Neuroprotective strategies of cerebrolysin for the treatment of infants with neonatal hypoxic-ischemic encephalopathy

Acta Neurol Belg. 2021 Dec;121(6):1401-1406. doi: 10.1007/s13760-021-01795-y. Epub 2021 Sep 8.

Abstract

Background: Perinatal asphyxia (PA) is a devastating neonatal condition characterized by a lack of oxygen supporting the organ systems. PA can lead to hypoxic-ischemic encephalopathy (HIE), a brain dysfunction due to oxygen deprivation with a complex neurological sequela. The pathophysiology of HIE and PA is not entirely understood, with therapeutic hypothermia being the standard treatment with only limited value. However, alternative neuroprotective therapies can be a potential treatment modality.

Methods: In this review, we will characterize the biochemical mechanisms of PA and HIE, while also giving insight into cerebrolysin, a neuroprotective treatment used for HIE and PA.

Results: We found that cerebrolysin has up to 6-month treatment window post-ischemic insult. Cerebrolysin injections of 0.1 ml/kg of body weight twice per week were found to provide gross motor and speech deficit improvement.

Conclusion: Our literature search emphasizes the positive effects of cerebrolysin for general improvement outcomes. Nevertheless, biomarker establishment is warranted to improve patient outcomes.

Keywords: Cerebrolysin; Hypoxic–ischemic encephalopathy; Perinatal asphyxia.

Publication types

  • Review

MeSH terms

  • Amino Acids / pharmacology
  • Amino Acids / therapeutic use*
  • Asphyxia Neonatorum / complications
  • Asphyxia Neonatorum / drug therapy*
  • Asphyxia Neonatorum / physiopathology
  • Cerebrovascular Circulation / drug effects
  • Cerebrovascular Circulation / physiology
  • Humans
  • Hypoxia-Ischemia, Brain / drug therapy*
  • Hypoxia-Ischemia, Brain / etiology
  • Hypoxia-Ischemia, Brain / physiopathology
  • Infant, Newborn
  • Neuroprotective Agents / pharmacology
  • Neuroprotective Agents / therapeutic use*
  • Randomized Controlled Trials as Topic / methods
  • Treatment Outcome

Substances

  • Amino Acids
  • Neuroprotective Agents
  • cerebrolysin