Functional improvements typically emerge 4–12 weeks post-infusion and stabilise by 3–6 months. Duration extends longer than acute stroke recovery: 50–60% of responders sustain clinically meaningful gains beyond 12 months, with some reporting continued slow improvement over 18–24 months. This extended window reflects gradual neural plasticity and axonal sprouting rather than acute effects. Repeat infusions at 12–24 month intervals may amplify gains, but optimal re-treatment protocols are not standardised. Long-term preservation of gains (≥3 years) is documented in retrospective series but requires formal prospective verification.
Acute ischaemic stroke causes focal neuronal death and surrounding tissue inflammation, leaving survivors with motor, sensory, cognitive, or speech deficits dependent on lesion location. Recovery is constrained by limited intrinsic neural regeneration; most functional improvement plateaus 3–6 months post-event. Stem cell therapies harness the brain's residual plasticity: neurogenic cells (foetal-derived or reprogrammed progenitors) migrate to lesion borders and differentiate into neurons and glia, partially reconstituting damaged circuits. Placental mesenchymal stem cells (MSCs) secrete neuroprotective and anti-inflammatory cytokines (IL-10, TGF-β) that suppress secondary neuronal death and glial scarring. Exosomes deliver growth factors systemically, activating endogenous repair mechanisms. The therapeutic window extends months to years post-stroke, distinguishing this from hyperacute thrombolysis. One hundred eight registered trials investigate stroke recovery; eleven actively recruit, reflecting major investment in post-stroke neural restoration.
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Medically reviewed by StemCellAtlas’s editorial team with Kiian Nadiia, MD, PhD (Paediatric Neurologist · Medical Director, CSM Clinic Network · 12+ yrs in Autism Spectrum Disorders) of partner clinic Stem Plus (Sofia), against ISSCR, FDA & EMA guidance. Educational information, not medical advice; figures indicative.
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