Repairing Your Brain with Cerebrolysin

Cerebrolysin is a mixture of purified neuropeptides derived from pig brains. Commonly prescribed in Russia for traumatic brain injuries (TBIs) and strokes, it has quite a bit of positive research backing it, which we will soon discuss in this article, along with how you can use it to benefit your own life.

Mechanism of Action

Cerebrolysin broadly increases neurogenesis [1, 2] - the creation of new neurons and neurological pathways - due to its composition, which includes multiple growth factors such as nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF). While the exact neurochemical pathways cerebrolysin modulates are not elucidated entirely in the literature, we do have some data describing how its profound multimodal mechanism can influence brain repair and stimulate neurogenesis.

First and foremost, cerebrolysin mimics the activities of neurological growth factors (also called neurotrophic factors, or NTFs) as described previously. In immunoassay, it has even been shown to mimic IGF-1 function neurologically [3]. This, at face value, would indicate that cerebrolysin accelerates brain growth via the same function by which our brain "builds" itself.

Not only does cerebrolysin mimic our own neurotrophic factors, it also seems to increase the expression of endogenous neurotrophic factors [4, 5].

Medical History and Uses

Among it's many benefits, cerebrolysin has been used clinically to treat traumatic brain injuries (TBIs) and is even currently approved for this purpose in some countries. There are multiple mechanisms by which cerebrolysin improves neurological recovery and repair following TBIs.

Firstly, cerebrolysin has been well established as an anti-neuroinflammatory, reducing overall inflammation in the brain. Brain scans of TBI patients clearly indicate neuroinflammation following injury [6], which we know, both acutely and long term, can cause brain degeneration and damage itself. Reducing this overall neuroinflammation with cerebrolysin has been shown to be beneficial in both preventing further neurodegeneration and improving TBI recovery times [7].

Cerebrolysin has also been shown to significantly upregulate neurogenesis, a process characterized by the creation of mature cells from neural stem cells in the brain. Since we know that TBIs can directly cause cell death, it is plausible that cerebrolysin may be able to restore these lost neurons to some degree.

Cerebrolysin has also been used to improve recovery in stroke patients following acute ischemic strokes. Research has shown that it drastically decreases infarct volume (area of dead cells due to oxygen loss) and increases neuron structure integrity [8, 9].

Practical Application

Aside from strokes and TBIs, there remains a vast case of hypothetical scenarios that one could use cerebrolysin for.

Since long-term drug abuse has been shown clearly to cause neurotoxicity through multiple mechanisms, such as excitotoxicity and oxidative stress [10], Cerebrolysin can be used to restore a brain damaged by drug abuse.

There is a large body of evidence to suggest that, both transiently and permanently, drug abuse causes a downregulation in neurogenesis and a loss in granular hippocampal cells [11]. This may be due to either a large-scale direct death of hippocampal cells, or maybe simply due to a decrease in the output of hippocampal cells, resulting in a net negative. So, upregulating neurogenesis drastically with cerebrolysin may very well be able to reverse these negative effects, though there is no direct data to support this.

Cerebrolysin’s effect on neurogenesis may indicate that it also has applications in the areas of depression and anxiety. SSRIs main mechanism by which they decrease anxiety and depression is largely via the long-term increase in neurotrophic factors. As Cerebrolysin does this immediately and to a higher degree, it may even be superior to SSRIs for treating anxiety and depression.

Though, there may be two issues with this theory:
1) The serotonergic portion of SSRIs is important to their action, which cerebrolysin does not possess
2) The neurogenesis is so profound that the brain may develop a tolerance to it

Cerebrolysin’s action, put very simply, can be described as an ability to rewire the brain and strengthen neurological associations. Since the brain works by associations, one could absolutely use cerebrolysin to improve the brains' positive associations and override negative ones. This is the premise of exposure therapy and cognitive behavioral therapy. It works on essentially the same idea as Pavlovian Conditioning.

My Experience

So far, I've only had a single experience with Cerebrolysin - a protocol of 5mL daily for 10 days straight. Here's why I started:

During March of 2024, I contracted what I believe to be the BA.2.86 Omicron variant of Covid-19. Through some unknown mechanism (potentially relating to the virus "attacking" my central nervous system), this caused me to develop an extreme form of panic disorder. I was having 2-3 panic attacks daily. This lasted for around a month, but I eventually had a breaking point where I couldn't handle the mental stress for much longer. I did a fair amount of research on neurology, the pathology of anxiety, and related matters. Eventually, I came across cerebrolysin by the recommendation of a friend, and decided to give it a try.

A few hours after my first injection, I immediately felt relief. I had a total of zero panic attacks or even anxious moments during the 10 days of my protocol.

After cessation of cerebrolysin, I did have a small bit of rebound anxiety for a few days, but it was very transient. To this day (it's been about 1.5 months since stopping cerebrolysin), I have had zero panic attacks since the protocol.

I will add that I started SSRI treatment a couple of days after starting the cerebrolysin, but I do not think the SSRI contributed much to the "reversal" of my anxiety, as SSRIs take months to fully exert effects. I almost entirely attribute the cure of my anxiety disorder to cerebrolysin.

Final Thoughts

Cerebrolysin, though not yet approved in the US, is one of the most potentially useful compounds in the field of neurology. Upregulating neurogenesis is an untapped area that can lead to profound changes, both transiently and long-term. In my opinion, it is likely that neuropharmacology will see the widespread use of cerebrolysin or similar compounds in the near future.

Looking to learn about Cerebrolysin or neurology in general? Book a consult call with me here

Sources

[1] Rockenstein, E., Desplats, P., Ubhi, K., Mante, M., Florio, J., Adame, A., et al. (2015) "Neuro-peptide treatment with Cerebrolysin improves the survival of neural stem cell grafts in an APP transgenic model of Alzheimer disease."

[2] Sanna, M. D., Ghelardini, C., and Galeotti, N. (2017) "HuD-mediated distinct BDNF regulatory pathways promote regeneration after nerve injury."

[3] CHEN, Honghui, et al. (2007) "Trophic factors counteract elevated FGF-2-induced inhibition of adult neurogenesis"

[4] X. Anton Alvarez, MD et al. (2016) "Synergistic Increase of Serum BDNF in Alzheimer Patients Treated with Cerebrolysin and Donepezil: Association with Cognitive Improvement in ApoE4 Cases"

[5] V N Shishkova, L I Zotova, N G Maljukova, I R Sutjusheva, N V Kan, E M Gasanova, E I Kerimova (2015) "An assessment of cerebrolysin effect on BDNF level in patients with post stroke aphasia depending on carbohydrate metabolism disorders"

[6] Lozano D., Gonzales-Portillo G., Acosta S., de la Pena I., Tajiri N., Kaneko Y., Borlongan C. (2014) "Neuroinflammatory responses to traumatic brain injury: etiology, clinical consequences, and therapeutic opportunities"

[7] Weihong Lu, Zhonghua Zhu, Dongliang Shi, Xiaoyu Li, Jingzhi Luo, Xingzhi Liao (2022) "Cerebrolysin alleviates early brain injury after traumatic brain injury by inhibiting neuroinflammation and apoptosis via TLR signaling pathway"

[8]  Wronski R, Tompa P, Hutter-Paier B, Crailsheim K, Friedrich P, Windisch M. (2000) "Inhibitory effect of a brain derived peptide preparation on the Ca++-dependent protease, calpain"

[9]  Hanson LR, Liu XF, Ross TM, Doppler E, Zimmermann-Meinzingen S, Moessler H, Frey II WH. (2009) "Cerebrolysin reduces infarct volume in a rat model of focal cerebral ischemic damage. "

[10] Márcia Carvalho et al. (2012) "Toxicity of amphetamines: an update"

[11] Dhanabalan, Gopalakrishnan (2018) "Impact of alcohol and drug abuse on hippocampal neurogenesis in humans"