project 2022ZD0208905the Zhejiang Province Basic Public Welfare Research Program LQ24H090006
6 · The paper itself

Abstract

backgroundEmerging evidence suggests that low-frequency neural oscillations are dynamically regulated by consciousness levels, with the recovery of low cortical activity potentially serving as a neurophysiological substrate for conscious emergence. Targeted enhancement of these low-frequency rhythms in patients with disorders of consciousness (DoC) may constitute a promising neuromodulation strategy to facilitate consciousness recovery in severe brain injury.

objectiveThis study systematically examined the neurophysiological effects of intermittent theta-burst stimulation (iTBS), specifically its potential to enhance low-frequency cortical activity and promote consciousness recovery in patients with DoC. Through multimodal neural assessments, we aimed to elucidate the mechanistic relationship between iTBS-induced neural oscillation modulation and behavioral manifestations of consciousness improvement.

resultsThis prospective cohort study enrolled 30 patients with DoC, of whom 18 completed the full intervention protocol. Two-way repeated-measures analysis of variance revealed significant group × time interaction effects on the Coma Recovery Scale-Revised (CRS-R) scores, F(1, 16) = 6.543, p = 0.021. Post hoc simple effects analysis demonstrated significant temporal improvement in the active transcranial magnetic stimulation (TMS) group, F(1, 16) = 36.463, p < 0.001, with mean CRS-R scores increased from 9.300 ± 1.320 at baseline to 11.700 ± 1.409 post-intervention (p < 0.001). Conversely, sham stimulation revealed statistically nonsignificant changes (9.845 ± 1.476 versus 10.750 ± 1.575, p = 0.067). Neurophysiological assessments revealed emerging neurophysiological changes in the iTBS group, including enhanced resting-state low-frequency oscillations (delta: 21.642% increase, p = 0.449; theta: 6.800% increase, p = 0.789) and augmented auditory-evoked responses (phrase-level 22.917% increase, p = 0.280; syllable-level: 22.963% increase, p = 0.504), suggesting potential neural plasticity mechanisms that require further validation.

conclusionCollectively, this study established iTBS targeting the left dorsolateral prefrontal cortex as a clinically effective and well-tolerated neuromodulation approach for consciousness rehabilitation in patients with DoC, with therapeutic effects mediated by iTBS-induced enhancement of thalamocortical low-frequency oscillations.

trial registrationhttps://www. CLINICALTRIALS: gov. Unique identifier: NCT03385278. Registered on October 24, 2017.

Indexed as

disorders of consciousnessiTBSlow‐frequency oscillationsprognosis

Identifiers

PMID41714857
PMCPMC13394916

What Socratic holds

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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 Socratic graph.