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Electromagnetic Stimulation to Reduce Disability After Ischemic Stroke: The EMAGINE Randomized Clinical Trial
Jeffrey L Saver1, Pamela W Duncan2, Joel Stein3,4
1Department of Neurology and Comprehensive Stroke Center, UCLA (University of California, Los Angeles).
JAMA Network Open
|October 17, 2025
Summary
Electromagnetic Network Targeting Field (ENTF) therapy appears safe for subacute ischemic stroke patients. While not statistically significant, results suggest potential benefits in reducing global disability, warranting further investigation in larger trials.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Ischemic stroke is a major cause of long-term disability globally.
- Noninvasive Electromagnetic Network Targeting Field (ENTF) stimulation shows preliminary promise for stroke recovery.
Purpose of the Study:
- To assess the safety and effectiveness of ENTF therapy in subacute ischemic stroke patients with moderate to severe disability and upper-extremity impairment.
- To evaluate ENTF's impact on global disability and functional recovery.
Main Methods:
- A multicenter, double-blind, randomized clinical trial involving 100 participants (50 active, 50 sham).
- Participants received 45 sessions of ENTF stimulation or sham over 90 days, combined with home-based exercises.
- Primary endpoint: change in modified Rankin Scale (mRS) score at day 90.
Main Results:
- ENTF therapy was found to be safe, with no device-related serious adverse events.
- The primary outcome (mRS score reduction) did not reach statistical significance between active and sham groups.
- Secondary outcomes favored the active group, though not significantly; point estimates suggested potential benefits.
Conclusions:
- ENTF therapy is safe for patients in the subacute phase of ischemic stroke.
- While not statistically significant in this trial, ENTF therapy may offer a potential benefit for reducing global disability.
- Larger, higher-powered pivotal trials are recommended to confirm these findings.
