Role and Impact of Cerebrolysin for Ischemic Stroke Care

Abstract

Stroke is still a significant health problem that affects millions of people worldwide, as it is the second-leading cause of death and the third-leading cause of disability. Many changes have occurred in the treatment of acute ischemic stroke. Although the innovative concepts of neuroprotection and neurorecovery have been vigorously investigated in a substantial number of clinical studies in the past, only a few trials managed to increase the number of promising outcomes with regard to the multidimensional construct of brain protection and rehabilitation. In terms of pharmacological therapies with proven benefits in the post-ischemic process, drugs with neurorestorative properties are thought to be effective in both the acute and chronic phases of stroke. One significant example is Cerebrolysin, a combination of amino acids and peptides that mimic the biological functions of neurotrophic factors, which has been shown to improve outcomes after ischemic stroke, while preserving a promising safety profile. The purpose of this paper is to offer an overview on the role and impact of Cerebrolysin for ischemic stroke care, by touching on various aspects, from its complex, multimodal and pleiotropic mechanism of action, to its efficacy and safety, as well as cost effectiveness.

Extended Poststroke Rehabilitation Combined with Cerebrolysin Promotes Upper Limb Motor Recovery in Early Subacute Phase of Rehabilitation: A Randomized Clinical Study

“…Higher scores of motor and functional improvement of the upper extremities in the group treated with Cerebrolysin after therapy and after 90-day follow-up indicate positive clinical effects. The effect of Cerebrolysin could be explained by its multimodal impact on the mechanisms of immediate neuroprotection and long-term neuroregeneration enhanced by extended neurorehabilitation [ 19 ]. It is worth mentioning that our subjects were in the early subacute post-stroke period with severe upper limb disability.…”

“…As a potent neuropeptide, it affects neurotrophy and neuroprotection, especially concerning neuronal recovery through the activity of the neurotrophic factor (NTF) and sonic hedgehog (Shh) signaling pathways [ 17 , 18 ]. Accordingly, it has the potential to amplify the capacity of neuroplasticity in early subacute post-stroke rehabilitation through synaptic remodeling and transmission, reduction in neurovascular reconstruction, neurite outgrowth, and oligodendrogenesis [ 16 , 19 ]. Furthermore, it is essential to point out that Cerebrolysin can be used without a time window limitation for the drug administration and relevant restrictions [ 16 ].…”

The Modulation of Hippocampus Plasticity

“…Cerebrolysin, an amino acid and peptide blend, mimics the biological effects of neurotrophic factors and has been shown to have positive effects when given to patients who have experienced an ischemic stroke while exhibiting a benign safety profile [55]. The mechanism of action of Cerebrolysin is multi-faceted and has been demonstrated in a range of studies, including animal and in vitro studies.…”

“…One of the key mechanisms of action of Cerebrolysin is its impact on the hippocampus, which is a crucial area for learning and memory. By regulating the growth of synapses and promoting neuroplasticity in the hippocampus, Cerebrolysin has been shown to improve memory and cognitive function in patients with ischemic stroke [55]. Additionally, Cerebrolysin activates the Sonic Hedgehog pathway, which boosts neurogenesis and oligodendrogenesis in the hippocampus, contributing to the development and structuring of the brain [56].…”

Efficacy of Cerebrolysin Treatment as an Add-On Therapy to Mechanical Thrombectomy in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion: Study Protocol for a Prospective, Open Label, Single-Center Study With 12 Months of Follow-Up

“…It mimics the action of endogenous neurotrophic factors in brain protection and recovery ( 26 ). Cerebrolysin has been the subject of many animal and in vitro studies, the majority of which have yielded encouraging results in terms of pleiotropic and multimodal activity ( 27 ). However, only a few preclinical and clinical studies tested the efficacy of Cerebrolysin as an add-on therapy to MT and/or r-tPA in AIS so far.…”