Hermann Dirk M, Chopp Michael
Department of Neurology, University Hospital Essen, Essen, Germany.
Eur Neurol. 2014;72(5-6):317-25. doi: 10.1159/000365171. Epub 2014 Oct 16.
Profound cellular and biochemical remodeling processes occur in the brain following an ischemic stroke, raising the possibility that we may be able to promote neurological recovery by harnessing the brain's endogenous recovery processes with pharmacological or cell-based therapies. There is a compelling body of evidence that cerebral plasticity and neurological recovery can be stimulated in the post-acute ischemic brain in this manner.
This overview of neurorestorative therapies highlights the main challenges in their development, and summarizes the implications of these findings to stroke patients. Key Message: Neurorestorative therapies are a highly promising avenue of treatment for the restitution of neuronal networks damaged by stroke.
The key supporting data have so far been obtained using in vivo models in animals, underscoring the need to validate these findings in humans. For human studies, several potentially confounding variables should be kept in mind, including age, and the presence of risk factors and comorbidities (such as hyperlipidemia and diabetes). Stroke patients vary considerably in age and genetic background, as well as in the etiology, localization and size of brain infarcts. The choice of patient population is a critical factor in the success of clinical trials, as patient heterogeneity could mask any potential therapeutic benefits.
缺血性中风后，大脑会发生深刻的细胞和生化重塑过程，这增加了我们通过药物或细胞疗法利用大脑内源性恢复过程来促进神经恢复的可能性。有令人信服的证据表明，以这种方式可以刺激急性缺血性脑损伤后的大脑可塑性和神经恢复。
本神经修复疗法概述突出了其发展中的主要挑战，并总结了这些发现对中风患者的意义。关键信息：神经修复疗法是恢复中风受损神经网络的极有前景的治疗途径。
目前为止，关键的支持数据是通过动物体内模型获得的，这强调了在人体中验证这些发现的必要性。对于人体研究，应牢记几个可能产生混淆的变量，包括年龄以及风险因素和合并症（如高脂血症和糖尿病）的存在。中风患者在年龄、遗传背景以及脑梗死的病因、部位和大小方面差异很大。患者群体的选择是临床试验成功的关键因素，因为患者的异质性可能掩盖任何潜在的治疗益处。
