Stroke最新文献

{"title":"Flipping the Script: Early Neurological Gains May Redefine Recovery Prognostication After Intracerebral Hemorrhage.","authors":"Miriam Quinlan, Susanne Muehlschlegel","doi":"10.1161/STROKEAHA.124.050306","DOIUrl":"10.1161/STROKEAHA.124.050306","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"628-630"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Conventional Stroke Risk Factors on Early- and Late-Onset Ischemic Stroke: A Mendelian Randomization Study.","authors":"Kevin T K Nguyen, Huichun Xu, Brady J Gaynor, Patrick F McArdle, Timothy D O'Connor, James A Perry, Bradford B Worrall, Rainer Malik, Giorgio B Boncoraglio, Sally N Adebamowo, Ramin Zand, John W Cole, Steven J Kittner, Braxton D Mitchell","doi":"10.1161/STROKEAHA.124.048015","DOIUrl":"10.1161/STROKEAHA.124.048015","url":null,"abstract":"<p><strong>Background: </strong>Stroke incidence is decreasing in older ages but increasing in young adults. These divergent trends are at least partially attributable not only to diverging trends in stroke risk factors but may also be due to differences in the impact of stroke risk factors at different ages. To address this latter possibility, we used Mendelian randomization to assess differences in the association of stroke risk factors between early-onset ischemic stroke ([EOS]; onset 18-59 years) and late-onset ischemic stroke ([LOS]; onset ≥60 years).</p><p><strong>Methods: </strong>We identified genetic variants from the GWAS Catalog for use as instrumental variables to proxy conventional stroke risk factors and then estimated the effects of these variants on risk factors in younger and older individuals in the UK Biobank. We then used these estimates to estimate the causal effects of stroke risk factors on EOS (n=6728 cases) and LOS (n=9272) cases from SiGN (Stroke Genetic Network) and the EOSC (Early-Onset Stroke Consortium). Lastly, we compared odds ratios between EOS and LOS, stratified by TOAST (Trial of ORG 10172 in Acute Stroke Treatment) subtypes, to determine if differences between estimates could be attributed to differences in stroke subtype distributions.</p><p><strong>Results: </strong>EOS was associated with higher levels of body mass index, blood pressure, type 2 diabetes, and lower levels of HDL (high-density lipoprotein) cholesterol (all <i>P</i>≤0.002), whereas LOS was associated with higher levels of systolic blood pressure (<i>P</i>=0.0001). The causal effect of body mass index on stroke was significantly stronger for EOS than for LOS (odds ratio, 1.26 versus 1.03; <i>P</i>=0.008). After the subtype-stratified analysis, the difference in causal effect sizes between EOS and LOS for body mass index diminished and was no longer significant.</p><p><strong>Conclusions: </strong>These results support a causal relationship between body mass index, blood pressure, type 2 diabetes, and HDL cholesterol levels with EOS and blood pressure levels in LOS. Interventions that target these traits may reduce stroke risk.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":"56 3","pages":"640-648"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Academic Comprehensive Stroke Program in Ethiopia: A Model for Lower-Middle-Income Countries.","authors":"Wondwossen G Tekle, Tariku A Soboka, Fasika A Yohannes, Ameer E Hassan, Akeza Teame","doi":"10.1161/STROKEAHA.123.041392","DOIUrl":"10.1161/STROKEAHA.123.041392","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"e104-e107"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiology of Intracerebral Hemorrhage: Recovery Trajectories.","authors":"Lauren M Mai, Raed A Joundi, Aristeidis H Katsanos, Magdy Selim, Ashkan Shoamanesh","doi":"10.1161/STROKEAHA.124.046130","DOIUrl":"10.1161/STROKEAHA.124.046130","url":null,"abstract":"<p><p>Recovery trajectories in intracerebral hemorrhage (ICH) are recognized as distinct from those observed in ischemic stroke. This narrative review aims to clarify the pathophysiology underlying ICH recovery patterns, highlighting the unique timeline and nature of functional improvements seen in ICH survivors. Population-based cohort studies tracking functional outcomes in a longitudinal fashion, along with randomized clinical trial data with standardized outcome assessments, have demonstrated that ICH recovery generally has a delayed onset in the first weeks, followed by a steep early subacute stage recovery (typically up to 3 months) continuing in protracted, gradual improvements beyond 3 to 6 months. Understanding these recovery patterns, and how these differ from ischemic stroke, is crucial for providing accurate prognostic information, facilitating targeted health care delivery, and optimizing therapeutic interventions and the design of ICH randomized trials. This article synthesizes current evidence on early- and late-stage functional recovery trajectories in primary, spontaneous ICH and cognitive outcomes, emphasizing the clinical and research implications of these recovery patterns.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"783-793"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Reperfusion Injury a Largely Intra-Ischemic Injury?","authors":"Jean-Claude Baron","doi":"10.1161/STROKEAHA.124.049541","DOIUrl":"10.1161/STROKEAHA.124.049541","url":null,"abstract":"<p><p>Reperfusion injury (RI) refers to an array of detrimental cellular and biochemical processes that are widely believed to be triggered by reperfusion following focal cerebral ischemia and to contribute to infarct extension and poor outcome despite complete recanalization. Accordingly, it is widely recommended that therapies targeting RI be administered after recanalization. The present topical review demonstrates, however, that the vast majority of, and possibly all, processes considered part of RI are not actually provoked by reperfusion but develop during the ischemic phase. This notion has significant implications for clinical trials. Thus, for optimal efficacy, treatments targeting RI should accordingly be started before recanalization. Conversely, interventions aimed at protecting the ischemic penumbra, either pharmacological or nonpharmacological, during arterial occlusion are likely to also benefit RI-related processes and should probably be continued after recanalization. Overall, that RI is largely an intra-ischemic process has important ramifications for drug development as well as clinical trials, and more broadly for the management of hyperacute ischemic stroke patients prior to, and following, recanalization.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"777-782"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subacute Neurological Improvement Predicts Favorable Functional Recovery After Intracerebral Hemorrhage: INTERACT2 Study.","authors":"Shoujiang You, Danni Zheng, Xiaoying Chen, Xia Wang, Menglu Ouyang, Qiao Han, Yongjun Cao, Candice Delcourt, Lili Song, Cheryl Carcel, Hisatomi Arima, Chun-Feng Liu, Richard I Lindley, Thompson Robinson, Craig S Anderson, John Chalmers","doi":"10.1161/STROKEAHA.124.048847","DOIUrl":"10.1161/STROKEAHA.124.048847","url":null,"abstract":"<p><strong>Background: </strong>The frequency and prognostic significance of subacute neurological improvement (SNI) on 90-day outcomes after acute intracerebral hemorrhage are unknown.</p><p><strong>Methods: </strong>Secondary analyses of participant data from the INTERACT2 trial (Second Intensive Blood Pressure Reduction in Acute Intracerebral Hemorrhage Trial). SNI included any, moderate, significant, and substantial neurological improvement defined as ≥1, ≥2, ≥3, and ≥4 points decrease, respectively, on the National Institutes of Health Stroke Scale from 24 hours to 7 days after intracerebral hemorrhage. Logistic regression models were used to assess associations of SNI and death or major disability (modified Rankin Scale score of 3-6), major disability (modified Rankin Scale scores, 3-5), and death alone at 90 days. Data are reported as odds ratios and 95% CIs.</p><p><strong>Results: </strong>Of 2571 patients included in analyses, 1492 (58.0%), 1057 (41.1%), 731 (28.4%), and 490 (19.1%) patients experienced any, moderate, significant, and substantial SNI (24 hours to 7 days) after intracerebral hemorrhage, respectively. After adjustment for key confounders, any SNI was associated with 49%, 25%, and 65% reduced odds of death or major disability (odds ratio, 0.51 [95% CI, 0.42-0.63]), major disability alone (odds ratio, 0.75 [95% CI, 0.63-0.90]), and death (odds ratio, 0.35 [95% CI, 0.24-0.50]), respectively. Moderate, significant, and substantial SNI were also significantly associated with decreased odds of death or major disability at 90 days. The relationship between any SNI and study outcomes was consistent in most subgroups, including age and baseline hematoma volume. Early intensive blood pressure-lowering treatment did not increase the odds of SNI.</p><p><strong>Conclusions: </strong>SNI from 24 hours to 7 days is common after intracerebral hemorrhage and predicts a lower likelihood of death or major disability.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT00716079.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"621-627"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten-Year Trends in Last Known Well to Arrival Time in Acute Ischemic Stroke Patients: 2014 to 2023.","authors":"Nicholas G Ferrone, Maria X Sanmartin, Joseph O'Hara, Sophia R Ferrone, Jason J Wang, Jeffrey M Katz, Pina C Sanelli","doi":"10.1161/STROKEAHA.124.049169","DOIUrl":"10.1161/STROKEAHA.124.049169","url":null,"abstract":"<p><strong>Background: </strong>Many national initiatives focus on promoting early hospital arrival of patients with acute ischemic stroke (AIS) because treatment effectiveness is time-dependent. However, several studies reported time-delays in hospital arrival, especially during the COVID-19 pandemic. Our purpose was to evaluate the 10-year trends in last known well to arrival (LKWA) time and assess disparities in patients with AIS.</p><p><strong>Methods: </strong>A retrospective study of consecutive patients with AIS in the United States admitted to a large, socioeconomically diverse health care system in the New York metropolitan area was performed from 2014 to 2023. LKWA time groups were categorized according to treatment eligibility: 0 to 4.5, >4.5 to 24, and >24 hours. Demographic and clinical characteristics, treatment utilization, and modified Rankin Scale at discharge were extracted from electronic health records. Trend, bivariable, and multivariable logistic regression analyses were conducted.</p><p><strong>Results: </strong>A total of 11 563 patients with AIS were included with 53% (6163) LKWA 0 to 4.5, 34% (3988) LKWA >4.5 to 24, and 12% (1412) LKWA >24 groups. From 2014 to 2023, there was a significant downtrend in the early LKWA 0 to 4.5 (61%-46%) with uptrends in the later LKWA >4.5 to 24 (31%-43%) and LKWA >24 (8%-11%) groups (<i>P</i><0.001). In the LKWA >4.5 groups, the gap widened between racial categories after COVID (2021-2023; <i>P</i>=0.004). Compared with LKWA 0 to 4.5, the LKWA >4.5 to 24 group was less likely to receive endovascular thrombectomy (<i>P</i><0.001) and more likely to have worse outcomes (modified Rankin Scale, 2-5; <i>P</i><0.001). LKWA >4.5 groups were more likely to be older >80 years of age (odds ratio, 1.33 [95% CIs, 1.11-1.58]), men (1.11 [1.03-1.20]), Black patients (1.21 [1.09-1.34]), Asian patients (1.20 [1.03-1.39]), Medicaid insurance (1.18 [1.08-1.29]), and low-income <$80 000 (1.39 [1.20-1.61]).</p><p><strong>Conclusions: </strong>In the past decade, there was a significant uptrend in patients with AIS arriving in the late LKWA >4.5 groups. Socioeconomic disparities were observed with a persistent uptrend in non-White patients in the late LKWA >4.5 groups after the COVID pandemic. These findings highlight the need to implement targeted efforts to improve disparities in LKWA time in patients with AIS.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"591-602"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Duration of Dual Antiplatelet Therapy After Carotid Artery Stenting: A Nationwide Cohort Study.","authors":"Joonsang Yoo, Hyunsun Lim, Kwon-Duk Seo","doi":"10.1161/STROKEAHA.124.048743","DOIUrl":"10.1161/STROKEAHA.124.048743","url":null,"abstract":"<p><strong>Background: </strong>Carotid artery stenting (CAS) is an alternative treatment for patients with carotid artery stenosis who are not eligible for carotid endarterectomy. Dual antiplatelet therapy (DAPT) after CAS aims to prevent ischemic stroke. However, its optimal duration remains unclear. We aimed to determine the optimal duration of DAPT by identifying the differences in clinical events that occur depending on the DAPT maintenance period.</p><p><strong>Methods: </strong>Data were obtained from the nationwide database of the Korean Health Insurance Review and Assessment Service between 2007 and 2019. Patients who received CAS, as identified by procedure codes, were divided into 2 groups according to the duration of DAPT (aspirin and clopidogrel): those who maintained DAPT for at least 90 days but for <6 months (short-DAPT group) and those who maintained it for longer (long-DAPT group). The primary outcome was a composite of ischemic stroke, gastrointestinal bleeding, and intracranial hemorrhage within 12 months of switching to single antiplatelet therapy. Statistical analyses used inverse probability of treatment weighting to balance baseline characteristics, with Cox regression and Fine and Gray competing risk models used to assess outcomes.</p><p><strong>Results: </strong>Of the 12 034 patients who underwent CAS, 2529 and 9505 were assigned to the short-DAPT and long-DAPT groups, respectively. In the short-DAPT group, ischemic stroke, gastrointestinal bleeding, and intracranial hemorrhage occurred in 41 (1.6%), 22 (0.9%), and 4 (0.2%) patients, respectively. In the long-DAPT group, ischemic stroke, gastrointestinal bleeding, and intracranial hemorrhage occurred in 108 (1.1%), 87 (0.9%), and 4 (0.04%) patients, respectively. The primary outcome did not differ significantly between the groups (2.5% versus 2.1%; adjusted hazard ratio of long-DAPT to short-DAPT, 0.869 [95% CI, 0.652-1.158]; <i>P</i>=0.337).</p><p><strong>Conclusions: </strong>Short-duration DAPT can be recommended, as it does not differ from long-duration DAPT in terms of clinical efficacy and adverse events after CAS.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"613-620"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Intermittent Hypoxia in People Living With Chronic Stroke: A Case Series.","authors":"Gregory E P Pearcey, Alexander J Barry, Milap S Sandhu, Timothy J Carroll, Elliot J Roth, W Zev Rymer","doi":"10.1161/STROKEAHA.124.046620","DOIUrl":"https://doi.org/10.1161/STROKEAHA.124.046620","url":null,"abstract":"<p><strong>Background: </strong>Acute intermittent hypoxia (AIH) is a novel therapeutic intervention that facilitates recovery of function, but the tolerability and effectiveness have not been tested in people living with chronic stroke. The purpose here was to examine whether AIH is tolerable and effective in this population.</p><p><strong>Methods: </strong>Ten participants with a unilateral, hemispheric stroke were assessed before and after 4 sessions of AIH separated by ≥48 hours in a case series at Shirley Ryan AbilityLab (Chicago). Physician-assessed signs and symptoms (assessed via: repeated symptom reviews, National Institutes of Health Stroke Scale, cranial nerve assessment, a muscle strength test, the Brunnstrom scale, sensory changes, reflexes, assessment of heart and lung status, Fugl-Meyer test, Chedoke-McMaster Stroke Assessment, Modified Ashworth Scale for Spasticity, and Delis Kaplan Executive Function System Color-Word Interference Test) and bilateral upper limb strength (grip and elbow flexion) were assessed before, ≈15 to 30 minutes, and ≈60 minutes after the intervention.</p><p><strong>Results: </strong>AIH was well-tolerated and there were no adverse events observed. After AIH, grip strength (12.91% and 16.53% improvement at 30 and 60 minutes post-AIH, respectively) and elbow flexion force (5.87% and 7.01% improvement at 30 and 60 minutes post-AIH, respectively) improved in the more-affected limb.</p><p><strong>Conclusions: </strong>AIH is potentially safe and effective for improving strength in the more-affected limb in people living with hemiparetic stroke. Future work should explore the use of AIH to enhance task-specific training-induced plasticity.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04019522.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech Therapy Combined With Cerebrolysin in Enhancing Nonfluent Aphasia Recovery After Acute Ischemic Stroke: ESCAS Randomized Pilot Study.","authors":"Volker Homberg, Dragoș Cătălin Jianu, Adina Stan, Ștefan Strilciuc, Vlad-Florin Chelaru, Michał Karliński, Michael Brainin, Wolf Dieter Heiss, Dafin F Muresanu, Pamela M Enderby","doi":"10.1161/STROKEAHA.124.049834","DOIUrl":"https://doi.org/10.1161/STROKEAHA.124.049834","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Stroke-induced aphasia significantly impacts communication and quality of life. Despite the standard treatment being speech and language therapy, outcomes vary, highlighting the need for additional therapies. Cerebrolysin, a neuroprotective and neurotrophic agent, has shown potential in stroke management. This study addresses the notable gap in research about the combined use of Cerebrolysin and speech therapy, evaluating their synergistic potential in the treatment of aphasia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The ESCAS trial (The Efficacy and Safety of Cerebrolysin in the Treatment of Aphasia After Acute Ischemic Stroke), a prospective, randomized-controlled, double-blinded study was conducted in 2 Romanian stroke centers. Participants included those with left middle cerebral artery territory ischemic stroke and nonfluent aphasia, enrolled 3 to 5 days poststroke. Inclusion criteria were right-handedness and Romanian as the mother tongue. Participants received Cerebrolysin or a placebo combined with speech and language therapy in 10-day cycles over 3 intervals, and evaluations were done at baseline, 30, 60, and 90 days respectively. The main outcome measure was Western Aphasia Battery for language function. Changes at days 30, 60, and 90 compared with baseline were quantified, and the effect estimand used was the difference in means between groups. Secondary outcome measurements were the National Institutes of Health Stroke Scale for neurological deficit, the modified Rankin Scale for global disability, and the Barthel Index for activities of daily living.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 132 enrolled patients, 123 were included in the intention-to-treat analysis, and 120 in the per-protocol analysis. Overall, both groups showed improvement at subsequent visits compared with the baseline for Western Aphasia Battery and the National Institutes of Health Stroke Scale. The Cerebrolysin group showed greater improvements in Western Aphasia Battery (visit 4 mean increase of 35.579±16.316 [95% CI, 31.289-39.869] points; &lt;i&gt;P&lt;/i&gt;&lt;0.001) compared with the placebo group (20.774±12.486 [95% CI, 17.603-23.945] points; &lt;i&gt;P&lt;/i&gt;&lt;0.001), a difference in means of 14.805 (95% CI, 9.521-20.089) points (&lt;i&gt;P&lt;/i&gt;&lt;0.001). The Cerebrolysin group also showed significant improvements (higher decreases) in National Institutes of Health Stroke Scale scores compared with the placebo group (2.085 [95% CI, 1.076-3.094] points; &lt;i&gt;P&lt;/i&gt;&lt;0.001). Safety analysis raised no concerns (number of patients with adverse events &lt;i&gt;P&lt;/i&gt;=0.105, number of adverse events per patient &lt;i&gt;P&lt;/i&gt;=0.134). Additionally, the Cerebrolysin group showed greater improvements in functional independence (Barthel Index) and a trend toward reduced disability (modified Rankin Scale) compared with the placebo group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Cerebrolysin combined with speech and language therapy offers promising potential for enhancing recovery in poststroke n","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}