{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:15:50Z","timestamp":1788963350188,"version":"build-2803163510"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Remote ischemic conditioning (RIC) is a noninvasive, safe, and well-tolerated non-pharmacological treatment that has shown application prospects in the field of ischemic stroke. However, its application in hemorrhagic stroke is still at an early stage, the mechanism has not been fully elucidated, and clinical evidence is relatively scarce. This review found that for ICH, the mechanism of RIC may involve coordinated metabolic and immune pathways. Clinical trials have confirmed its safety, but the efficacy conclusions are inconsistent: studies involving interventions in the subacute phase have shown the potential to promote hematoma resolution, while studies involving interventions in the ultra-early phase have failed to show improvements in functional outcomes. For subarachnoid hemorrhage, the research is more preliminary, and there is no randomized controlled trial (RCT). The underlying mechanisms are thought to involve immune inflammation and vascular reactivity, while existing pilot studies have mainly focused on verifying safety rather than efficacy. In conclusion, RIC is safe when applied to hemorrhagic stroke, but its therapeutic effectiveness has not been demonstrated. Significant gaps remain, including uncertainty about the optimal timing and dosing regimens for interventions and the lack of large, multicenter trials. Future research should focus on identifying biomarkers, standardizing treatment protocols, and conducting high-quality RCTs.<\/jats:p>","DOI":"10.3389\/fneur.2026.1923449","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:53:30Z","timestamp":1788962010000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Research progress of remote ischemic conditioning in hemorrhagic stroke"],"prefix":"10.3389","volume":"17","author":[{"given":"Tonghu","family":"Jin","sequence":"first","affiliation":[{"name":"Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liuyu","family":"Xu","sequence":"additional","affiliation":[{"name":"Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Niu","sequence":"additional","affiliation":[{"name":"Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Guan","sequence":"additional","affiliation":[{"name":"People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuang","family":"Yan","sequence":"additional","affiliation":[{"name":"People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Disease, Neurological Disease Center, Beijing Anzhen Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aihua","family":"Liu","sequence":"additional","affiliation":[{"name":"Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University","place":["Beijing, China"]},{"name":"People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1161\/STROKEAHA.122.037155","article-title":"Role of inflammatory processes in hemorrhagic stroke","volume":"54","author":"Ohashi","year":"2023","journal-title":"Stroke"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"123329","DOI":"10.1016\/j.jns.2024.123329","article-title":"Recent and future advances in intracerebral hemorrhage","volume":"467","author":"Puy","year":"2024","journal-title":"J Neurol Sci"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1161\/STROKEAHA.124.049969","article-title":"Long-term cognitive decline after subarachnoid hemorrhage: pathophysiology, management, and future directions","volume":"56","author":"Aydin","year":"2025","journal-title":"Stroke"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"746486","DOI":"10.3389\/fneur.2021.746486","article-title":"Immune modulation as a key mechanism for the protective effects of remote ischemic conditioning after stroke","volume":"12","author":"Abbasi-Habashi","year":"2021","journal-title":"Front Neurol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1038\/s41582-024-01035-w","article-title":"Intracerebral haemorrhage\u2014mechanisms, diagnosis and prospects for treatment and prevention","volume":"20","author":"Seiffge","year":"2024","journal-title":"Nat Rev Neurol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1016\/S1474-4422(16)00130-7","article-title":"Dementia risk after spontaneous intracerebral haemorrhage: a prospective cohort study","volume":"15","author":"Moulin","year":"2016","journal-title":"Lancet Neurol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1136\/jnnp-2020-324741","article-title":"Long-term functional decline of spontaneous intracerebral haemorrhage survivors","volume":"92","author":"Pasi","year":"2021","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"266","DOI":"10.5853\/jos.2021.01823","article-title":"Etiology, 3-month functional outcome and recurrent events in non-traumatic intracerebral Hemorrhage","volume":"24","author":"Goeldlin","year":"2022","journal-title":"J Stroke"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1212\/WNL.0b013e3182143317","article-title":"Defining hematoma expansion in intracerebral hemorrhage: relationship with patient outcomes","volume":"76","author":"Dowlatshahi","year":"2011","journal-title":"Neurology"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1177\/23969873231157884","article-title":"The association between perihaematomal oedema and functional outcome after spontaneous intracerebral haemorrhage: a systematic review and meta-analysis","volume":"8","author":"Cliteur","year":"2023","journal-title":"Eur Stroke J"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1002\/ana.25732","article-title":"Neurosurgical intervention for supratentorial intracerebral hemorrhage","volume":"88","author":"Sondag","year":"2020","journal-title":"Ann Neurol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1007\/s12975-012-0171-z","article-title":"Ischemic preconditioning attenuates brain edema after experimental intracerebral hemorrhage","volume":"3","author":"He","year":"2012","journal-title":"Transl Stroke Res"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"2636","DOI":"10.1084\/jem.20171905","article-title":"Remote ischemic post-conditioning promotes hematoma resolution via AMPK-dependent immune regulation","volume":"215","author":"Vaibhav","year":"2018","journal-title":"J Exp Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"102842","DOI":"10.1016\/j.arr.2025.102842","article-title":"Bidirectional regulation of neuronal autophagy in ischemic stroke: mechanisms and therapeutic potential","volume":"111","author":"Wu","year":"2025","journal-title":"Ageing Res Rev"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1177\/17474930211006580","article-title":"Safety and efficacy of remote ischemic conditioning for the treatment of intracerebral hemorrhage: a proof-of-concept randomized controlled trial","volume":"17","author":"Zhao","year":"2022","journal-title":"Int J Stroke"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1001\/jama.2023.16893","article-title":"Remote ischemic conditioning for acute stroke: the RESIST randomized clinical trial","volume":"330","author":"Blauenfeldt","year":"2023","journal-title":"JAMA"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2696","DOI":"10.3390\/jcm13092696","article-title":"Remote ischemic conditioning to reduce perihematoma edema in patients with intracerebral hemorrhage (RICOCHET): a randomized control trial","volume":"13","author":"Kakarla","year":"2024","journal-title":"J Clin Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"103900","DOI":"10.1016\/j.eclinm.2026.103900","article-title":"Remote ischaemic conditioning in patients with supratentorial intracerebral haemorrhage (RICH-2): a multicentre, randomised, sham-controlled phase 3 trial in China","volume":"95","author":"Zhao","year":"2026","journal-title":"EClinicalMedicine"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1016\/S0140-6736(22)00938-2","article-title":"Spontaneous subarachnoid haemorrhage","volume":"400","author":"Claassen","year":"2022","journal-title":"Lancet"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/j.wneu.2018.03.220","article-title":"Estimating the global incidence of aneurysmal subarachnoid hemorrhage: a systematic review for central nervous system vascular lesions and meta-analysis of ruptured aneurysms","volume":"115","author":"Hughes","year":"2018","journal-title":"World Neurosurg"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e519","DOI":"10.1161\/STROKEAHA.110.581975","article-title":"Cognitive and functional outcome after aneurysmal subarachnoid hemorrhage","volume":"41","author":"Al-Khindi","year":"2010","journal-title":"Stroke"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1227\/NEU.0000000000001042","article-title":"Predictors of poor quality of life 1 year after subarachnoid hemorrhage","volume":"78","author":"Taufique","year":"2016","journal-title":"Neurosurgery"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1016\/S1474-4422(11)70017-5","article-title":"Long-term outcomes of patients with aneurysmal subarachnoid haemorrhage","volume":"10","author":"Rinkel","year":"2011","journal-title":"Lancet Neurol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1813","DOI":"10.1161\/STROKEAHA.115.009288","article-title":"Long-term excess mortality after aneurysmal subarachnoid hemorrhage: patients with multiple aneurysms at risk","volume":"46","author":"Huhtakangas","year":"2015","journal-title":"Stroke"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1056\/nejm198303173081103","article-title":"Cerebral arterial spasm--a controlled trial of nimodipine in patients with subarachnoid hemorrhage","volume":"308","author":"Allen","year":"1983","journal-title":"N Engl J Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/S0140-6736(12)60724-7","article-title":"Magnesium for aneurysmal subarachnoid haemorrhage (MASH-2): a randomised placebo-controlled trial","volume":"380","author":"Dorhout Mees","year":"2012","journal-title":"Lancet"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1016\/S1474-4422(14)70084-5","article-title":"Simvastatin in aneurysmal subarachnoid haemorrhage (STASH): a multicentre randomised phase 3 trial","volume":"13","author":"Kirkpatrick","year":"2014","journal-title":"Lancet Neurol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1161\/STROKEAHA.117.017956","article-title":"Induced hypertension for delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: a randomized clinical trial","volume":"49","author":"Gathier","year":"2018","journal-title":"Stroke"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/S0140-6736(20)32518-6","article-title":"Ultra-early tranexamic acid after subarachnoid haemorrhage (ULTRA): a randomised controlled trial","volume":"397","author":"Post","year":"2021","journal-title":"Lancet"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1707","DOI":"10.3171\/2022.2.JNS212914","article-title":"Effects of clazosentan on cerebral vasospasm-related morbidity and all-cause mortality after aneurysmal subarachnoid hemorrhage: two randomized phase 3 trials in japanese patients","volume":"137","author":"Endo","year":"2022","journal-title":"J Neurosurg"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1001\/jamaneurol.2023.1792","article-title":"Effectiveness of lumbar cerebrospinal fluid drain among patients with aneurysmal subarachnoid hemorrhage: a randomized clinical trial","volume":"80","author":"Wolf","year":"2023","journal-title":"JAMA Neurol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"2445","DOI":"10.1161\/STROKEAHA.115.009618","article-title":"Remote ischemic conditioning alters methylation and expression of cell cycle genes in aneurysmal subarachnoid hemorrhage","volume":"46","author":"Nikkola","year":"2015","journal-title":"Stroke"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"568","DOI":"10.3390\/biom12040568","article-title":"Comparing protection of remote limb with resveratrol preconditioning following rodent subarachnoid hemorrhage","volume":"12","author":"Koch","year":"2022","journal-title":"Biomolecules"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1007\/s12975-024-01235-y","article-title":"Remote ischemic post-conditioning reduces cognitive impairment in rats following subarachnoid hemorrhage: possible involvement in STAT3\/STAT5 phosphorylation and Th17\/treg cell homeostasis","volume":"16","author":"Zhu","year":"2024","journal-title":"Transl Stroke Res"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1161\/STROKEAHA.110.605840","article-title":"Remote ischemic limb preconditioning after subarachnoid hemorrhage: a phase ib study of safety and feasibility","volume":"42","author":"Koch","year":"2011","journal-title":"Stroke"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"590\u2013598; discussion 598","DOI":"10.1227\/NEU.0000000000000514","article-title":"Phase I clinical trial for the feasibility and safety of remote ischemic conditioning for aneurysmal subarachnoid hemorrhage","volume":"75","author":"Gonzalez","year":"2014","journal-title":"Neurosurgery"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1227\/NEU.0000000000000282","article-title":"Preconditioning effect on cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage","volume":"74","author":"Kim","year":"2014","journal-title":"Neurosurgery"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1007\/s12975-015-0437-3","article-title":"Matched cohort analysis of the effects of limb remote ischemic conditioning in patients with aneurysmal subarachnoid hemorrhage","volume":"7","author":"Laiwalla","year":"2016","journal-title":"Transl Stroke Res"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1007\/s10072-019-04057-1","article-title":"The effect of remote ischemic conditioning on blood coagulation function and cerebral blood flow in patients with aneurysmal subarachnoid hemorrhage","volume":"41","author":"Xu","year":"2020","journal-title":"Neurol Sci"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1007\/s12028-020-01122-y","article-title":"Remote ischemic pre-conditioning in subarachnoid hemorrhage: a prospective pilot trial","volume":"34","author":"Raval","year":"2021","journal-title":"Neurocrit Care"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1923449\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:53:31Z","timestamp":1788962011000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1923449\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":40,"alternative-id":["10.3389\/fneur.2026.1923449"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1923449","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"1923449"}}