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)