4. Discussion
subacute stroke stage, post-stroke, upper extremity motor impairment, motor impairment, acute ischemic stroke, sub-acute stroke
The present study aimed to investigate the effects of a three-week intravenous administration of Cerebrolysin added to the conventional rehabilitation treatment of patients at the early stage of severe sub-acute stroke compared to rehabilitation treatment only. This study’s results have shown that adding Cerebrolysin reduced paretic upper extremity motor impairment and improved functional ability better than rehabilitation treatment alone.We included patients with severe motor impairment in the early subacute post-stroke phase. Based on animal models and human studies, the data suggest that the subacute stroke stage is characterized by heightened plasticity and neural reorganization, and presents the most critical period for modification by rehabilitation treatment [In our study, the Cerebrolysin group showed a 2.6 (±1.1)-point improvement in NIHSS score after the therapy and a 5.6 (±1.5)-point improvement in the mean NIHSS score at 90-day follow-up; the placebo group only showed 1.6 (±0.7)-point improvement after the therapy and a 3.0 (±0.8)-point improvement after the 90-day follow-up. Additionally, a meta-analysis of nine randomized trials by Bornstein NM and colleagues demonstrated the treatment efficacy of Cerbolysin compared to placebo through changes in NIHSS greater than four points or the resolution of symptoms [However, some clinical studies have reported mixed evidence of Cerebrolysin’s benefit in improving recovery in acute ischemic stroke and safety characteristics. A recent meta-analysis [