An injected extract of cattle brain cortex, given as short courses of daily injections. Strongest evidence: recovery after a stroke caused by a blocked artery, and thinking-test gains where brain blood flow is long reduced — consistent but small. Without brain disease, work-capacity gains fade within about two months. Harms are few, mostly allergic. Almost all research comes from one region. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Montreal Cognitive Assessment | 26–30 of 30 | Primary efficacy endpoint |
| Mini-Mental State Examination | 28–30 of 30 | Comparator to the trial data |
| Blood pressure | 110–125 / 70–80 mmHg | Detects the labeled rare pressure rise |
| Eosinophil count | 0.0–0.15 ×109/L | Marks allergic phenotype before first exposure |
| Total immunoglobulin E | Below 60 IU/mL | Quantifies baseline allergic risk |
| Glycated hemoglobin | 4.8–5.4% | Tracks the metabolic signal seen in the diabetes trial |
| High-sensitivity C-reactive protein | Below 1.0 mg/L | Background inflammatory load that modifies cognitive trajectory |
| Homocysteine | Below 8 µmol/L | Modifiable vascular contributor to cognitive decline |
| Neuron-specific enolase | No established target; track own baseline | Marker of neuronal stress that fell during Cortexin therapy |
| Multidimensional Fatigue Inventory | No established target; track own baseline | Quantifies the asthenia endpoint the drug is most used for |
Cadence: Baseline, day 10, 4–6 weeks, then before each repeat course at 3–6 month intervals; blood count and metabolic panel annually, or immediately if a reaction occurs