Adjunctive vagus nerve stimulation associated with reduced neurobehavioral symptoms in chronic mTBI with PTSD
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Key Takeaway
Consider these preliminary associative findings from a retrospective analysis without a comparator group.
This was a retrospective post-hoc subgroup analysis of adults with chronic mild traumatic brain injury (mTBI) symptoms and comorbid PTSD, defined by a PCL-5 score ≥31. The study examined the association of adjunctive non-invasive vagus nerve stimulation (nVNS) with symptom changes over a 3–4 month follow-up period, using within-group comparisons from baseline.
The primary outcome was the change in total Neurobehavioral Symptom Inventory (NSI) score. Mean total NSI scores decreased from 2.50 ± 0.60 at baseline to 2.03 ± 0.46 at follow-up, representing a significant reduction in overall symptom burden (FDR-corrected, q). Secondary outcomes included changes in NSI symptom domains and item-level responses, though specific results were not reported.
Safety and tolerability data were not reported; no adverse events, serious adverse events, or discontinuations were described. The study had no comparator group, and the sample size and setting were not reported.
Key limitations include the post-hoc, retrospective design, absence of a control group, and unreported sample size. The findings are preliminary and associative, not causal. Practice relevance was not reported, and clinicians should not generalize beyond the reported subgroup or infer real-world impact without direct evidence.
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View Original Abstract ↓
IntroductionPersistent 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.MethodsThis 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.ResultsAmong 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, q
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