Application and perspective of novel auditory intervention paradigms based on verbal and nonverbal stimuli for severe traumatic brain injury_Journal of Biomedical Engineering

Authors：

LI Xulong ¹ , YUAN Yuzhe ¹ ,  CHEN Peng ¹ , LIU Zhiyong ² , LI Kang ³ , TENG Haibo ²

1. School of Mechanical Engineering, Southwest Jiaotong University, Chengdu 610031, P.R.China;
2. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610044, P. R. China;
3. West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

CHEN Peng, Email: chenpeng@swjtu.edu.cn

Keywords：

Traumatic brain injury; Auditory interventions; Speech stimulation; Consciousness recovery; Closed-loop brain-computer interface

DOI：

10.7507/1001-5515.202601035

Video：

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Abstract Full text Figures/Tables Video References Cited by

Patients with severe traumatic brain injury (TBI) often experience disorders of consciousness (DoC) and motor impairments, which pose challenges to the implementation of conventional intervention approaches. As one of the relatively preserved sensory pathways in these patients, the auditory system holds considerable potential for assessing consciousness and facilitating its recovery. Therefore, this review systematically examines the mechanisms of verbal and nonverbal stimuli in consciousness recovery, focusing on analyzing the synergistic effects and limitations of language stimuli in emotional arousal and semantic integration. Based on this, a complementary mechanism leveraging the respective strengths of both approaches has been explored to establish a new intervention paradigm. Furthermore, integrating advancements in brain-computer interface (BCI) technology, it proposes a closed-loop intervention approach that combines multi-type auditory stimuli with real-time neural feedback. This framework emphasizes individual differences and dynamic regulation, providing theoretical foundations and developmental directions for constructing precision-oriented, mechanism-driven auditory intervention paradigms for severe TBI.

Citation： LI Xulong, YUAN Yuzhe, CHEN Peng, LIU Zhiyong, LI Kang, TENG Haibo. Application and perspective of novel auditory intervention paradigms based on verbal and nonverbal stimuli for severe traumatic brain injury. Journal of Biomedical Engineering, 2026, 43(3): 625-632. doi: 10.7507/1001-5515.202601035 Copy

1.	Dams-O’Connor K, Juengst S B, Bogner J, et al. Traumatic brain injury as a chronic disease: insights from the United States traumatic brain injury model systems research program. Lancet Neurol, 2023, 22(6): 517-528.
2.	Lippert J, Guggisberg A G. Diagnostic and therapeutic approaches in neurorehabilitation after traumatic brain injury and disorders of consciousness. Clin Transl Neurosci, 2023, 7(3): 21.
3.	Tani J, Wen Y T, Hu C J, et al. Current and potential pharmacologic therapies for traumatic brain injury. Pharmaceuticals, 2022, 15(7): 838.
4.	Schwertfeger J L, Beyer C, Hung P, et al. A map of evidence using transcranial direct current stimulation (tDCS) to improve cognition in adults with traumatic brain injury (TBI). Front Neuroergon, 2023, 4: 1170473.
5.	Shen L, Huang Y, Liao Y, et al. Effect of high‐frequency repetitive transcranial magnetic stimulation over M1 for consciousness recovery after traumatic brain injury. Brain Behav, 2023, 13(5): e2971.
6.	Liu P, Gao J, Pan S, et al. Effects of high-frequency repetitive transcranial magnetic stimulation on cerebral hemodynamics in patients with disorders of consciousness: a sham-controlled study. Eur Neurol, 2016, 76(1-2): 1-7.
7.	Srihagulang C, Vongsfak J, Vaniyapong T, et al. Potential roles of vagus nerve stimulation on traumatic brain injury: evidence from in vivo and clinical studies. Exp Neurol, 2022, 347: 113887.
8.	Hakon J, Moghiseh M, Poulsen I, et al. Transcutaneous vagus nerve stimulation in patients with severe traumatic brain injury: a feasibility trial. Neuromodulation, 2020, 23(6): 859-864.
9.	Harris M, Nguyen A, Brown N J, et al. Mild traumatic brain injury and the auditory system: an overview of the mechanisms, clinical presentations, and current diagnostic modalities. J Neurotrauma, 2024, 41(13-14): 1524-1532.
10.	Park C H, Kim S H, Jung H Y. Diffusion-tensor-tractography-based diagnosis for injury of corticospinal tract in a patient with hemiplegia following traumatic brain injury. Diagnostics, 2020, 10(3): 156.
11.	Jang S H, Kim S H, Seo Y S. Injury of the optic radiation in patients with mild TBI: a DTT study. Transl Neurosci, 2020, 11(1): 335-340.
12.	Togher L, Douglas J, Turkstra L S, et al. INCOG 2. 0 guidelines for cognitive rehabilitation following traumatic brain injury, part IV: cognitive-communication and social cognition disorders. J Head Trauma Rehabil, 2023, 38(1): 65-82.
13.	Liu X Y, Wang W L, Liu M, et al. Recent applications of EEG-based brain-computer-interface in the medical field. Mil Med Res, 2025, 12(1): 14.
14.	Qu S, Wu X, Tang Y, et al. Analyzing brain-activation responses to auditory stimuli improves the diagnosis of a disorder of consciousness by non-linear dynamic analysis of the EEG. Sci Rep, 2024, 14(1): 17446.
15.	Norton L, Kazazian K, Gofton T, et al. Functional neuroimaging as an assessment tool in critically ill patients. Ann Neurol, 2023, 93(1): 131-141.
16.	Hu J, Chen C, Wu M, et al. Assessing consciousness in acute coma using name-evoked responses. Brain Res Bull, 2024, 218: 111091.
17.	Hoseini S H, Eghbali M, Froutan R, et al. Effectiveness of auditory sensory stimulation on level of consciousness and cognitive function in traumatic brain injury patients: a randomized controlled clinical trial. Nurs Pract Today, 2022, 9(4): 349-359.
18.	Buriti A K L, Luiz C B L, Oliveira L R B, et al. Central auditory processing and self-perception questionnaire after acoustically controlled auditory training in individuals with mild traumatic brain injury. Codas, 2024, 36(2): e20230048.
19.	Campbell K R, Peterka R J, Fino P C, et al. The effects of augmenting traditional rehabilitation with audio biofeedback in people with persistent imbalance following mild traumatic brain injury. Front Neurol, 2022, 13: 926691.
20.	Lu H C, Gevirtz R, Yang C C, et al. Heart rate variability biofeedback for mild traumatic brain injury: a randomized-controlled study. Appl Psychophysiol Biofeedback, 2023, 48(4): 405-421.
21.	Goizueta S, Maza A, Sierra A, et al. Heart rate variability responses to personalized and non-personalized affective videos: a study on healthy subjects and patients with disorders of consciousness. Front Psychol, 2025, 16: 1560496.
22.	Lorek M, B?k D, Kwiecień-Jagu? K, et al. The effect of music as a non-pharmacological intervention on the physiological, psychological, and social response of patients in an intensive care unit. Healthcare, 2023, 11(12): 1687.
23.	Sihvonen A J, Siponkoski S T, Martínez-Molina N, et al. Neurological music therapy rebuilds structural connectome after traumatic brain injury: secondary analysis from a randomized controlled trial. J Clin Med, 2022, 11(8): 2184.
24.	Martínez-Molina N, Siponkoski S T, S?rk?m? T. Cognitive efficacy and neural mechanisms of music‐based neurological rehabilitation for traumatic brain injury. Ann N Y Acad Sci, 2022, 1515(1): 20-32.
25.	Kasdan A V, Burgess A N, Pizzagalli F, et al. Identifying a brain network for musical rhythm: a functional neuroimaging meta-analysis and systematic review. Neurosci Biobehav Rev, 2022, 136: 104588.
26.	Hennessy S, Janata P, Ginsberg T, et al. Music‐evoked nostalgia activates default mode and reward networks across the lifespan. Hum Brain Mapp, 2025, 46(4): e70181.
27.	Xiao Q, Zheng X, Wen Y, et al. Individualized music induces theta-gamma phase-amplitude coupling in patients with disorders of consciousness. Front Neurosci, 2024, 18: 1395627.
28.	Keller I, Garbacenkaite R. Neurofeedback in three patients in the state of unresponsive wakefulness. Appl Psychophysiol Biofeedback, 2015, 40(4): 349-356.
29.	O’Kelly J, James L, Palaniappan R, et al. Neurophysiological and behavioral responses to music therapy in vegetative and minimally conscious states. Front Hum Neurosci, 2013, 7: 884.
30.	Alvarsson J J, Wiens S, Nilsson M E. Stress recovery during exposure to nature sound and environmental noise. Int J Environ Res Public Health, 2010, 7(3): 1036-1046.
31.	Grassini S, Segurini G V, Koivisto M. Watching nature videos promotes physiological restoration: evidence from the modulation of alpha waves in electroencephalography. Front Psychol, 2022, 13: 871143.
32.	Costa M, Visentin C, Occhionero M, et al. Pentatonic sequences and monaural beats to facilitate relaxation: an EEG study. Front Psychol, 2024, 15: 1369485.
33.	?irin G?k M, Balci Akpinar R. The effect of different auditory stimuli on vital signs and consciousness level in intensive care patients: music, nature‐based sound and voices of patients’ relatives. Nurs Open, 2025, 12(8): e70273.
34.	Ribeiro A S F, Ramos A, Bermejo E, et al. Effects of different musical stimuli in vital signs and facial expressions in patients with cerebral damage: a pilot study. J Neurosci Nurs, 2014, 46(2): 117-124.
35.	Thaut M H, McIntosh G C, Hoemberg V. Neurobiological foundations of neurologic music therapy: rhythmic entrainment and the motor system. Front Psychol, 2015, 5: 1185.
36.	Sander K, Scheich H. Auditory perception of laughing and crying activates human amygdala regardless of attentional state. Cogn Brain Res, 2001, 12(2): 181-198.
37.	Nummenmaa L, Malèn T, Nazari-Farsani S, et al. Decoding brain basis of laughter and crying in natural scenes. Neuroimage, 2023, 273: 120082.
38.	Vutakuri N. Detection of emotional and behavioural changes after traumatic brain injury: a comprehensive survey. Cogn Comput Syst, 2023, 5(1): 42-63.
39.	Thaut M H. The discovery of human auditory–motor entrainment and its role in the development of neurologic music therapy. Prog Brain Res, 2015, 217: 253-266.
40.	Elsayed S M, Weheida S M, Elmasry M M, et al. Effect of using two different auditory stimulation on patients clinical outcomes in cardiac intensive care units. Assiut Sci Nurs J, 2025, 13(51): 184-197.
41.	Moretta P, Femiano C, Cavallo N D, et al. Family caregivers improve the diagnostic accuracy of disorders of consciousness: from remote to near-bed auditory stimulation. Eur J Phys Rehabil Med, 2024, 60(2): 198.
42.	Zora H, Csépe V. Perception of prosodic modulations of linguistic and paralinguistic origin: evidence from early auditory event-related potentials. Front Neurosci, 2021, 15: 797487.
43.	Portnova G V, Podlepich V V, Skorokhodov I V. Patients with better outcome have higher ERP response to emotional auditory stimuli. J Clin Neurophysiol, 2023, 40(7): 634-640.
44.	Ahmed F R, Attia A K, Mansour H, et al. Outcomes of family‐centred auditory and tactile stimulation implementation on traumatic brain injured patients. Nurs Open, 2023, 10(3): 1601-1610.
45.	Adak S, Pradhan R, Jena S, et al. Impact of nurse and beloved family member's voice stimulus on the level of consciousness and physiological parameters in comatose patients. J Integr Nurs, 2025, 7(1): 33-41.
46.	McDonald S, Togher L, Tate R, et al. A randomised controlled trial evaluating a brief intervention for deficits in recognising emotional prosody following severe ABI. Neuropsychol Rehabil, 2013, 23(2): 267-286.
47.	Marquardt T P, Rios-Brown M, Richburg T, et al. Comprehension and expression of affective sentences in traumatic brain injury. Aphasiology, 2001, 15(10-11): 1091-1101.
48.	Aubinet C, Gillet A, Regnier A. Disorders of consciousness, language and communication following severe brain injury. Psychol Belg, 2025, 65(1): 169.
49.	Perri R, Carlesimo G A, Loasses A, et al. Deficient intentional access to semantic knowledge in patients with severe closed-head injury. Cortex, 2000, 36(2): 213-225.
50.	Ledwidge P S, Jones C M, Huston C A, et al. Electrophysiology reveals cognitive-linguistic alterations after concussion. Brain Lang, 2022, 233: 105166.
51.	潘家輝, 張志航, 張源霖, 等. 面向意識障礙患者的腦機接口技術及其應用. 生物醫學工程學雜志, 2025, 42(3): 438-446.
52.	龐澤欣, 王毅軍, 董青鵬, 等. 基于弱視聽覺刺激誘發響應的混合腦機接口研究. 生物醫學工程學雜志, 2025, 42(4): 660-667.
53.	Lo C C H, Woo P Y M, Cheung V C K. Task-based EEG and fMRI paradigms in a multimodal clinical diagnostic framework for disorders of consciousness. Rev Neurosci, 2024, 35(7): 775-787.
54.	Popa L L, Chira D, Strilciuc ?, et al. Non-invasive systems application in traumatic brain injury rehabilitation. Brain Sci, 2023, 13(11): 1594.
55.	Séguin P, Maby E, Fouillen M, et al. The challenge of controlling an auditory BCI in the case of severe motor disability. J Neuroeng Rehabil, 2024, 21(1): 9.
56.	Rutiku R, Fiscone C, Massimini M, et al. Assessing mismatch negativity (MMN) and P3b within‐individual sensitivity—a comparison between the local–global paradigm and two specialized oddball sequences. Eur J Neurosci, 2024, 59(5): 842-859.
57.	Flaugher T. Comprehension after concussion: an analysis of the impact of mild traumatic brain injury and related symptoms on sentence and word-pair comprehension. San Antonio: The University of Texas at San Antonio, 2024.
58.	Wang N, Chai X, Song J, et al. Motor intention quantization for patients with disorders of consciousness by multimodal BCI combining electroencephalography and functional near‐infrared spectroscopy. CNS Neurosci Ther, 2025, 31(12): e70679.
59.	Nicolini P, Malfatto G, Lucchi T. Heart rate variability and cognition: a narrative systematic review of longitudinal studies. J Clin Med, 2024, 13(1): 280.
60.	Silva B C S, Araújo E S, Valenti V E, et al. The effects of auditory stimulation on heart rate variability in healthy individuals with normal hearing and with hearing loss: a systematic review and meta-analysis//CoDAS. Sociedade Brasileira de Fonoaudiologia, 2024, 36: e20230111.
61.	Wang I N, Kim H, Kim H, et al. Neurophysiological and cognitive enhancements in autonomous sensory meridian response identified using heart rate variability and electroencephalography connectivity. Front Psychol, 2025, 16: 1652185.
62.	Dolinay T, Hsu L, Maller A, et al. Ventilator weaning in prolonged mechanical ventilation—a narrative review. J Clin Med, 2024, 13(7): 1909.
63.	Pradeep M, Sasi A, Farrukh N, et al. Cross-modal computational model of brain-heart interactions via HRV and EEG feature. arXiv, 2026: 2601.06792.
64.	Chen G, Liu Y, Zhang X. EEG–fNIRS-based emotion recognition using graph convolution and capsule attention network. Brain Sci, 2024, 14(8): 820.
65.	Zakeri S, Makouei S, Danishvar S. State-dependent CNN–GRU reinforcement framework for robust EEG-based sleep stage classification. Biomimetics, 2026, 11(1): 54.

1. Dams-O’Connor K, Juengst S B, Bogner J, et al. Traumatic brain injury as a chronic disease: insights from the United States traumatic brain injury model systems research program. Lancet Neurol, 2023, 22(6): 517-528.
2. Lippert J, Guggisberg A G. Diagnostic and therapeutic approaches in neurorehabilitation after traumatic brain injury and disorders of consciousness. Clin Transl Neurosci, 2023, 7(3): 21.
3. Tani J, Wen Y T, Hu C J, et al. Current and potential pharmacologic therapies for traumatic brain injury. Pharmaceuticals, 2022, 15(7): 838.
4. Schwertfeger J L, Beyer C, Hung P, et al. A map of evidence using transcranial direct current stimulation (tDCS) to improve cognition in adults with traumatic brain injury (TBI). Front Neuroergon, 2023, 4: 1170473.
5. Shen L, Huang Y, Liao Y, et al. Effect of high‐frequency repetitive transcranial magnetic stimulation over M1 for consciousness recovery after traumatic brain injury. Brain Behav, 2023, 13(5): e2971.
6. Liu P, Gao J, Pan S, et al. Effects of high-frequency repetitive transcranial magnetic stimulation on cerebral hemodynamics in patients with disorders of consciousness: a sham-controlled study. Eur Neurol, 2016, 76(1-2): 1-7.
7. Srihagulang C, Vongsfak J, Vaniyapong T, et al. Potential roles of vagus nerve stimulation on traumatic brain injury: evidence from in vivo and clinical studies. Exp Neurol, 2022, 347: 113887.
8. Hakon J, Moghiseh M, Poulsen I, et al. Transcutaneous vagus nerve stimulation in patients with severe traumatic brain injury: a feasibility trial. Neuromodulation, 2020, 23(6): 859-864.
9. Harris M, Nguyen A, Brown N J, et al. Mild traumatic brain injury and the auditory system: an overview of the mechanisms, clinical presentations, and current diagnostic modalities. J Neurotrauma, 2024, 41(13-14): 1524-1532.
10. Park C H, Kim S H, Jung H Y. Diffusion-tensor-tractography-based diagnosis for injury of corticospinal tract in a patient with hemiplegia following traumatic brain injury. Diagnostics, 2020, 10(3): 156.
11. Jang S H, Kim S H, Seo Y S. Injury of the optic radiation in patients with mild TBI: a DTT study. Transl Neurosci, 2020, 11(1): 335-340.
12. Togher L, Douglas J, Turkstra L S, et al. INCOG 2. 0 guidelines for cognitive rehabilitation following traumatic brain injury, part IV: cognitive-communication and social cognition disorders. J Head Trauma Rehabil, 2023, 38(1): 65-82.
13. Liu X Y, Wang W L, Liu M, et al. Recent applications of EEG-based brain-computer-interface in the medical field. Mil Med Res, 2025, 12(1): 14.
14. Qu S, Wu X, Tang Y, et al. Analyzing brain-activation responses to auditory stimuli improves the diagnosis of a disorder of consciousness by non-linear dynamic analysis of the EEG. Sci Rep, 2024, 14(1): 17446.
15. Norton L, Kazazian K, Gofton T, et al. Functional neuroimaging as an assessment tool in critically ill patients. Ann Neurol, 2023, 93(1): 131-141.
16. Hu J, Chen C, Wu M, et al. Assessing consciousness in acute coma using name-evoked responses. Brain Res Bull, 2024, 218: 111091.
17. Hoseini S H, Eghbali M, Froutan R, et al. Effectiveness of auditory sensory stimulation on level of consciousness and cognitive function in traumatic brain injury patients: a randomized controlled clinical trial. Nurs Pract Today, 2022, 9(4): 349-359.
18. Buriti A K L, Luiz C B L, Oliveira L R B, et al. Central auditory processing and self-perception questionnaire after acoustically controlled auditory training in individuals with mild traumatic brain injury. Codas, 2024, 36(2): e20230048.
19. Campbell K R, Peterka R J, Fino P C, et al. The effects of augmenting traditional rehabilitation with audio biofeedback in people with persistent imbalance following mild traumatic brain injury. Front Neurol, 2022, 13: 926691.
20. Lu H C, Gevirtz R, Yang C C, et al. Heart rate variability biofeedback for mild traumatic brain injury: a randomized-controlled study. Appl Psychophysiol Biofeedback, 2023, 48(4): 405-421.
21. Goizueta S, Maza A, Sierra A, et al. Heart rate variability responses to personalized and non-personalized affective videos: a study on healthy subjects and patients with disorders of consciousness. Front Psychol, 2025, 16: 1560496.
22. Lorek M, B?k D, Kwiecień-Jagu? K, et al. The effect of music as a non-pharmacological intervention on the physiological, psychological, and social response of patients in an intensive care unit. Healthcare, 2023, 11(12): 1687.
23. Sihvonen A J, Siponkoski S T, Martínez-Molina N, et al. Neurological music therapy rebuilds structural connectome after traumatic brain injury: secondary analysis from a randomized controlled trial. J Clin Med, 2022, 11(8): 2184.
24. Martínez-Molina N, Siponkoski S T, S?rk?m? T. Cognitive efficacy and neural mechanisms of music‐based neurological rehabilitation for traumatic brain injury. Ann N Y Acad Sci, 2022, 1515(1): 20-32.
25. Kasdan A V, Burgess A N, Pizzagalli F, et al. Identifying a brain network for musical rhythm: a functional neuroimaging meta-analysis and systematic review. Neurosci Biobehav Rev, 2022, 136: 104588.
26. Hennessy S, Janata P, Ginsberg T, et al. Music‐evoked nostalgia activates default mode and reward networks across the lifespan. Hum Brain Mapp, 2025, 46(4): e70181.
27. Xiao Q, Zheng X, Wen Y, et al. Individualized music induces theta-gamma phase-amplitude coupling in patients with disorders of consciousness. Front Neurosci, 2024, 18: 1395627.
28. Keller I, Garbacenkaite R. Neurofeedback in three patients in the state of unresponsive wakefulness. Appl Psychophysiol Biofeedback, 2015, 40(4): 349-356.
29. O’Kelly J, James L, Palaniappan R, et al. Neurophysiological and behavioral responses to music therapy in vegetative and minimally conscious states. Front Hum Neurosci, 2013, 7: 884.
30. Alvarsson J J, Wiens S, Nilsson M E. Stress recovery during exposure to nature sound and environmental noise. Int J Environ Res Public Health, 2010, 7(3): 1036-1046.
31. Grassini S, Segurini G V, Koivisto M. Watching nature videos promotes physiological restoration: evidence from the modulation of alpha waves in electroencephalography. Front Psychol, 2022, 13: 871143.
32. Costa M, Visentin C, Occhionero M, et al. Pentatonic sequences and monaural beats to facilitate relaxation: an EEG study. Front Psychol, 2024, 15: 1369485.
33. ?irin G?k M, Balci Akpinar R. The effect of different auditory stimuli on vital signs and consciousness level in intensive care patients: music, nature‐based sound and voices of patients’ relatives. Nurs Open, 2025, 12(8): e70273.
34. Ribeiro A S F, Ramos A, Bermejo E, et al. Effects of different musical stimuli in vital signs and facial expressions in patients with cerebral damage: a pilot study. J Neurosci Nurs, 2014, 46(2): 117-124.
35. Thaut M H, McIntosh G C, Hoemberg V. Neurobiological foundations of neurologic music therapy: rhythmic entrainment and the motor system. Front Psychol, 2015, 5: 1185.
36. Sander K, Scheich H. Auditory perception of laughing and crying activates human amygdala regardless of attentional state. Cogn Brain Res, 2001, 12(2): 181-198.
37. Nummenmaa L, Malèn T, Nazari-Farsani S, et al. Decoding brain basis of laughter and crying in natural scenes. Neuroimage, 2023, 273: 120082.
38. Vutakuri N. Detection of emotional and behavioural changes after traumatic brain injury: a comprehensive survey. Cogn Comput Syst, 2023, 5(1): 42-63.
39. Thaut M H. The discovery of human auditory–motor entrainment and its role in the development of neurologic music therapy. Prog Brain Res, 2015, 217: 253-266.
40. Elsayed S M, Weheida S M, Elmasry M M, et al. Effect of using two different auditory stimulation on patients clinical outcomes in cardiac intensive care units. Assiut Sci Nurs J, 2025, 13(51): 184-197.
41. Moretta P, Femiano C, Cavallo N D, et al. Family caregivers improve the diagnostic accuracy of disorders of consciousness: from remote to near-bed auditory stimulation. Eur J Phys Rehabil Med, 2024, 60(2): 198.
42. Zora H, Csépe V. Perception of prosodic modulations of linguistic and paralinguistic origin: evidence from early auditory event-related potentials. Front Neurosci, 2021, 15: 797487.
43. Portnova G V, Podlepich V V, Skorokhodov I V. Patients with better outcome have higher ERP response to emotional auditory stimuli. J Clin Neurophysiol, 2023, 40(7): 634-640.
44. Ahmed F R, Attia A K, Mansour H, et al. Outcomes of family‐centred auditory and tactile stimulation implementation on traumatic brain injured patients. Nurs Open, 2023, 10(3): 1601-1610.
45. Adak S, Pradhan R, Jena S, et al. Impact of nurse and beloved family member's voice stimulus on the level of consciousness and physiological parameters in comatose patients. J Integr Nurs, 2025, 7(1): 33-41.
46. McDonald S, Togher L, Tate R, et al. A randomised controlled trial evaluating a brief intervention for deficits in recognising emotional prosody following severe ABI. Neuropsychol Rehabil, 2013, 23(2): 267-286.
47. Marquardt T P, Rios-Brown M, Richburg T, et al. Comprehension and expression of affective sentences in traumatic brain injury. Aphasiology, 2001, 15(10-11): 1091-1101.
48. Aubinet C, Gillet A, Regnier A. Disorders of consciousness, language and communication following severe brain injury. Psychol Belg, 2025, 65(1): 169.
49. Perri R, Carlesimo G A, Loasses A, et al. Deficient intentional access to semantic knowledge in patients with severe closed-head injury. Cortex, 2000, 36(2): 213-225.
50. Ledwidge P S, Jones C M, Huston C A, et al. Electrophysiology reveals cognitive-linguistic alterations after concussion. Brain Lang, 2022, 233: 105166.
51. 潘家輝, 張志航, 張源霖, 等. 面向意識障礙患者的腦機接口技術及其應用. 生物醫學工程學雜志, 2025, 42(3): 438-446.
52. 龐澤欣, 王毅軍, 董青鵬, 等. 基于弱視聽覺刺激誘發響應的混合腦機接口研究. 生物醫學工程學雜志, 2025, 42(4): 660-667.
53. Lo C C H, Woo P Y M, Cheung V C K. Task-based EEG and fMRI paradigms in a multimodal clinical diagnostic framework for disorders of consciousness. Rev Neurosci, 2024, 35(7): 775-787.
54. Popa L L, Chira D, Strilciuc ?, et al. Non-invasive systems application in traumatic brain injury rehabilitation. Brain Sci, 2023, 13(11): 1594.
55. Séguin P, Maby E, Fouillen M, et al. The challenge of controlling an auditory BCI in the case of severe motor disability. J Neuroeng Rehabil, 2024, 21(1): 9.
56. Rutiku R, Fiscone C, Massimini M, et al. Assessing mismatch negativity (MMN) and P3b within‐individual sensitivity—a comparison between the local–global paradigm and two specialized oddball sequences. Eur J Neurosci, 2024, 59(5): 842-859.
57. Flaugher T. Comprehension after concussion: an analysis of the impact of mild traumatic brain injury and related symptoms on sentence and word-pair comprehension. San Antonio: The University of Texas at San Antonio, 2024.
58. Wang N, Chai X, Song J, et al. Motor intention quantization for patients with disorders of consciousness by multimodal BCI combining electroencephalography and functional near‐infrared spectroscopy. CNS Neurosci Ther, 2025, 31(12): e70679.
59. Nicolini P, Malfatto G, Lucchi T. Heart rate variability and cognition: a narrative systematic review of longitudinal studies. J Clin Med, 2024, 13(1): 280.
60. Silva B C S, Araújo E S, Valenti V E, et al. The effects of auditory stimulation on heart rate variability in healthy individuals with normal hearing and with hearing loss: a systematic review and meta-analysis//CoDAS. Sociedade Brasileira de Fonoaudiologia, 2024, 36: e20230111.
61. Wang I N, Kim H, Kim H, et al. Neurophysiological and cognitive enhancements in autonomous sensory meridian response identified using heart rate variability and electroencephalography connectivity. Front Psychol, 2025, 16: 1652185.
62. Dolinay T, Hsu L, Maller A, et al. Ventilator weaning in prolonged mechanical ventilation—a narrative review. J Clin Med, 2024, 13(7): 1909.
63. Pradeep M, Sasi A, Farrukh N, et al. Cross-modal computational model of brain-heart interactions via HRV and EEG feature. arXiv, 2026: 2601.06792.
64. Chen G, Liu Y, Zhang X. EEG–fNIRS-based emotion recognition using graph convolution and capsule attention network. Brain Sci, 2024, 14(8): 820.
65. Zakeri S, Makouei S, Danishvar S. State-dependent CNN–GRU reinforcement framework for robust EEG-based sleep stage classification. Biomimetics, 2026, 11(1): 54.

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