Neurorehabilitation Stroke

The role of Cerebrolysin in early motor rehabilitation of acute ischemic stroke patients

Recently, a meta-analysis was published indicating  a beneficial effect of Cerebrolysin, a multimodal molecule, in the early rehabilitation of patients with acute ischemic stroke, enhancing motor function and improving neurological status. 

Recently, a meta-analysis was published indicating a beneficial effect of Cerebrolysin, a multimodal molecule, in the early rehabilitation of patients with acute ischemic stroke, enhancing motor function and improving neurological status. The meta-analysis focuses on two studies, CARS -1 and CARS-2, with identical design: in these two prospective, randomized, placebo-controlled trials, patients with acute stroke received Cerebrolysin, 30 ml per day, for 3 weeks, starting 24-72 hours after the ischemic stroke onset, together with 2 hours of standard rehabilitation. Study visits were performed at 7 days, 14 and 21 days after baseline and at 42 and 90 days post-stroke. The studies rely on the concept that a multimodal approach is needed for the treatment of acute ischemic stroke, in order to stimulate recovery in the acute but also in the subacute and chronic stages, and that Cerebrolysin has the appropriate characteristics to produce that effect. The primary end point for the meta-analysis as for the two studies, was ARAT score at 90 days compared to baseline. The final results were statistically significant, indicating a positive effect of Cerebrolysin on the motor recovery of stroke patients. NIH stroke scale (NIHSS) was also used to assess the early improvements, at 14 and 21 days, and a benefit for the patients treated with Cerebrolysin was observed with statistical significance. The corresponding number-needed-to-treat (NNT) for clinically relevant changes in early NIHSS was 7.1. According to the results of this meta-analysis, Cerebrolysin can be considered as a contributory therapeutic option to the early motor neurorecovery of patients with acute ischemic stroke.

References:
Guekht A, Vester J Heiss WD, Gusev E, Hoemberg V, Rahlfs VW, Bajenaru O, Popescu BO, Doppler E, Winter S, Moessler H, Muresanu D. Safety and efficacy of Cerebrolysin in motor function recovery after stroke: a meta-analysis of the CARS trials. Neurol Sci. 2017 Jul 13. doi: 10.1007/s10072-017-3037-z