Cerebrolysin combined with rehabilitation promotes motor recovery in patients with severe motor impairment after stroke

No clue on what the mechanism of action is that would deliver these better results. Just saying it is neuroprotective is worthless puffery if you have no clue why it works.
http://bmcneurol.biomedcentral.com/articles/10.1186/s12883-016-0553-z

• Won Hyuk Chang†,
• Chang-hyun Park†,
• Deog Young Kim,
• Yong-Il Shin,
• Myoung-Hwan Ko,
• Ahee Lee,
• Shin Yi Jang and
• Yun-Hee KimEmail author

†Contributed equally

BMC NeurologyBMC series – open, inclusive and trusted201616:31

DOI: 10.1186/s12883-016-0553-z

©  Chang et al. 2016

Received: 23 June 2015

Accepted: 25 February 2016

Published: 2 March 2016

Open Peer Review reports

Abstracts

Background

Cerebrolysin is a neuropeptide preparation with neuroprotective and neurorestorative effects. Combining Cerebrolysin treatment with a standardized rehabilitation program may have a potential synergistic effect in the subacute stage of stroke. This study aims to evaluate whether Cerebrolysin provides additional motor recovery on top of rehabilitation therapy in the subacute stroke patients with moderate to severe motor impairment.

Methods

This phase IV trial was designed as a prospective, multicenter, randomized, double-blind, placebo-controlled, parallel-group study. A total of 70 patients (Cerebrolysin n = 35, placebo n  = 35) with moderate to severe motor function impairment were included within 7 days after stroke onset and were randomized to receive a 21-day treatment course of either Cerebrolysin or placebo, given in addition to standardized rehabilitation therapy. Assessments were performed at baseline, immediately after treatment as well as 2 and 3 months after stroke onset. The plasticity of motor system was assessed by diffusion tensor imaging and with resting state functional magnetic resonance imaging.

Results

Both groups demonstrated significant improvement in motor function (p  < 0.05); however, no significant difference was found between the two groups. In the stroke patients with severe motor impairment, the Cerebrolysin group exhibited significantly more improvement in motor function compared with the placebo group (p  < 0.05). Effects of Cerebrolysin were demonstrated as restricted increments of corticospinal diffusivity and as recovery of the sensorimotor connectivity.

Conclusion

The combination of standard rehabilitation therapy with Cerebrolysin treatment in the subacute stroke has shown additional benefit on motor recovery and plastic changes of the corticospinal tract in patients with severe motor impairment.

Trial registration

NCT01996761 (November 5, 2013)