Stroke is a leading cause of serious long-term disability in adults and is the second leading cause of death worldwide. Early reperfusion and neuroprotection techniques have been the focus of much effort with the aim of very acute treatment of the
stroke. Targeting different mechanisms, pharmacological
therapies have the potential to reduce disability in a large fraction of patients who survive the
acute stroke. The brain's capacity to reorganize after
stroke through plasticity mechanisms can be modulated by pharmacological agents. A number of therapeutic interventions are under study, including small molecules,
growth factors, and
monoclonal antibodies. Recently it has been shown that the SSRI
fluoxetine improved motor deficit in patients with
ischaemic stroke and
hemiplegia which appeared to be independent of the presence of depression. In this context, it is of major importance to support innovative research in order to promote the emergence of new pharmacological treatments targeting neurological recovery after
stroke, as opposed to acute de-occlusion and neuroprotection. This paper is the work of a group of 14 scientists with aim of (1) addressing key areas of the basic and clinical aspects of human brain plasticity after
stroke and potential pharmacological targets for recovery, (2) asking questions about the most appropriate characteristics of clinical trials testing drugs in post
stroke recovery and (3) proposing recommendations for future clinical trials.