Effect of encephalomyosynangiosis procedure on post stroke recovery in a permanent model of ischemic stroke.

This correspondence responds to the comments by Gong and Zou et al., regarding our study of encephalomyosynangiosis (EMS) in an acute ischemic stroke mouse model. We clarify that the selection of a 4-h post-ischemia intervention window was intentional and aligned with the study's proof-of-concept objective to evaluate the feasibility and biological impact of EMS in a hyperacute stroke setting, rather than modeling delayed or chronic recovery paradigms. We further address concerns regarding surgical controls, detailing the rationale for temporalis muscle handling and craniectomy design to minimize intracranial pressure-related confounding while maintaining physiological relevance. The absence of additional control arms and the use of a non-surgical sham group are acknowledged as limitations inherent to the study's scope. Overall, this response contextualizes the experimental design choices and reinforces the study's primary contribution as an initial demonstration of EMS efficacy when applied early after ischemic injury, providing a foundation for future investigations using delayed or staged interventions.