Why some brains defy stroke — and drugs to help the

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- Céline Gillebert's KU Leuven study of more than 2,000 people found pre-stroke brain condition — measured by brain volume and white matter integrity — was a stronger predictor of post-stroke cognitive function than the location of the damage itself.
- Sandor Nardai at Semmelweis University showed the psychedelic DMT prevented cell death, supported brain rewiring and reduced inflammation in post-stroke rats; Nardai envisions administering it in ambulances, pending further research.
- Naohiko Okabe's UCLA team identified a gamma-oscillation-boosting drug — originally developed by Istvan Mody for Alzheimer's — that replicated physical rehab's post-stroke benefits in mice; human trials are the next step.
- A CCR5 gene mutation disproportionately common among Ashkenazi Jews is linked to notably better stroke recovery, and an existing HIV drug targeting CCR5 is now being studied to duplicate that natural advantage in patients.
- CorTec received an FDA "breakthrough device designation" in April for a brain-computer interface that translates thoughts into action, potentially restoring lost function while helping the brain rewire through practice.
- William Zeiger's 2021 mouse study challenged the dominant "remapping" hypothesis, finding that neurons do not take over from damaged areas after stroke — instead, surviving neurons within the affected region appear to be strengthened by rehabilitation.
Why it matters: Only about 35% of stroke survivors make a full or near-full recovery, leaving roughly 100 million people globally with disabling after-effects including aphasia and paralysis. The therapies now in animal or early human studies — a repurposed HIV drug, a gamma-boosting compound, DMT, psilocybin and a brain-computer interface — could convert what is currently a luck-of-the-draw recovery into a treatable one, though none has yet passed human efficacy trials.
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