Neurorestoration after stroke

Abstract

<jats:p>Recent advancements in stem cell biology and neuromodulation have ushered in a battery of new neurorestorative therapies for ischemic stroke. While the understanding of stroke pathophysiology has matured, the ability to restore patients' quality of life remains inadequate. New therapeutic approaches, including cell transplantation and neurostimulation, focus on reestablishing the circuits disrupted by ischemia through multidimensional mechanisms to improve neuroplasticity and remodeling. The authors provide a broad overview of stroke pathophysiology and existing therapies to highlight the scientific and clinical implications of neurorestorative therapies for stroke.</jats:p>

Autologous Endothelial Progenitor Cells Transplantation for Acute Ischemic Stroke: A 4-Year Follow-Up Study

“…Despite the enormous health impact of stroke, the only approved treatments for acute ischemic stroke, thrombolytic therapies and endovascular recanalization techniques, have a narrow time‐window and only benefit a small subset of patients . Because few neuroprotective reagents have been successfully translated “from bench to bedside” in the past several decades, neurorestoration has become a new research hot spot in stroke treatment , of which stem cell transplantation has been shown by both animal research and clinical trials to open a novel avenue to promote tissue and function repair after stroke .…”

Cortical waves and post‐stroke brain stimulation

“…But controlling dynamics in neural systems via brain stimulation techniques remains challenging because as indicated by Tang and Bassett, “While some understanding has been gained of the control of single neurons, the control of large scale neural systems networks of multiply interacting components remains poorly understood.” As a result, in most cortical stimulation protocols, be they electric or magnetic, parameter values are still adjusted in an empirical fashion. Despite this limitation, cortical stimulation studies clearly produce encouraging results suggesting that these techniques have some potential, but overall, the results remain mixed or limited for example for stroke (see previous studies()), with improvements sometimes limited to 10% to 20%, and for post‐stroke aphasia (see other works()). Aphasia is a complex brain disorder of language and communication caused by damage to the language networks affecting speaking, reading, writing, or understanding language.…”

“…As a result, in most cortical stimulation protocols, be they electric or magnetic, parameter values are still adjusted in an empirical fashion. Despite this limitation, cortical stimulation studies clearly produce encouraging results suggesting that these techniques have some potential, but overall, the results remain mixed or limited for example for stroke (see previous studies [18][19][20][21][22][23], with improvements sometimes limited 24 to 10% to 20%, and for post-stroke aphasia (see other works [25][26][27][28][29][30] ). Aphasia is a complex brain disorder of language and communication caused by damage to the language networks affecting speaking, reading, writing, or understanding language.…”

Salvia miltiorrhiza enhances the survival of mesenchymal stem cells under ischemic conditions

“…Mesenchymal stem cells (MSCs) have the therapeutic ability of self‐renewal, proliferation and multi‐lineage differentiation into cells, such as myocytes, hepatocytes, osteoblast, chondrocytes and adipocytes. These abilities make MSCs an attractive candidate for cellular replacement therapies . Transplanted MSCs can migrate into the ischemic stroke region, and differentiate into astrocytes or neuron‐like cells .…”

“…These abilities make MSCs an attractive candidate for cellular replacement therapies. [18,21] Transplanted MSCs can migrate into the ischemic stroke region, and differentiate into astrocytes or neuron-like cells. [22,23] Further, they are able to indirectly stimulate tissue repairing and restructuring, and functional recovery of the infarcted brain by secreting trophic factors into the injured brain region.…”