Objective:

This narrative review evaluates the current state of stem cell therapies for stroke recovery, highlighting preclinical and clinical evidence, challenges, and future research priorities.

Background:

Stem cell therapies, including mesenchymal and induced pluripotent stem cells, offer potential for neuroregeneration in stroke recovery, yet clinical translation remains limited. Narrative reviews analysing preclinical and clinical data on efficacy, safety, and optimal therapeutic approaches (e.g., timing, delivery) are scarce, particularly for chronic stroke patients.

Design/Methods:

A literature search (2010–2025) across PubMed, Embase, and ClinicalTrials.gov was conducted, focusing on preclinical (animal models) and clinical studies of stem cell therapies for ischemic and hemorrhagic stroke. Key areas include cell types, delivery methods (e.g., intravenous, intra-arterial), timing (acute vs. chronic), and outcomes (e.g., functional recovery, neuroplasticity).

Results:

Preclinical studies demonstrate improved motor function and neurogenesis in 70–80% of models, but clinical trials show variable efficacy, with only 50% reporting significant functional gains. Safety concerns (e.g., tumorigenesis) and optimal timing (acute vs. chronic) remain unresolved. Intravenous delivery is most common but may limit cell homing to damaged tissue.

Conclusions:

Stem cell therapies hold promise but require standardized protocols and larger trials to confirm efficacy and safety. This review proposes a roadmap for future research, emphasizing chronic stroke applications and novel delivery strategies.