Other Neuroprotective Therapies on Trial in Acute Stroke

  title={Other Neuroprotective Therapies on Trial in Acute Stroke},
  author={Jos{\'e} M. Ferro and Antoni D{\'a}valos},
  journal={Cerebrovascular Diseases},
  pages={127 - 130}
New neuroprotective agents on trial may potentially offer benefit to stroke patients without the associated hemorrhagic risk of thrombolytic therapy. Clinical investigation of these drugs has been designed to obtain the highest probability of success, or concentrates on the salvageable ischemic brain and use infarct growth on MRI as a surrogate end-point. Nine substances in 10 trials are currently being tested in three therapeutical strategies in patients with acute ischemic stroke. These… 

Acute Stroke Management: Brain Protection, Reperfusion and Improving Recovery after Stroke

New drugs should be investigated defining the minimally and maximally effective dose, the efficacy in the appropriate time window, controlling physiological variables, in randomized blinded studies conducted in independent laboratories, including function measures and long-term assessment.

Neuroprotection in Cerebral Infarction: The Opportunity of New Studies

Evaluating neuroprotectant capacity to salvage the penumbra using MRI both in animals and humans as a surrogate outcome can help to select drugs more likely to demonstrate clinical benefit and enlarge the window of opportunity for reperfusion therapies and protect vascular structures.

Serum Albumin in Ischemic Stroke Patients: The Higher the Better

It is indicated that high serum albumin is associated with better outcome and lower mortality in ischemic stroke patients and may be neuroprotective in isChemic stroke in humans.


Induction of HO-1 upon acute brain injury seems to be neuroprotective, provided that hemorrhage is absent from the clinical manifestations of the primary pathophysiological event.

Recovery from focal brain ischemia induced by extradural compression in diabetic and non-diabetic rats

In agreement with clinical evidence, larger infarct sizes and neurodegeneration were observed in rats following hyperglycemic brain ischemia, and the improvement in LPT performance of naïve-compressed rats was followed by a reduction of damage in cortical associative areas.

Investigation of the effect of hyperglycemia on intracerebral hemorrhage by proteomic approaches

Proteomic approaches utilized to investigate the role of hyperglycemia in ICH suggest the protection role of albumin in acute stage of ICH, which may be dependent on different blood sugar levels.

Stem Cells for Enhancing Recovery after Stroke: A Review

  • T. EnglandP. MartinP. Bath
  • Biology, Medicine
    International journal of stroke : official journal of the International Stroke Society
  • 2009
This review summarises current knowledge in regard to stem cells and their potential for helping improve recovery after stroke.

AMPA receptors and pain—A future therapeutic intervention?

Several antagonists for AMPA receptors developed for preclinical studies of stroke, seizure, amyotropic lateral sclerosis, Alzheimer's disease, addiction, and pain have shown promise as potential targeted therapeutic interventions for these diseases, and clinical trials are ongoing for many specific AMPA antagonists.

Impact of serum uric acid, albumin and their interaction on Parkinson’s disease

Serum UA and albumin levels significantly decreased in PD patients and were independent risk factors for PD, according to receiver operating characteristic curve analyses.

Towards a unifying, systems biology understanding of large-scale cellular death and destruction caused by poorly liganded iron: Parkinson’s, Huntington’s, Alzheimer’s, prions, bactericides, chemical toxicology and others as examples

  • D. Kell
  • Biology
    Archives of Toxicology
  • 2010
This work highlights specifically the role of iron metabolism, and the detailed speciation of iron, in chemical and other toxicology, and has significant implications for the use of iron chelating substances as nutritional or therapeutic agents in inhibiting both the progression of these mainly degenerative diseases and the sequelae of both chronic and acute toxin exposure.



Major ongoing stroke trials.

  • Medicine
  • 2007
Treatment with oral anticoagulants in the current INR range is safe, and potential mechanisms of action include lowering blood pressure, improving cerebral perfu-sion, and neuroprotection, according to preclinical and preliminary clinical data.

Oral Citicoline in Acute Ischemic Stroke: An Individual Patient Data Pooling Analysis of Clinical Trials

Treatment with oral citicoline within the first 24 hours after onset in patients with moderate to severe stroke increases the probability of complete recovery at 3 months, and the overall safety ofciticoline was similar to placebo.

Recommendations for standards regarding preclinical neuroprotective and restorative drug development.

The suggestions contained in this document are meant to serve as overall guidelines that must be adapted to the individual characteristics related to particular drugs and their preclinical and clinical development needs.

NXY-059 for acute ischemic stroke.

The administration of NXY-059 within six hours after the onset of acute ischemic stroke significantly improved the primary outcome (reduced disability at 90 days), but it did not significantly improve other outcome measures, including neurologic functioning as measured by the NIHSS score.

Recommendations for Clinical Trial Evaluation of Acute Stroke Therapies

The recommendations contained in this document may help to focus attention on how to achieve the goal of developing an expanding number of a effective and safe acute stroke therapies.

Major ongoing stroke trials.

The following is a list of major ongoing studies about stroke. Information about other multicenter studies that might be included in this list should be submitted to the Stroke Editorial Office by

The BRAINS Study: Safety, Tolerability, and Dose-finding of Repinotan in Acute Stroke

  • P. TealF. SilverD. Simard
  • Medicine
    Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
  • 2005
The incidence of adverse events was comparable with all doses of repinotan and placebo, and no safety issues were observed, and a trend toward better tolerability with evidence of efficacy was observed with the rep inotan 1.25 mg/d dose.

Glucose potassium insulin infusions in the treatment of acute stroke patients with mild to moderate hyperglycemia: the Glucose Insulin in Stroke Trial (GIST).

GKI infusions can be safely administered to acute stroke patients with mild to moderate hyperglycemia producing a physiological but attenuated glucose response to acute strokes, the effectiveness of which remains to be elucidated.

Recommendations for the Management of Intracranial Haemorrhage – Part I: Spontaneous Intracerebral Haemorrhage

These recommendations are endorsed by the 3 European societies which are represented in the EUSI: the European Stroke Council, the European Neurological Society and the European Federation of Neurological Societies.