Resilience to Injury: A New Approach to Neuroprotection?

Despite thousands of neuroprotectants demonstrating promise in preclinical trials, a neuroprotective therapeutic has yet to be approved for the treatment of acute brain injuries such as stroke or traumatic brain injury. Developing a more detailed understanding of models and populations demonstrating...

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Bibliographic Details
Published in:Neurotherapeutics 2020-04, Vol.17 (2), p.457-474
Main Authors: Singhal, Neel S., Sun, Chung-Huan, Lee, Evan M., Ma, Dengke K.
Format: Article
Language:English
Subjects:
Adaptation
Adaptation, Physiological
Animal models
Animals
Biomedical and Life Sciences
Biomedicine
Brain Diseases
Clinical trials
Humans
Neurobiology
Neurology
Neuroprotection
Neurosciences
Neurosurgery
Patients
Review
Traumatic brain injury
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Summary:Despite thousands of neuroprotectants demonstrating promise in preclinical trials, a neuroprotective therapeutic has yet to be approved for the treatment of acute brain injuries such as stroke or traumatic brain injury. Developing a more detailed understanding of models and populations demonstrating “neurological resilience” in spite of brain injury can give us important insights into new translational therapies. Resilience is the process of active adaptation to a stressor. In the context of neuroprotection, models of preconditioning and unique animal models of extreme physiology (such as hibernating species) reliably demonstrate resilience in the laboratory setting. In the clinical setting, resilience is observed in young patients and can be found in those with specific genetic polymorphisms. These important examples of resilience can help transform and extend the current neuroprotective framework from simply countering the injurious cascade into one that anticipates, monitors, and optimizes patients’ physiological responses from the time of injury throughout the process of recovery. This review summarizes the underpinnings of key adaptations common to models of resilience and how this understanding can be applied to new neuroprotective approaches.
ISSN:1933-7213
1878-7479
1878-7479
DOI:10.1007/s13311-020-00832-7