Neuroprotective Treatment

Neuroprotective treatment includes therapeutic strategies aimed at preserving neuronal structure and function and preventing cell death in neurological diseases, trauma, or neurodegeneration.

Goal: Limit neuronal damage, promote recovery, and improve functional outcome.
Critical timing: Most effective when initiated early (“time is brain”).
Pathophysiological targets:
- Oxidative stress
- Excitotoxicity
- Inflammation
- Mitochondrial dysfunction
- Apoptosis
- Blood-brain barrier disruption

Class	Examples	Mechanism of Action
NMDA receptor antagonists	Memantine, Ketamine	Block glutamate-induced excitotoxicity
Antioxidants	Edaravone, N-acetylcysteine	Reduce oxidative damage
Anti-inflammatory agents	Minocycline, Corticosteroids	Suppress microglial activation and cytokine release
Mitochondrial stabilizers	Coenzyme Q10, Creatine	Improve mitochondrial energy production
Calcium channel blockers	Nimodipine	Prevent intracellular calcium overload
Therapeutic hypothermia	Induced cooling	Decrease metabolism and inflammation

Stem cell therapy – Promotes regeneration and neurotrophic support
Gene therapy – Modulates gene expression toward neuroprotection
Exosome or miRNA delivery – Modifies intercellular signaling for survival
Remote ischemic conditioning – Activates endogenous protective pathways
Preconditioning protocols – Mild stress to build cellular resilience

Disease	Neuroprotective Approach
Stroke	rtPA + edaravone (in some countries), hypothermia (experimental)
Parkinson’s Disease	MAO-B inhibitors, CoQ10, experimental agents
Alzheimer’s Disease	Antioxidants, anti-amyloid drugs, lifestyle interventions
Traumatic Brain Injury	Hypothermia, neurohormonal therapies, early rehab
Multiple Sclerosis	Early disease-modifying therapies (DMTs)
Intracerebral Hemorrhage	Agents under research: deferoxamine, minocycline, miR-210