Mesenchymal stromal cells and platelet-rich plasma improve motor recovery in stroke patients: a case report

Despite advancements in stroke treatment, recovery potential after a stroke is limited, affecting quality of life. The brain is crucial for motor control, but changes in muscle tissue structure, metabolism, and function also significantly contribute to post-stroke disability. Rehabilitation efforts have typically focused on central strategies, neglecting affected muscles. This study aims to investigate the effects of intramuscular injections of mesenchymal stromal cells (MSCs) and platelet-rich plasma (PRP) on motor recovery in stroke survivors. The patients were two Iranian males of Middle Eastern ethnicity, aged 63 and 62 years, who experienced a stroke 5 and 10 years prior, respectively. Patients had motor impairment in the left upper limb. Initially, patients received a single intramuscular injection of PRP into the biceps brachii muscle. One year after, patients were re-examined and then received a single intramuscular injection of umbilical cord-derived MSCs into the same biceps muscle. Patients were followed-up for 3 months after each injection and clinical outcomes recorded. Both interventions resulted in improvements in most clinical and imaging measures. We observed improvements in biceps spasticity, upper limb function, elbow range of motion, and muscle structure. However, MSCs demonstrated a more significant effectiveness in muscle spasticity reduction and upper limb function enhancement, particularly evident during the second and third months after injection.