[Neuropsychologic and clinical effects of protirelin tartrate in patients with stroke sequelae]

An ischemic cerebral lesion involves a progressive metabolic damage to neurons and neurotransmitter alterations. The consequent functional deficits give rise to the neurological and cognitive impairment seen in most stroke patients. As soon as neuronal loss brings synaptic activities to an end, a maximum release of neurotransmitters and peptides occurs, no longer balanced by effective synthesis activity. This unbalanced control of neurotransmitters causes the typical neurological and psychological disturbances of the post-stroke phase. In particular, the unbalance of the catecholaminergic and/or serotoninergic system seems to be related to emotional disturbances, whereas the cholinergic unbalance seems to be the cause of cognitive impairment (which is manifested in memory and learning capacity deficits). The recent demonstration that peptides also act as synaptic transmission modulators supplied the rationale to propose the use of neuropeptides as a substitutive therapy in many neurodegenerative pathologies and particularly in post-traumatic encephalopathies and stroke sequelae. Furthermore, one of these neuropeptides, protirelin, has been proved to have neurotransmitter and neuromodulator activities as well as being capable of inducing the functional maturity and regeneration of neurons and improving functional recovery and vigilance in cases of stroke sequelae. A double-blind multicenter trial versus placebo was therefore performed to evaluate the efficacy and tolerability of protirelin tartrate (TRH-T) in this pathology. The neuropsychological functions (attentiveness, learning capacity, memory) were evaluated in 136 patients with stroke sequelae, treated with TRH-T or with placebo.(ABSTRACT TRUNCATED AT 250 WORDS)