Neurorepair versus Neuroprotection in Stroke

• Published in: Cerebrovascular diseases (Basel, Switzerland) Vol. 21; no. Suppl 2; pp. 54 - 63
• Main Authors: Hurtado, Olivia, Pradillo, Jesus M., Alonso-Escolano, David, Lorenzo, Pedro, Sobrino, Tomás, Castillo, José, Lizasoain, Ignacio, Moro, María Angeles
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.05.2006
• Subjects: Animals; Brain - drug effects; Brain - pathology; Brain - physiopathology; Cell Differentiation; Cell Movement; Cell Proliferation; Clinical Trials as Topic; Combined Modality Therapy; Cytidine Diphosphate Choline - pharmacology; Cytidine Diphosphate Choline - therapeutic use; Dopamine Agents - pharmacology; Dopamine Agents - therapeutic use; Humans; Neuronal Plasticity; Neurons - drug effects; Neurons - pathology; Neuroprotective Agents - pharmacology; Neuroprotective Agents - therapeutic use; Regenerative Medicine - trends; Serotonin Uptake Inhibitors - pharmacology; Serotonin Uptake Inhibitors - therapeutic use; Stem Cell Transplantation; Stem Cells - cytology; Stem Cells - drug effects; Stroke - pathology; Stroke - physiopathology; Stroke - therapy; Stroke Rehabilitation; Stroke, recovery; Cerebral ischemia; Brain plasticity; Neurogenesis; Stroke, neurorepair vs. neuroprotection
• ISBN: 380558122X; 9783805581226
• ISSN: 1015-9770; 1421-9786
• DOI: 10.1159/000091704

Stroke is the second to third leading cause of death and the main cause of severe, long-term disability in adults. However, treatment is almost reduced to fibrinolysis, a therapy useful in a low percentage of patients. Given that the immediate treatment for stroke is often unfeasible in the clinical setting, the need for new therapy strategies is imperative. After stroke, the remaining impairment in functions essential for routine activities, such as movement programming and execution, sensorimotor integration, language and other cognitive functions have a deep and life-long impact on the quality of life. An interesting point is that a slow but consistent recovery can be observed in the clinical practice over a period of weeks and months. Whereas the recovery in the first few days likely results from edema resolution and/or from reperfusion of the ischemic penumbra, a large part of the recovery afterwards is due mainly to brain plasticity, by which some regions of the brain assume the functions previously performed by the damaged areas. Neurogenesis and angiogenesis are other possible mechanisms of recovery after stroke. An understanding of the mechanisms underlying functional recovery may shed light on strategies for neurorepair, an alternative with a wide therapeutic window when compared with neuroprotective strategies.