Review

The Past and Future of Neuroprotection in Cerebral Ischaemic Stroke
Ashfaq Shuaib, Muhammad S. Hussain

Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Alta., Canada

Address of Corresponding Author

Eur Neurol 2008;59:4-14 (DOI: 10.1159/000109254)

  Key Words

• Neuroprotection
• Stroke
• Ischaemia

  Abstract

Following the realization that cerebral tissue may survive for hours after an ischaemic insult, several agents with neuroprotective properties in small-animal models of cerebral ischaemia have been tested in patients with acute ischaemic stroke (AIS). Initial attempts at translating the positive effects of these agents from animal models to patients were unsuccessful, possibly as a result of poorly planned experiments in models of ischaemia, and/or clinical trials of AIS that were not optimized to show a positive effect. Newer neuroprotective agents that are believed to act later in the ischaemic cascade may offer a greater chance of success. However, before these agents can be introduced into clinical practice they must undergo assessment in rodent and large-animal models of AIS and, in particular, the dose-response relationship and the treatment time window should be defined. This should be followed by evaluation in carefully designed clinical trials of adequate power, involving subjects receiving an appropriate dose within an optimum time window following the onset of symptoms. There is hope that such careful strategies may guide continued progress in neuroprotective drug development.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Prof. Ashfaq Shuaib, MD, FRCPC, FAHA
2E3.13 Walter Mackenzie Center
University of Alberta
Edmonton, Alta. T6G 2B7 (Canada)
Tel. +1 780 407 6395, Fax +1 780 407 1325, E-Mail ashfaq.shuaib@ualberta.ca

  Article Information

Received: September 6, 2006
Accepted: April 13, 2007
Published online: October 4, 2007
Number of Print Pages : 11
Number of Figures : 3, Number of Tables : 2, Number of References : 65