Mitchell S.V. Elkind, M.D., is American Heart Association president-elect, chair of the Advisory Committee of the American Stroke Association — a division of the American Heart Association and professor of neurology and epidemiology at Columbia University New York. copyright American Heart Association "Recovery is really, what I think of as the black box of stroke management. You know, we've gotten good at stroke prevention. More recently, we've gotten very good at acute interventions like endovascular therapy. But we're still just beginning to crack open the possibility of what we can do around stroke recovery, and promoting brain reorganization after someone has a stroke. And transcranial magnetic stimulation has been an exciting potential approach to doing this, and this trial I think is very exciting because the investigators used a randomized trial design to test whether a wearable device that provides continuous transcranial magnetic stimulation can promote brain reorganization that may be of benefit. It was a small study, kind of a pilot study, phase I, phase II, to show that this was possible on really a proof of principle. So they were able to show that by giving people 20 sessions of transcranial magnetic stimulation over several weeks, they could using fMRI, they could show a change in cortical organization and activation. And so that suggests that there is potentially a beneficial effect on the brain, from this approach. This study was too small to prove that there was a clinical benefit, but it really wasn't intended to show that. And there were suggestive benefits even in clinical outcomes also. So again, this is an area that's been evolving over many years, and it's very exciting to see that it's reached this level. The advantage to this kind of wearable magnetic stimulation is that the patient could have it at home with them. They don't necessarily have to come in to the clinic or to the academic medical center to have this sort of treatment applied to them. They could potentially use it at home and do it on their own as well. So I think this really sets the stage for important studies that will be coming down the line in the area of stroke recovery."