Despite thousands of neuroprotectants demonstrating promise in preclinical trials, a neuroprotective therapeutic has yet to be approved for the treatment of acute brain injuries such as stroke or traumatic brain injury. Developing a more detailed understanding of models and populations demonstrating “neurological resilience” in spite of brain injury can give us important insights into new translational therapies. Resilience is the process of active adaptation to a stressor. In the context of neuroprotection, models of preconditioning and unique animal models of extreme physiology (such as hibernating species) reliably demonstrate resilience in the laboratory setting. In the clinical setting, resilience is observed in young patients and can be found in those with specific genetic polymorphisms. These important examples of resilience can help transform and extend the current neuroprotective framework from simply countering the injurious cascade into one that anticipates, monitors, and optimizes patients’ physiological responses from the time of injury throughout the process of recovery. This review summarizes the underpinnings of key adaptations common to models of resilience and how this understanding can be applied to new neuroprotective approaches.

中文翻译：

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抗损伤的能力：神经保护的新方法？

尽管成千上万种神经保护剂在临床前试验中显示出希望，但神经保护剂尚未被批准用于治疗急性脑损伤，例如中风或脑外伤。尽管存在脑损伤，但对表现出“神经适应力”的模型和人群进行更详细的了解，可以使我们对新的转化疗法产生重要的见解。弹性是主动适应压力源的过程。在神经保护的背景下，预处理模型和极端生理学的独特动物模型（例如冬眠物种）在实验室环境中可靠地展现了弹性。在临床环境中，在年轻患者中观察到了弹性，并且可以在具有特定遗传多态性的患者中发现。这些重要的弹性示例可以帮助将当前的神经保护框架从简单的抵制有害的级联转变为一种扩展，并将其扩展到可以预测，监控和优化患者从受伤时到恢复过程中的生理反应的框架。这篇综述总结了适应力模型共有的关键适应的基础，以及如何将这种理解应用于新的神经保护方法。