Sesame-based interventions for stroke and stroke-related disorders: A systematic review

Stroke remains a leading cause of death and disability, with limited access to costly rehabilitation, especially in developing regions. Sesame ( Sesamum indicum ), known for its health benefits, shows promise as a neuroprotective agent. This systematic review evaluates current evidence on its potential in stroke treatment and recovery in animal models (In vivo). The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). A comprehensive search of PubMed and Google Scholar identified original research on the effects of sesame on stroke and related disorders. Studies were screened in stages, and their quality was evaluated using Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk of bias tool. 19 studies were included (18 from Asia, 1 from Africa). Sesame derivatives especially sesamin and sesamol demonstrated strong, multi-targeted neuroprotection in stroke models by reducing infarct volume, brain edema, oxidative stress, inflammation, and neuronal damage, while improving neurological recovery. Mechanisms involve enhancing antioxidant enzymes, lowering oxidative markers, suppressing pro-inflammatory mediators, inhibiting apoptosis, and modulating key pathways like ( PI3K / AKT , MAPK / ERK , Notch1 / NLRP3 ). Advanced formulations such as sesamol-loaded nanocarriers and the sesamin derivative BBD further enhanced efficacy. Overall, the evidence supports sesame compounds as potent neuroprotective agents against cerebral ischemia. Overall, sesame shows potential as a therapeutic agent for stroke through its antioxidant, anti-inflammatory, anti-apoptotic, and anti-edematous actions. These effects highlight its potential as a natural, supportive treatment for stroke. • Stroke is a major cause of death and disability, especially in low-resource areas. • Sesame shows strong neuroprotective properties. • Reduces stroke damage, inflammation, and oxidative stress. • Sesame and its derivatives may aid stroke treatment naturally and affordably.