Carotenoids are naturally occurring bio-pigments found in microalgae, plants, fungi, bacteria, and various aquatic animals. They are generally classified into carotenes and xanthophylls based on their structural features. Among them, astaxanthin-a xanthophyll carotenoid-has attracted increasing attention due to its potent antioxidant, anti-inflammatory, and anti-apoptotic properties, which contribute to a range of health benefits. This review highlights the structural features, physicochemical properties, pharmacokinetics, and therapeutic potential of astaxanthin, particularly focusing on its neuroprotective effects in neurological disorders. To provide a comprehensive overview, we systematically searched published articles across Scopus, Google Scholar, PubMed, and Medline databases from inception to January 1, 2025. Recent advancements in drug formulation and delivery technologies have enhanced astaxanthin's ability to cross the blood-brain barrier (BBB), significantly increasing its potential as a therapeutic agent for neurological diseases. With its multifaceted biological effects and growing evidence of neuroprotection, astaxanthin shows great promise in the treatment of neurological disorders, particularly stroke. These findings support its future development and application in pharmaceutical strategies aimed at brain health.

Ischemic stroke is one of the leading causes of death worldwide, and poses a great burden to society and the healthcare system. There have been many recent advances in the treatment of ischemic stroke, which usually results from the interruption of blood flow to a particular part of the brain. Current treatments for ischemic stroke mainly focus on revascularization or reperfusion of cerebral blood flow to the infarcted tissue. Nevertheless, reperfusion injury may exacerbate ischemic injury in patients with stroke. In recent decades, vagus nerve stimulation (VNS) has emerged as an optimistic therapeutic intervention. Accumulating evidence has demonstrated that VNS is a promising treatment for ischemic stroke in various rat models through improved neural function, cognition, and neuronal deficit scores. We thoroughly examined previous evidence from stroke-induced animal studies using VNS as an intervention until June 2022. We concluded that VNS yields stroke treatment potential by improving neurological deficit score, infarct volume, forelimb strength, inflammation, apoptosis, and angiogenesis. This review also discusses potential molecular mechanisms underlying VNS-mediated neuroprotection. This review could help researchers conduct additional translational research on patients with stroke.