Efficacy and safety of pulsed electromagnetic field therapy for fatigue in patients with multiple sclerosis: A systematic review and meta-analysis

Mohamed Ezzat M Mansour; Mufreh Amin; Khalid Radwan Alsaadany; Mohamed Awad E Ahmed; Ahmed Ezzat Elmetwalli; Mohamed Refaat Abdelhamid; Rami Ismail Mahmoud; Pacinthe Ayman; Mohamed Mohsen Helal

doi:10.1016/j.msard.2025.106549

Efficacy and safety of pulsed electromagnetic field therapy for fatigue in patients with multiple sclerosis: A systematic review and meta-analysis

Mult Scler Relat Disord. 2025 Sep:101:106549. doi: 10.1016/j.msard.2025.106549. Epub 2025 May 30.

Authors

Mohamed Ezzat M Mansour¹, Mufreh Amin², Khalid Radwan Alsaadany³, Mohamed Awad E Ahmed⁴, Ahmed Ezzat Elmetwalli², Mohamed Refaat Abdelhamid², Rami Ismail Mahmoud², Pacinthe Ayman⁵, Mohamed Mohsen Helal⁶

Affiliations

¹ Faculty of Medicine, Zagazig University, Zagazig, Egypt. Electronic address: 20512020100810@medicine.zu.edu.eg.
² Faculty of Medicine, Misr University for Science and Technology, Giza, Egypt.
³ Faculty of Medicine, Mansoura University, Mansoura, Egypt.
⁴ Faculty of Medicine, Suez University, Suez, Egypt.
⁵ Faculty of Medicine, Ain Shams University, Cairo, Egypt.
⁶ Faculty of Medicine, Zagazig University, Zagazig, Egypt.

PMID: 40540924
DOI: 10.1016/j.msard.2025.106549

Abstract

Introduction: Multiple sclerosis (MS) is a chronic, progressive neurological disorder characterized by inflammation, demyelination, and neurodegeneration of the central nervous system. Globally, it affects approximately 2.8 million people, often leading to significant disability and impaired quality of life. Fatigue is among the most common and debilitating symptoms of MS, profoundly impacting daily functioning. Pulsed Electromagnetic Field (PEMF) therapy has recently gained attention as a promising non-invasive intervention. This study aimed to synthesize evidence from randomized controlled trials (RCTs) on the efficacy of PEMF in managing fatigue among patients with MS.

Methods: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane CENTRAL to identify RCTs comparing PEMF therapy with sham treatment. The primary outcome was fatigue severity, measured as the standardized mean difference (SMD) from baseline to endpoint. Secondary outcomes included quality of life and depressive symptoms. Reporting on this review followed the PRISMA guidelines.

Results: Seven RCTs involving a total of 327 participants met the inclusion criteria. PEMF therapy was associated with a significant reduction in fatigue severity compared to sham (SMD -0.23, 95% CI [-0.45 to -0.01], P = 0.04). The studies were homogenous (Chi-square P = 0.97, I² = 0%). For quality of life and depressive symptoms, no significant differences were observed between groups: quality of life (SMD 0.16, 95% CI [-0.13 to 0.45], P = 0.27) and depressive symptoms (SMD -0.07, 95% CI [-0.46 to 0.31], P = 0.70). These outcomes also showed low heterogeneity (P > 0.1).

Conclusion: The study demonstrated the therapeutic potential of PEMF therapy in reducing fatigue severity in MS patients. While no significant improvements were observed in quality of life or depressive symptoms, its targeted effect on fatigue supports its role as a complementary treatment. Further large-scale RCTs are warranted to validate these findings and assess long-term benefits across diverse MS-related outcomes.

Keywords: Electromagnetic field; Fatigue; Meta-analysis; Multiple Sclerosis; Neurodegeneration.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Fatigue* / etiology
Fatigue* / therapy
Humans
Magnetic Field Therapy* / adverse effects
Magnetic Field Therapy* / methods
Multiple Sclerosis* / complications
Multiple Sclerosis* / therapy
Outcome Assessment, Health Care*
Quality of Life
Randomized Controlled Trials as Topic