Department of General Biochemistry, Faculty of Biology and Environmental Protection. University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland.
Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa 14, 93-113 Lodz, Poland.
Curr Neuropharmacol. 2020;18(1):51-64. doi: 10.2174/1570159X17666190726104139.
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.
神经可塑性是大脑在整个生命过程中发生的自然过程。中风是全球长期残疾和巨大医疗和财政问题的主要原因。过去十年的研究主要集中在中风急性期的神经保护上，而针对慢性期的研究却很少。中风后的恢复取决于我们的大脑重新建立神经血管网络的结构和功能组织的能力。联合辅助治疗和药物可能会增强修复过程并恢复受损的大脑功能。目前，有一些药物和康复策略可以促进大脑修复并提高中风发作多年后的临床效果。此外，一些化合物，如胞磷胆碱、氟西汀、烟酸、左旋多巴等，已经在临床使用或正在进行临床试验。许多研究也在测试细胞疗法；在我们的综述中，我们重点关注了在中风早期应用细胞的研究。接下来，我们讨论药物干预。在这一节中，我们选择了认知、行为和身体康复的方法以及神经保护的辅助干预措施，包括非侵入性脑刺激和极低频电磁场。现代康复代表了一种新的物理干预模式，其治疗窗口在中风后长达六个月。然而，先前的研究表明，中风恢复的时间窗口比以前认为的要长得多。本综述试图介绍神经保护策略的进展，包括药物和非药物治疗，以刺激中风后患者的内源性神经可塑性。
