Stroke Recovery

20 Natural Agents Backed by Science to Prevent and Aid Stroke Recovery

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Research shows 20 natural substances like curcumin and therapies like music improve stroke outcomes by reducing risk factors, protecting brain cells, and aiding regeneration, without the concerning side effects of pharmaceuticals

Stroke is a leading cause of disability and death worldwide, with over 17 million new cases annually.[1] Unfortunately, current medical interventions like clot-busting pharmaceuticals have a very narrow treatment window and provide only modest benefits.[2] Rehabilitation efforts also have limited effectiveness at alleviating post-stroke cognitive, motor, and speech disorders over the longer term.[3]

Given these gaps, natural medicine has received increasing scientific scrutiny as a safe, affordable complementary approach. Abundant research now highlights the neuroprotective and restorative potential of certain nutritional supplements, herbal remedies, and mind-body practices. This review summarizes evidence for the 20 most promising natural adjunctive therapies for ischemic and hemorrhagic stroke.

Vitamin D

The “sunshine vitamin” tops stroke research with over 4,000 PubMed citations. Studies confirm vitamin D regulates cerebrovascular integrity and deficiency associates with increased risk.[4] Supplementation beyond routine requirements demonstrates neuroprotection and aids recovery, especially in those with pre-existing low vitamin D status.[5]

Omega-3 Fatty Acids  

Found abundantly in coldwater fish, omega-3s EPA and DHA enhance multiple mechanisms to preserve threatened penumbral tissue in acute stroke.[6] Omega-3 intake also significantly reduces incidence, perhaps more effectively than aspirin.[7] Animal research also indicates supplements augment post-stroke neuronal sprouting and remyelination.[8]

Curcumin

This vibrant yellow turmeric root compound exhibits versatile antioxidant, anti-inflammatory, and neural proliferative properties without concerning toxicity. Clinical investigations confirm oral curcumin improves recovery across a variety of outcome measures.[9] Parallel preclinical evidence shows protection equivalent to pharmaceuticals but with wider benefit and fewer contraindications.[10]  

Melatonin  

The pineal gland’s chronobiotic hormone displays immense experimental neuroprotective potential against complex pathophysiological processes driving ischemic damage and hemorrhagic conversion.[11] Studies also demonstrate melatonin powerfully stimulates endogenous regenerative activities like neurogenesis.[12]

Gingko Biloba

Concentrated leaf extracts boost cerebral blood flow and ATP production, while reducing inflammatory cytokine release.[13] Multiple meta-analyses confirm clinical efficacy and safety for neurocognitive symptoms of stroke and vascular dementia.[14] Proposed active biochemicals like ginkgolides curb apoptotic signaling cascades.[15]

Magnesium

This essential mineral governs cerebral vascular tone and neuronal excitability.[16] Higher dietary magnesium associates with significant reduction in multiple stroke risk factors as well as total incidence.[17] Peri-infarct intravenous administration confers robust protection from permanent damage in rodents.[18]

Resveratrol

The famed “red wine molecule” rescues neurons from ischemic brink through modulation of cell danger response pathways driving necrosis and apoptosis.[19] As a potent activator of longevity gene SIRT1, resveratrol also shows promise for alleviating broader central nervous system consequences.[20]  

Cannabinoids

Infarct-limiting and anti-edemic effects make manipulation of endogenous cannabinoid signaling highly attractive.[21] Select synthetic ligands also assist later phase recovery via oligodendrogenesis and other reparative processes.[22] Adjunct use warrants controlled investigation given practical complexities of modulating CB1/2 pathways.

Green Tea (EGCG)

Abundant experimental evidence and epidemiological data link habitual consumption to reduced risk of stroke incidence and severity.[23] This foremost catechin constituent augments angiogenesis and neurogenesis when administered post-ischemia.[24] EGCG also chelates free iron to hinder oxidative damage and calcium overload.[25]

Astaxanthin

Unlike other carotenoid antioxidants, this red pigment achieves blood-brain barrier permeability and concentrates in neuronal membranes.[26] There astaxanthin effectively scavenges singlet oxygen and attenuates inflammation. Studies demonstrate vascular and neuroprotective benefit in hypertensive stroke models.[27]

Linden Flower Tea

Used medicinally across cultures to reduce stress and anxiety, aromatic linden infusions exhibit anti-platelet characteristics and neural shielding effects from induced oxidative toxicity.[28] Experimental models confirm applicability for both primary prevention and cellular preservation post-ischemia.[29]

Citicoline  

This endogenous nucleotide compound integrates acetylcholine synthesis with membrane phospholipid metabolism to optimize neuronal bioenergetics.[30] Citicoline also mitigates excitotoxicity and stabilizes cellular membranes against oxidative stress. Multiple trials show improved recovery in ischemic stroke.[31]

Music Therapy  

Extensive research affirms short and long-term neurorehabilitation efficacy across motor, language, attention, and mood disorders.[32] Combined clinical and preclinical evidence suggest music uniquely engages perilesional areas and distant networks to enhance neuroplastic compensation.[33]

Acupuncture  

Repeated mechano-electrical stimulations amplify endogenous neurorepair activities partially via glial cell-mediated reorganization of neuronal connectivity.[34] RCT data and systematic reviews endorse acupuncture for sensory and motor recovery, dysphagia, spasticity, depression and decreased dependence.[35]

Meditation

Enhanced mental control over physiological responses improves cerebral circulation while ameliorating pathological processes implicated in vascular disease progression.[36] Imaging studies reveal meditation uniquely molds stress-reactive structures and strengthens modulatory higher cortical regions.[37]

Yoga

Gentle postures coordinated with breathing technique provide mild exertion together with mindfulness-based stress reduction.[38] Yogic movement therapies improve balance and gait in mobility disorders, while regular practice bolsters vascular health.[39] Adaptability suits various capacities and enables independent practice.  

Creative Arts Therapies

Painting, writing, or music engagement elicits complex cognition through emotional processing, executive planning, and associative memory integration in supportive, stimulating environments.[40] Arts therapies measurably aid language production, visual/spatial deficits, apraxia, neglect syndromes and mood disorders.[41]

Vinpocetine  

This derivative of vincamine and constituent of various plants acts as vasodilator and cerebral metabolic enhancer. Reviews validate applications for carotid atherosclerosis, stroke recovery, and prevention of age-related cognitive decline.[42] Good safety profile but limited human trial data warrants further research.

L-Carnitine

Best known as transporter of fatty acids into mitochondria for β-oxidation, evidence suggests supplemental L-carnitine protects neurons from ischemia-reperfusion injury.[43] Proposed mechanisms include stabilization of cell membranes, improved mitochondrial function, and reduced oxidative damage.[44]

Lion’s Mane Mushroom

Used traditionally in parts of Asia, research corroborates neuroregenerative and neuroprotective properties of bioactive fungal polysaccharides.[45] Both in vivo and clinical investigations affirm value for memory and cognitive disorders from vascular or other neurodegenerative etiologies.[46]

Rosemary

Carnosic acid and other antioxidant constituents confer potent anti-inflammatory, anti-apoptotic effects in neural tissues challenged by hypoxic/ischemic and neurotoxic insults.[47] Neural precursor proliferation and white matter lesion rebuilding shown in animal models awaits human validation.

Easing Sleep Apnea May Be Key to Stroke Recovery

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Sleep apnea is a known risk factor for stroke, and new research suggests that curbing the condition might also aid the recovery of people who’ve suffered a stroke or mini-stroke.

Patients in the study typically used the CPAP mask — “continuous positive airway pressure” — to ease their nighttime breathing difficulties.

The investigators found that, among stroke patients, “treatment of sleep apnea with CPAP therapy provides significant benefits, even greater than the benefits of tPA, the FDA-approved drug treatment for stroke,” said study lead researcher Dr. Dawn Bravata.

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“That’s a substantial clinical effect,” she said. “The added good news for stroke patients is that CPAP has been used as a sleep apnea therapy for many years, and it has an excellent safety record.” Bravata is a research scientist with the Regenstrief Institute and Roudebush VA Medical Center in Indianapolis.

According to the researchers, sleep apnea is common among people who’ve had a stroke or mini-stroke, but few are currently diagnosed and treated for the condition. It’s estimated that two out of three stroke patients are thought to have the condition, which causes irregular breathing during sleep. Sleep apnea can lead to low oxygen levels, high blood pressure and an irregular heartbeat.

In the new study, Bravata’s group tracked outcomes for 252 people who had experienced a stroke or mini-stroke (known as a transient ischemic attack, or TIA) for up to one year. Patients were treated at one of five different hospitals in two states.

The patients were randomly divided into three groups: a control group who received standard care without sleep apnea treatment; standard care plus CPAP therapy; or enhanced care with CPAP therapy. Patients who used CPAP did so for an average of 50 percent of nights.

The researchers reported that 59 percent of patients who received CPAP therapy showed marked improvement in their recovery, in terms of improvements in neurological symptoms. This compared with 38 percent of those who didn’t get CPAP.

Timing of therapy may be key, as well, the study authors said.

“Preliminary data suggests the sooner you treat sleep apnea in stroke patients with CPAP, the more potent the effect of that treatment,” Bravata said in a Regenstrief news release.

“Usually, diagnosing sleep apnea is an outpatient service. But we need to make sleep testing acutely available to stroke and TIA patients in the hospital as part of their work-up,” she said, “just as we do brain imaging, lab testing and cardiac monitoring as part of the initial stroke/TIA evaluation.”

Two experts in stroke care believe the approach has real merit.

“This study is very interesting — it shows that a simple intervention, treating obstructive sleep apnea, can improve outcomes in stroke patients,” said Dr. Andrew Rogrove. He is director of stroke services at Northwell Health’s Southside Hospital in Bay Shore, N.Y.

Rogrove said it would be even more interesting to assess recovery rates when CPAP was used more frequently than the 50 percent of nights observed in this study.

Dr. Salman Azhar directs stroke care at Lenox Hill Hospital in New York City. He noted that several studies have shown sleep apnea to be a factor in poor stroke recovery.

Testing for sleep apnea shouldn’t add much to the burden of care for stroke survivors, Azhar added.

“With the current ease of doing home sleep studies, the diagnosis of obstructive sleep apnea has become much simpler and should be considered in all stroke patients with positive screening questionnaire results,” he said.

The findings were published earlier this month in the Journal of the American Heart Association.