Toward a multimodal neuroprotective treatment of stroke.

Title
Toward a multimodal neuroprotective treatment of stroke.

Source
Stroke. 37(4):1129-36, 2006 Apr.

BACKGROUND AND PURPOSE:

Stroke remains a common medical problem with importance attributable to the demographic changes in industrialized societies.

SUMMARY OF REVIEW:

After years of setbacks, acute stroke therapy has finally emerged, including thrombolysis with tissue plasminogen activator (t-PA). However, t-PA treatment is limited by a narrow time window and side effects, so that only 3% of all stroke patients receive thrombolysis. Unimodal targeting of key events in stroke pathophysiology was not effective in providing long-term benefits, leading to negative results in previous clinical neuroprotective stroke trials. A successful future stroke therapy should approach multiple pathophysiological mechanisms besides revascularization at once, including reduction of t-PA-related side effects, prevention of cell death, stimulation of neuroregeneration, and plasticity.

CONCLUSIONS:

Strategies targeting these processes include multiple combination therapies as well as treatment with multimodal drugs that interact with these mechanisms.