2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T9e7,Greater levels of treatment resistance in major depressive disorder (MDD) are associated with lower rates of initial benefit and higher rates of relapse (lower durability). Characterize depressive symptoms, function, and quality of life (QoL) over 24 months of adjunctive vagus nerve stimulation (VNS) in participants with markedly treatment-resistant depression. Prospective, open-label, single-arm, long-term extension study (RECOVER) conducted from September 2019 to April 2025. Outpatient. Adults with moderate-severe MDD with ≥ 4 failed antidepressant trials in the current episode, randomized to blinded, adjunctive VNS for 12 months, who subsequently received open-label, adjunctive VNS for 12 additional months (n = 214). Vagus nerve stimulation and concomitant psychotropic medications and interventional psychiatric modalities (electroconvulsive therapy, transcranial magnetic stimulation, and ketamine/esketamine) were characterized over the 12-month extension. The durability of benefit achieved at 12 months was assessed at 18 and 24 months for depressive symptoms (3 scales), daily function, QoL, a tripartite composite of all 3 domains, and the Clinical Global Impression-Improvement (CGI-I) scale (overall improvement). Loss of benefit and relapse were assessed, along with the emergence of meaningful benefit in participants without benefit at 12 months. Substantial benefit (at least 50% symptom reduction from baseline; CGI-I of 1 or 2; tripartite measures with at least 2 of 3 subscales evidencing benefit) and meaningful benefit thresholds for symptoms (at least 30% reduction from baseline), function, QoL, CGI-I, and the tripartite measure were set a priori. Most participants with substantial benefit maintained their benefit (18-month median = 78.8%; 24-month median = 79.0% across 5 measures), as did participants with at least meaningful benefit at 12 months (18-month median = 83.1%; 24-month median = 81.3% across 7 measures). Furthermore, many participants with no meaningful benefit at 12 months achieved it at 18 (median = 30.6%) and 24 (median = 37.8%) months. The strong maintenance of benefit was not accounted for by changes in psychotropic medications or interventional psychiatric modalities. Depressive symptom, daily function, and QoL benefits obtained after 12 months of adjunctive VNS were sustained in about 80% of participants continuing VNS. Approximately 30% with no meaningful benefit at 12 months accrued increased benefit over the subsequent year.31:Tff1,Abstract Importance Greater levels of treatment resistance in major depressive disorder (MDD) are associated with lower rates of initial benefit and higher rates of relapse (lower durability). Objective Characterize depressive symptoms, function, and quality of life (QoL) over 24 months of adjunctive vagus nerve stimulation (VNS) in participants with markedly treatment-resistant depression. Design Prospective, open-label, single-arm, long-term extension study (RECOVER) conducted from September 2019 to April 2025. Setting Outpatient. Participants Adults with moderate–severe MDD with ≥ 4 failed antidepressant trials in the current episode, randomized to blinded, adjunctive VNS for 12 months, who subsequently received open-label, adjunctive VNS for 12 additional months (n = 214). Interventions Vagus nerve stimulation and concomitant psychotropic medications and interventional psychiatric modalities (electroconvulsive therapy, transcranial magnetic stimulation, and ketamine/esketamine) were characterized over the 12-month extension. Main Outcomes and Measures The durability of benefit achieved at 12 months was assessed at 18 and 24 months for depressive symptoms (3 scales), daily function, QoL, a tripartite composite of all 3 domains, and the Clinical Global Impression–Improvement (CGI-I) scale (overall improvement). Loss of benefit and relapse were assessed, along with the emergence of meaningful benefit in participants without benefit at 12 months. Substantial benefit (at least 50% symptom reduction from baseline; CGI-I of 1 or 2; tripartite measures with at least 2 of 3 subscales evidencing benefit) and meaningful benefit thresholds for symptoms (at least 30% reduction from baseline), function, QoL, CGI-I, and the tripartite measure were set a priori. Results Most participants with substantial benefit maintained their benefit (18-month median = 78.8%; 24-month median = 79.0% across 5 measures), as did participants with at least meaningful benefit at 12 months (18-month median = 83.1%; 24-month median = 81.3% across 7 measures). Furthermore, many participants with no meaningful benefit at 12 months achieved it at 18 (median = 30.6%) and 24 (median = 37.8%) months. The strong maintenance of benefit was not accounted for by changes in psychotropic medications or interventional psychiatric modalities. Conclusions and Relevance Depressive symptom, daily function, and QoL benefits obtained after 12 months of adjunctive VNS were sustained in about 80% of participants continuing VNS. Approximately 30% with no meaningful benefit at 12 months accrued increased benefit over the subsequent year. Highlights 32:T938,Treatment of facial flushing and erythema for patients with erythematotelangiectatic rosacea (ETR) is challenging. Transcutaneous auricular vagus nerve stimulation (taVNS) therapy may be beneficial for treating ETR; however, it has not been rigorously evaluated in a randomized clinical trial. To evaluate the efficacy of taVNS for ETR compared with sham stimulation (SS). Enrollment for this single-center, randomized, double-blind, sham-controlled device clinical trial was initiated in February 2024 and ended in August 2024. The follow-up period ended in February 2025, and data were analyzed in March 2025. Patients with ETR that was accompanied by a Clinician's Erythema Assessment (CEA) score of at least 2 were selected from the Department of Dermatology of Southwest Hospital in China. Patients were allocated to the taVNS group (stimulation pulses at a frequency of 30 Hz and a pulse width of 200 μs for 30 minutes per day) or the SS group at a 1:1 ratio. Both groups received 3 weeks of treatment and 24 weeks of follow-up. The primary outcome was CEA score after 3 weeks of treatment. The secondary outcomes included improvements in erythema and facial flushing, sleep disorders, migraine, anxiety, fatigue, and depression, as measured via clinical tools. Seventy-two participants (67 female individuals [93.1%]; median [IQR] age: 29.5 [24.0-36.0] years) with ETR were randomized into either the taVNS (36 [50.0%]) or SS groups (36 [50.0%]). At 3 weeks, the mean (SD) CEA score was lower in the taVNS group than the SS group (1.56 [0.84] vs 2.47 [0.81]; mean difference, -0.92; 95% CI, -1.3 to -0.53; P < .001). Moreover, taVNS also reduced the severity of anxiety (mean difference, -5.42; 95% CI, -8.11 to -2.73; P < .001) and depression (mean difference, -6.22; 95% CI, -9.69 to -2.75; P < .001). This relief persisted until the follow-up period. The effects on sleep disorders, migraine, and fatigue were consistent with the previously described indicators. Adverse events were not common for taVNS (2 of 36 [5.6%]) and SS (3 of 36 [8.3%]). This randomized clinical trial demonstrated that treating ETR with taVNS concurrently ameliorated cutaneous symptoms and systemic comorbidities, and the results suggest that taVNS is a novel therapeutic option for ETR management. Chinese Clinical Trial Register Identifier: ChiCTR2400080637.33:T1051, Importance Treatment of facial flushing and erythema for patients with erythematotelangiectatic rosacea (ETR) is challenging. Transcutaneous auricular vagus nerve stimulation (taVNS) therapy may be beneficial for treating ETR; however, it has not been rigorously evaluated in a randomized clinical trial. Objective To evaluate the efficacy of taVNS for ETR compared with sham stimulation (SS). Design, Setting, and Participants Enrollment for this single-center, randomized, double-blind, sham-controlled device clinical trial was initiated in February 2024 and ended in August 2024. The follow-up period ended in February 2025, and data were analyzed in March 2025. Patients with ETR that was accompanied by a Clinician’s Erythema Assessment (CEA) score of at least 2 were selected from the Department of Dermatology of Southwest Hospital in China. Interventions Patients were allocated to the taVNS group (stimulation pulses at a frequency of 30 Hz and a pulse width of 200 μs for 30 minutes per day) or the SS group at a 1:1 ratio. Both groups received 3 weeks of treatment and 24 weeks of follow-up. Main Outcomes and Measures The primary outcome was CEA score after 3 weeks of treatment. The secondary outcomes included improvements in erythema and facial flushing, sleep disorders, migraine, anxiety, fatigue, and depression, as measured via clinical tools. Results Seventy-two participants (67 female individuals [93.1%]; median [IQR] age: 29.5 [24.0-36.0] years) with ETR were randomized into either the taVNS (36 [50.0%]) or SS groups (36 [50.0%]). At 3 weeks, the mean (SD) CEA score was lower in the taVNS group than the SS group (1.56 [0.84] vs 2.47 [0.81]; mean difference, −0.92; 95% CI, −1.3 to −0.53; P &lt; .001). Moreover, taVNS also reduced the severity of anxiety (mean difference, −5.42; 95% CI, −8.11 to −2.73; P &lt; .001) and depression (mean difference, −6.22; 95% CI, −9.69 to −2.75; P &lt; .001). This relief persisted until the follow-up period. The effects on sleep disorders, migraine, and fatigue were consistent with the previously described indicators. Adverse events were not common for taVNS (2 of 36 [5.6%]) and SS (3 of 36 [8.3%]). Conclusions and Relevance This randomized clinical trial demonstrated that treating ETR with taVNS concurrently ameliorated cutaneous symptoms and systemic comorbidities, and the results suggest that taVNS is a novel therapeutic option for ETR management. Trial Registration Chinese Clinical Trial Register Identifier: ChiCTR2400080637 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Vagus Nerve Stimulation: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Vagus Nerve Stimulation (modality). Clinician-written summaries and actionable practice insights. 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Causal attribution should be interpreted with caution.","value_numeric":null}],"summaries":{"what_studied":"This post hoc analysis of the triple-blind, sham-controlled VNS-REHAB pivotal RCT examined long-term (2- and 3-year) outcomes of implanted paired vagus nerve stimulation (VNS) plus rehabilitation in adults with moderate-to-severe chronic ischemic stroke and upper extremity (UE) deficits (n=49 at 2 years; n=16 at 3 years).","key_result":"At 2 years, FMA-UE scores improved by **7.51 points** (95% CI 5.80–9.22; p<0.001) and WMFT-FAS scores improved by **0.63 points** (95% CI 0.50–0.75; p<0.001) from baseline; **76% of participants (37/49)** achieved a clinically meaningful improvement in FMA-UE and/or WMFT. Significant gains were seen in 5 of 7 participation and quality-of-life measures (SIS-ADL, SIS-Hand, MAL-AOU, MAL-QOM, SS-QOL), and improvements were retained at 3 years in the 16-person subset.","limitations":"- **No control comparator** in the long-term phase — all participants received active VNS, so natural recovery cannot be separated from treatment effect.\n- **Unblinded assessments** during the long-term follow-up introduce potential bias.\n- Only **49 of 108** original participants had 2-year data (largely due to COVID-19 pandemic disruptions), raising concerns about attrition bias; self-activated therapy frequency was poorly documented.","practice_takeaway":"Paired VNS (Vivistim) delivers durable UE motor gains lasting at least 2 years in selected chronic ischemic stroke patients — clinicians should consider it for those with moderate-to-severe arm/hand deficits who remain motivated to engage in ongoing self-activated home therapy. Nearly 3 in 4 users reached a clinically meaningful threshold at 2 years, and some continued to improve beyond year 1."}},{"doi":"10.1038/s41575-026-01203-x","pmid":"42014861","title":"The critical role of gut–brain signalling in eating behaviour and obesity","journal_title":"Nature Reviews Gastroenterology & Hepatology","journal_issn":"1759-5045","published_at":"2026-04-21T00:00:00.000Z","url":"https://doi.org/10.1038/s41575-026-01203-x","source_score":29,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:50:20.731Z","updated_at":"2026-05-07T22:50:20.731Z","tags":[{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"condition","value":"Hyperphagia","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"condition","value":"Leptin Resistance","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"modality","value":"Vagus Nerve Stimulation","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"warning","value":"Much of the mechanistic data on vagal remodelling and leptin resistance is derived from animal studies — human translational evidence is not always explicitly distinguished.","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the review's reframing of the vagus nerve as a key obesity target; this is a hypothesis-generating claim, not a trial-validated finding.","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01203-x","tag_type":"warning","value":"This is a narrative review published in 2026; no systematic search strategy or PRISMA reporting is described, so conclusions reflect expert synthesis rather than exhaustive evidence grading.","value_numeric":null}],"summaries":{"what_studied":"This review examines how gut–brain axis signalling — primarily via the vagus nerve — regulates the three phases of eating behaviour (food seeking, consumption, and non-prandial activity) and how chronic high-fat, high-sugar diets disrupt these mechanisms to drive obesity.","key_result":"Chronic exposure to high-fat, high-sugar diets causes maladaptive gut–brain dysfunction through vagal fibre remodelling, altered gene expression, and leptin resistance, leading to hyperphagia and habitual overeating. GLP-1 receptor agonists promote weight loss but do not reverse the underlying gut–brain axis disruption.","limitations":"As a narrative review, it synthesises existing evidence without systematic search or meta-analytic methods, which limits conclusions about effect sizes. Much of the mechanistic data cited is from animal models, which may not fully translate to humans.","practice_takeaway":"Consider the vagus nerve as an underutilised therapeutic target in obesity, beyond current GLP-1 receptor agonist strategies. Patients on GLP-1 therapies should be counselled that weight-loss medications may not correct the root gut–brain signalling dysfunction caused by long-term poor diet."}},{"doi":"10.1093/ijnp/pyaf080","pmid":"41529263","title":"Durability of the benefit of vagus nerve stimulation in markedly treatment-resistant major depression: a RECOVER trial report","journal_title":"International Journal of Neuropsychopharmacology","journal_issn":"1461-1457","published_at":"2026-01-13T00:00:00.000Z","url":"https://doi.org/10.1093/ijnp/pyaf080","source_score":205,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-15","doi":"10.1093/ijnp/pyaf080","days":"7","issn":"1461-1457","rank":"1","field":"Clinical Medicine","score":"205","category":"Clinical Neurology","categories":["Clinical Neurology","Neurosciences","Psychiatry"],"_categories":["Clinical Neurology","Neurosciences","Psychiatry"]},"pubmed":{"doi":"10.1093/ijnp/pyaf080","title":"Durability of the benefit of vagus nerve stimulation in markedly treatment-resistant major depression: a RECOVER trial report.","journal":"The international journal of neuropsychopharmacology","methods":"","results":"Most participants with substantial benefit maintained their benefit (18-month median = 78.8%; 24-month median = 79.0% across 5 measures), as did participants with at least meaningful benefit at 12 months (18-month median = 83.1%; 24-month median = 81.3% across 7 measures). Furthermore, many participants with no meaningful benefit at 12 months achieved it at 18 (median = 30.6%) and 24 (median = 37.8%) months. The strong maintenance of benefit was not accounted for by changes in psychotropic medications or interventional psychiatric modalities.","abstract":"$30","keywords":["difficult-to-treat depression","durability","long-term extension","treatment-resistant depression","vagus nerve stimulation"],"pubmed_id":"41529263","conclusions":"","publication_date":"2026-01-13T00:00:00"},"crossref":{"DOI":"10.1093/ijnp/pyaf080","URL":"https://doi.org/10.1093/ijnp/pyaf080","ISSN":["1461-1457","1469-5111"],"link":[{"URL":"https://academic.oup.com/ijnp/article-pdf/29/1/pyaf080/66383204/pyaf080.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https://academic.oup.com/ijnp/article-pdf/29/1/pyaf080/66383204/pyaf080.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"1","score":1,"title":["Durability of the benefit of vagus nerve stimulation in markedly treatment-resistant major depression: a RECOVER trial report"],"author":[{"given":"Charles R","family":"Conway","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Washington University in St Louis , St Louis, MO ,"}]},{"given":"Augustus John","family":"Rush","sequence":"additional","affiliation":[{"name":"Duke-NUS Medical School ,"},{"name":"Curbstone Consultant LLC , Dallas, TX ,"}]},{"given":"Scott T","family":"Aaronson","sequence":"additional","affiliation":[{"name":"Institute for Advanced Diagnostics and Therapeutics, Sheppard Pratt Health System , Baltimore, MD ,"}]},{"given":"Mark T","family":"Bunker","sequence":"additional","affiliation":[{"name":"LivaNova PLC (or a subsidiary) , London ,"}]},{"given":"Charles","family":"Gordon","sequence":"additional","affiliation":[{"name":"LivaNova PLC (or a subsidiary) , London ,"}]},{"given":"Mark S","family":"George","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Medical University of South Carolina , Charleston, SC ,"},{"name":"Ralph H. Johnson VA Health Care System , Charleston, SC ,"}]},{"given":"Patricio","family":"Riva-Posse","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine , Atlanta, GA ,"}]},{"given":"Rebecca M","family":"Allen","sequence":"additional","affiliation":[{"name":"Seattle Neuropsychiatric Treatment Center , Seattle, WA ,"}]},{"given":"Ziad","family":"Nahas","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota , Minneapolis, MN ,"}]},{"given":"Christopher L","family":"Kriedt","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University in St Louis , St Louis, MO ,"}]},{"given":"John","family":"Zajecka","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Rush University Medical Center , Chicago, IL ,"},{"name":"Psychiatric Medicine Associates, LLC , Skokie, IL ,"}]},{"given":"David L","family":"Dunner","sequence":"additional","affiliation":[{"name":"Center for Anxiety and Depression , Mercer Island, WA ,"}]},{"given":"João","family":"Quevedo","sequence":"additional","affiliation":[{"name":"Center for Interventional Psychiatry, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth Houston) , Houston, TX ,"}]},{"given":"Yvette","family":"Sheline","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Perelman School of Medicine , Philadelphia, PA ,"}]},{"given":"Walter","family":"Duffy","sequence":"additional","affiliation":[{"name":"Alivation Research , Lincoln, NE ,"}]},{"given":"Brian J","family":"Mickey","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Huntsman Mental Health Institute, University of Utah , Salt Lake City, UT ,"}]},{"given":"Mary","family":"Stedman","sequence":"additional","affiliation":[{"name":"Stedman Clinical Trials , Tampa, FL ,"}]},{"given":"Gustavo","family":"Alva","sequence":"additional","affiliation":[{"name":"ATP Clinical Research , Costa Mesa, CA ,"}]},{"given":"Lucian","family":"Manu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University , Stony Brook, NY ,"}]},{"given":"Quyen","family":"Tran","sequence":"additional","affiliation":[{"name":"LivaNova PLC (or a subsidiary) , London ,"}]},{"given":"Charles F","family":"Zorumski","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University in St Louis , St Louis, MO ,"}]},{"given":"Matthew","family":"Macaluso","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Alabama , Birmingham, AL ,"}]},{"given":"Michael","family":"Banov","sequence":"additional","affiliation":[{"name":"PsychAtlanta Research Center , Marietta, GA ,"}]},{"given":"Cristina","family":"Cusin","sequence":"additional","affiliation":[{"name":"Depression Clinical & Research Program, Mass General Psychiatry , Boston, MA ,"}]},{"given":"Jeffrey I","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, SIU Neuroscience Institute , Springfield, IL ,"}]},{"given":"Hunter","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University in St Louis , St Louis, MO ,"}]},{"given":"Jeffrey","family":"Way","sequence":"additional","affiliation":[{"name":"LivaNova PLC (or a subsidiary) , London ,"}]},{"given":"Olivia","family":"Shy","sequence":"additional","affiliation":[{"name":"LivaNova PLC (or a subsidiary) , London ,"}]},{"given":"Ying-Chieh (Lisa)","family":"Lee","sequence":"additional","affiliation":[{"name":"LivaNova PLC (or a subsidiary) , London ,"}]},{"given":"Richard Hamish","family":"McAllister-Williams","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Newcastle University , Newcastle upon Tyne ,"},{"name":"Northern Centre for Mood Disorders, Newcastle University , Newcastle upon Tyne ,"},{"name":"Cumbria, Northumberland Tyne and Wear NHS Foundation Trust , Newcastle upon Tyne ,"}]},{"given":"Roger S","family":"McIntyre","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Toronto , Toronto, ON ,"}]},{"given":"Harold A","family":"Sackeim","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Medical University of South Carolina , Charleston, SC 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endpoint.","value_numeric":null}],"summaries":{"what_studied":"A prospective, open-label, single-arm 12‑month extension of adjunctive vagus nerve stimulation (VNS) evaluated durability of benefit at 18 and 24 months in adults with markedly treatment‑resistant major depressive disorder (≥4 failed antidepressant trials) who had completed 12 months of blinded adjunctive VNS (n=214). Outcomes included depressive symptoms (3 scales), daily function, quality of life, a tripartite composite, and CGI‑I; concomitant medications and interventional therapies were tracked.","key_result":"Among those with substantial benefit at 12 months, the median proportion maintaining benefit was 78.8% at 18 months and 79.0% at 24 months (across 5 measures). For participants with at least meaningful benefit at 12 months, medians were 83.1% at 18 months and 81.3% at 24 months (across 7 measures); among those without meaningful benefit at 12 months, 30.6% at 18 months and 37.8% at 24 months achieved it. Maintenance was not explained by changes in psychotropic medications or interventional modalities.","limitations":"Open‑label, single‑arm extension without a control group limits causal inference. Concomitant treatments were allowed, posing potential confounding despite analyses suggesting they did not account for maintenance. Findings apply to a highly refractory MDD population and may not generalize to less resistant cases.","practice_takeaway":"In markedly treatment‑resistant MDD continuing adjunctive VNS, benefits at 12 months commonly persist to 24 months (~80% by median across measures), and a meaningful share of 12‑month non‑responders gain benefit by 18–24 months. Durability did not appear driven by changes in medications or other interventional therapies."}},{"doi":"10.1001/jamadermatol.2025.3796","pmid":"41060641","title":"Transcutaneous Auricular Vagus Nerve Stimulation Treatment for Erythematotelangiectatic Rosacea","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2025-10-08T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12509084/","source_score":33,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-19","doi":"10.1001/jamadermatol.2025.3796","days":"30","issn":"2168-6068","rank":"9","field":"Clinical Medicine","score":"33","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2025.3796","title":"Transcutaneous Auricular Vagus Nerve Stimulation Treatment for Erythematotelangiectatic Rosacea: A Randomized Clinical Trial.","journal":"JAMA dermatology","methods":"","results":"Seventy-two participants (67 female individuals [93.1%]; median [IQR] age: 29.5 [24.0-36.0] years) with ETR were randomized into either the taVNS (36 [50.0%]) or SS groups (36 [50.0%]). At 3 weeks, the mean (SD) CEA score was lower in the taVNS group than the SS group (1.56 [0.84] vs 2.47 [0.81]; mean difference, -0.92; 95% CI, -1.3 to -0.53; P < .001). Moreover, taVNS also reduced the severity of anxiety (mean difference, -5.42; 95% CI, -8.11 to -2.73; P < .001) and depression (mean difference, -6.22; 95% CI, -9.69 to -2.75; P < .001). This relief persisted until the follow-up period. The effects on sleep disorders, migraine, and fatigue were consistent with the previously described indicators. Adverse events were not common for taVNS (2 of 36 [5.6%]) and SS (3 of 36 [8.3%]).","abstract":"$32","keywords":[],"pubmed_id":"41060641","conclusions":"","publication_date":"2025-10-08T00:00:00"},"crossref":{"DOI":"10.1001/jamadermatol.2025.3796","URL":"https://doi.org/10.1001/jamadermatol.2025.3796","ISSN":["2168-6068"],"link":[{"URL":"https://jamanetwork.com/journals/jamadermatology/articlepdf/2839734/jamadermatology_li_2025_oi_250049_1765313915.99001.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"1229","type":"journal-article","issue":"12","score":1,"title":["Transcutaneous Auricular Vagus Nerve Stimulation Treatment for Erythematotelangiectatic Rosacea"],"author":[{"given":"Jian","family":"Li","sequence":"first","affiliation":[{"name":"Department of Dermatology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China"},{"name":"Department of Dermatology, Southwest Hospital, Third Military 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University), Chongqing, China"}]},{"given":"Mei","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China"}]},{"given":"Zhifei","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China"}]},{"given":"Jing","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China"}]},{"given":"Zuzhen","family":"Ou","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China"}]},{"given":"Shuguang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China"}]},{"given":"Aiai","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China"}]},{"given":"Li","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China"}]},{"given":"Zhiqiang","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China"}]},{"given":"Jingming","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 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Anxiety and depression scores improved (mean differences −5.42 [95% CI, −8.11 to −2.73] and −6.22 [95% CI, −9.69 to −2.75], respectively), and adverse events were uncommon (2/36 [5.6%] vs 3/36 [8.3%]); benefits persisted through follow-up.","limitations":"Single-center study with a small sample (n=72) and predominantly female participants (93.1%), which may limit generalizability; active treatment lasted only 3 weeks.","practice_takeaway":"Short-course taVNS improved clinician-rated erythema and mood symptoms versus sham in ETR with few adverse events; clinicians may discuss this noninvasive option with patients while noting the single-center, small-sample evidence base."}}],"initialOffset":4,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Vagus Nerve Stimulation"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Vagus Nerve Stimulation"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Vagus Nerve Stimulation"}}}]]

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