Neuroprotection for Ischemic Stroke
----Two Decades of Success and Failure
 
Yu Dennis Cheng, Lama Al-Khoury, and Justin A. Zivin
Stroke Center, University of California School of Medicine, and University of California San Diego, La Jolla, California, 92093-0624
 
Abstract
Alteplase (rt-PA) is the first therapy successfully developed for acute stroke therapy. The success of rt-PA spurred development of new avenues for acute stroke management. For the last two decades, a great deal of attention has been paid to neuroprotective therapies. Initial preclinical studies demonstrated numerous drugs are effective for treating acute stroke in animal models; however, subsequent clinical trials have been frustrating, and none of the agents has proven effective. The various outcomes of preclinical and clinical trials have been the subject of much discussion. In this presentation, we review some key neuroprotective trials and the possible reasons for their failures. By identifying the discrepancies between preclinical studies and clinical trials, we may be able to set guidelines for future effective trials.
Keywords: Neuroprotection trials, glutamate antagonists, anti-inflammatory agents, ion channel blocks, free radical scavengers, neurotrophic factors, neural stem cells.

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