Treatments to Promote Neural Repair after Stroke

Abstract

Stroke remains a major cause of human disability worldwide. In parallel with advances in acute stroke interventions, new therapies are under development that target restorative processes. Such therapies have a treatment time window measured in days, weeks, or longer and so have the advantage that they may be accessible by a majority of patients. Several categories of restorative therapy have been studied and are reviewed herein, including drugs, growth factors, monoclonal antibodies, activity-related therapies including telerehabilitation, and a host of devices such as those related to brain stimulation or robotics. Many patients with stroke do not receive acute stroke therapies or receive them and do not derive benefit, often surviving for years thereafter. Therapies based on neural repair hold the promise of providing additional treatment options to a majority of patients with stroke.

Keywords: Neuronal plasticity; Recovery of function; Stroke; Stroke rehabilitation; Telerehabilitation.

Figure 1.

The brain progresses through three epochs after stroke. Each has a distinct biology defined by multiple processes ongoing in parallel. For each epoch, the general time scale, key therapeutic strategies, and main treatment approaches studied in preclinical and human studies are summarized.