Speech therapy combined with a cerebroprotective agent enhances aphasia recovery after AIS: Results from the ESCAS study

Prof. Muresanu explained that Cerebrolysin is a biological multimodal drug composed of neuropeptides and amino acids that mimic natural neurotrophic factors. Unlike single-target chemical agents, Cerebrolysin acts pleiotropically, supporting both neuroprotection and neuroregeneration. This dual action mirrors the brain’s natural recovery sequence: protecting neurons first, then stimulating repair and reorganization.

Prof. Muresanu presented findings from the randomized, double-blind ESCAS (The Efficacy and Safety of Cerebrolysin in the Treatment of Aphasia After Acute Ischemic Stroke) study involving 132 stroke patients with non-fluent aphasia. Participants received either Cerebrolysin (30 ml daily for 10 days in three cycles) plus speech therapy, or placebo plus therapy. Results demonstrated significantly greater improvements in language (Western Aphasia Battery), neurological function (NIHSS – National Institutes of Health Stroke Scale) and activities of daily living (Barthel Index) in the Cerebrolysin group, particularly by day 90. The treatment was well tolerated, with no safety concerns reported.

He concluded that combining Cerebrolysin with early, targeted rehabilitation optimizes neuroplasticity and leads to superior recovery compared to rehabilitation alone. This approach aligns with European Academy of Neurology (EAN) recommendations supporting Cerebrolysin as an add-on therapy for moderate-to-severe stroke.