OBJECTIVE: To explore the effect of combined rehabilitation training and transcutaneous vagus nerve electrical stimulation (t-VNS) on promoting central nervous system remodeling and neurological function recovery in stroke patients. METHODS: A total of 124 S patients admitted to our hospital from January to December 2023 were included in this study. The therapeutic effects were evaluated using the Modified Barthel Index (MBI) and the simplified Fugl-Meyer Assessment Scale (sFMA) to measure patients' activities of daily living and motor function recovery. Additionally, neurophysiological assessments, including electromyography (EMG) and motor evoked potentials (MEPs), were conducted to evaluate changes in neuromuscular and central nervous system function. Changes in neural activity in the frontal lobe and motor cortex were assessed through transcutaneous vagus nerve stimulation and electroencephalography. Moreover, all adverse events were recorded. RESULTS: After treatment, patients in the t-VNS combined with rehabilitation training group showed significant improvements in sFMA and MBI scores compared to the pure rehabilitation training group (P <
0.05). In terms of neurophysiology, patients in the combined treatment group exhibited significant increases in electromyographic activity and MEPs (P <
0.05). EEG results indicated enhanced neuroplasticity of the frontal lobe and motor cortex with t-VNS treatment. The incidence of skin stimulation and ear pain in the combined treatment group was significantly higher than that in the pure rehabilitation training group. CONCLUSION: Combined rehabilitation training and transcutaneous vagus nerve electrical stimulation have significant effects on neurological function recovery and central nervous system remodeling in stroke patients, effectively improving patients' motor function and activities of daily living.