Non-invasive vagus nerve magnetic stimulation combined with rehabilitation training for vocal cord paralysis and dysphagia following brain injury: a prospective case series study
Abstract
Background Vocal cord paralysis combined with dysphagia following brain injury is a severe complication associated with aspiration pneumonia, asphyxiation, and malnutrition, for which traditional rehabilitation yields limited efficacy. Non-invasive vagus nerve magnetic stimulation (nVNMS) is an emerging neuromodulation technology; however, systematic clinical studies addressing this specific dual-deficit population remain lacking. Methods A prospective case series study was conducted at Guangdong Sanjiu Brain Hospital (June 2024–May 2025), consecutively enrolling 38 inpatients with brain injury–related vocal cord paralysis and dysphagia. All patients received a 21-day combined protocol comprising left mastoid nVNMS (5 Hz, 20 min/session, once daily), low-frequency pulse electrical stimulation for swallowing (20 min/session, once daily), and manual swallowing training (30 min/session, once daily). Outcomes were assessed at baseline and post-treatment using the Standardized Swallowing Assessment (SSA), Food Intake Level Scale (FILS), Penetration-Aspiration Scale (PAS), and laryngoscopy, with adverse events recorded throughout. Results After treatment, SSA scores decreased from 36.92 ± 4.71 to 32.63 ± 7.10 (p < 0.001, Cohen’s d = 0.72, large effect), FILS scores increased from 2 (2–2) to 3 (2–3) (p < 0.001, representing transition from total tube-feeding dependence to eligibility for supervised minimal oral intake), and PAS scores decreased from 6 (4–6) to 4 (4–4) (p < 0.001, r…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 12 participants or records.
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