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Neuroprotective effect of magnesium supplementation on cerebral ischemic diseases
Runnan Xu1, Liping Wang2, Liyuan Sun1
1Department of Guangxi Key Laboratory of Brain and Cognitive Neuroscience, Guilin Medical University, Guilin, Guangxi 541004, China.
Insights
Magnesium shows neuroprotective effects for cerebral ischemia in basic studies, but clinical trials show mixed results. Further research is needed to optimize magnesium supplementation strategies for ischemic stroke treatment.
Area of Science:
- Neuroscience
- Pharmacology
- Neurology
Background:
- Ischemic encephalopathy, particularly ischemic stroke, has high mortality and disability rates.
- Current treatments like revascularization have limitations, including strict time windows for thrombolytic therapy.
- Effective neuroprotective drugs are crucial for improving outcomes in ischemic stroke patients.
Purpose of the Study:
- To review basic and clinical studies on magnesium supplementation for cerebral ischemia.
- To summarize potential influencing factors affecting magnesium ion intervention in cerebral ischemia.
- To propose future research directions for magnesium-based therapies.
Main Methods:
- Review of basic and clinical studies on magnesium supplementation in cerebral ischemia.
- Categorization of magnesium administration routes: intraperitoneal, intravenous, arterial, and intracranial.
- Analysis of factors influencing magnesium's neuroprotective effects.
Main Results:
- Basic studies suggest magnesium supplementation benefits cerebral ischemia.
- Large clinical trials using intravenous magnesium have not shown improved prognosis for ischemic patients.
- Various administration routes and influencing factors were identified.
Conclusions:
- Magnesium's role in treating cerebral ischemia requires further investigation due to conflicting study results.
- Optimizing magnesium administration routes and considering combination therapies are key.
- Future research should explore novel strategies like combined intraventricular and circulatory magnesium supplementation, or magnesium with hypothermia.
Abstract:
Ischemic encephalopathy is associated with a high mortality and rate of disability. The most common type of ischemic encephalopathy, ischemic stroke, is the second leading cause of death in the world. At present, the main treatment for ischemic stroke is to reopen blocked blood vessels. However, despite revascularization, many patients are not able to achieve good functional results. At the same time, the strict time window (<4.5 h) of thrombolytic therapy limits clinical application. Therefore, it is important to explore effective neuroprotective drugs for the treatment of ischemic stroke. Magnesium is a natural calcium antagonist, which exerts neuroprotective effects through various mechanisms. However, while most basic studies have shown that magnesium supplementation can help treat cerebral ischemia, intravenous magnesium supplementation in large clinical trials has failed to improve prognosis of ischemic patients. Therefore, we review the basic and clinical studies of magnesium supplementation for cerebral ischemia. According to the route of administration, treatment can be divided into intraperitoneal magnesium supplementation, intravenous magnesium supplementation, arterial magnesium supplementation and intracranial magnesium supplementation. We also summarized the potential influencing factors of magnesium ion intervention in cerebral ischemia injury. Finally, in combination with influencing factors derived from basic research, this article proposes three future research directions, including magnesium supplementation into the circulatory system combined with magnesium supplementation in the lateral ventricle, magnesium supplementation in the lateral ventricle combined with hypothermia therapy, and lateral ventricle magnesium supplementation combined with intracarotid magnesium supplementation combined with selective hypothermia.
