This systematic review and meta-analysis aim to investigate the improvements in functional outcomes with cerebrolysin in patients suffering from acute ischemic stroke.

Cerebrolysin is a neurotropic agent that is used in stroke recovery, with studies examining its impact on neurological function, activities of daily living, and the assessment of cognitive performance in post-stroke patients.

Four studies reported NIHSS as a continuous outcome. At 30 days, the pooled mean difference (MD) was –1.27 [–1.89, 0.65] (I² = 35%), and at 90 days –2.06 [–2.86, –1.46] (I² = 0%), with an overall MD of –1.51 [–2.06, –0.96] (I² = 40%), favoring Cerebrolysin. Arm function improved significantly (MD = 9.92 [0.95–18.89]), though heterogeneity was high. Modified Rankin Scale (mRS) showed a favorable trend (RR = 1.52 [0.75–3.08]). Barthel Index continuous analysis indicated improved mobility (MD = 8.67 [2.23–15.11]). Cognitive assessments (MMSE) showed modest gains with Cerebrolysin, while Fugl-Meyer scores revealed small-to-moderate effects, particularly for upper limb recovery during later follow-up, suggesting progressive benefit over time.

Cerebrolysin demonstrates potential benefits in reducing NIHSS scores, improving ARAT and BI as continuous outcomes, and enhancing upper limb FMA in later phases, with favorable trends in mRS and MMSE, though heterogeneity and non-significant effects in some dichotomous outcomes limit conclusions. Safety profiles were comparable to placebo, supporting its use as an adjunct in stroke rehabilitation.