Title:Pharmacological Interventions and Rehabilitation Approach for Enhancing Brain Self-repair and Stroke Recovery
Volume: 18
Issue: 1
Author(s): Rafał Szelenberger, Joanna Kostka, Joanna Saluk-Bijak and Elżbieta Miller*
Affiliation:
- Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa 14, 93-113 Lodz,Poland
Keywords:
Stroke, neuroprotection, recovery, drugs, rehabilitation, rehabilitation, stem cell.
Abstract: Neuroplasticity is a natural process occurring in the brain for the entire life. Stroke is the
leading cause of long term disability and a huge medical and financial problem throughout the
world. Research conducted over the past decade focused mainly on neuroprotection in the acute
phase of stroke while very little studies target the chronic stage. Recovery after stroke depends on
the ability of our brain to reestablish the structural and functional organization of neurovascular
networks. Combining adjuvant therapies and drugs may enhance the repair processes and restore
impaired brain functions. Currently, there are some drugs and rehabilitative strategies that can facilitate
brain repair and improve clinical effect even years after stroke onset. Moreover, some of the
compounds such as citicoline, fluoxetine, niacin, levodopa, etc. are already in clinical use or are
being trialed in clinical issues. Many studies are also testing cell therapies; in our review, we focused
on studies where cells have been implemented at the early stage of stroke. Next, we discuss
pharmaceutical interventions. In this section, we selected methods of cognitive, behavioral, and
physical rehabilitation as well as adjuvant interventions for neuroprotection including noninvasive
brain stimulation and extremely low-frequency electromagnetic field. The modern rehabilitation
represents a new model of physical interventions with the limited therapeutic window up to six
months after stroke. However, previous studies suggest that the time window for stroke recovery is
much longer than previously thought. This review attempts to present the progress in neuroprotective
strategies, both pharmacological and non-pharmacological that can stimulate the endogenous
neuroplasticity in post-stroke patients.