Evaluating the Effectiveness of Neuroprotective Strategies in Enhancing Post-stroke Recovery: A Systematic Review of Meta-Analyses and Clinical Trials.

Autor:	Hassan BD; College of Medicine, Hawler Medical University, Erbil, IRQ., Dabas MM; General Surgery, University of Jordan, Amman, JOR., Kanemitsu K; Clinical Sciences, Windsor University School of Medicine, Chicago, USA., Faran N; Internal Medicine, Fatima Memorial Hospital, Lahore, PAK., Abbas T; Internal Medicine, Nishtar Medical University, Multan, PAK.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Oct 12; Vol. 16 (10), pp. e71343. Date of Electronic Publication: 2024 Oct 12 (Print Publication: 2024).
DOI:	10.7759/cureus.71343
Abstrakt:	This systematic review evaluates the effectiveness of various neuroprotective strategies in enhancing recovery following acute ischemic stroke, focusing on interventions such as normobaric oxygen (NBO), lithium, selective serotonin reuptake inhibitors (SSRIs), and Cerebrolysin. Drawing upon data from six primary studies, including randomized controlled trials (RCTs) and meta-analyses, we assessed these therapies' impact on functional outcomes, motor recovery, and neurological improvement. Normobaric oxygen, across 12 RCTs, demonstrated limited efficacy in improving recovery outcomes or reducing mortality. Lithium, supported by animal models but with inconclusive human data, showed potential in reducing stroke volume but did not significantly enhance functional recovery in clinical trials. SSRIs, particularly fluoxetine, showed moderate success in improving motor recovery, as evidenced by the FLAME (Fluoxetine for Motor Recovery after Acute Ischaemic Stroke) trial and meta-analyses. Cerebrolysin demonstrated consistent improvement in early neurological function and motor recovery, with a number-needed-to-treat (NNT) of 7.1 for early NIHSS (National Institutes of Health Stroke Scale) score improvements. Our Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided search covered PubMed, Medline, Embase, and the Cochrane Library up to September 2024. These findings emphasize the mixed efficacy of these neuroprotective interventions and underscore the necessity for personalized treatment protocols and further large-scale, controlled trials to clarify their roles in clinical practice. This review contributes to the ongoing dialogue on optimizing post-stroke recovery and highlights the critical need for evidence-based neuroprotective strategies. Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Hassan et al.)
Databáze:	MEDLINE
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