Cerebrolysin exerts its neuroprotective effects primarily through the modulation of the endorphinergic system, enhancing the release of brain-derived neurotrophic factor (BDNF) and stabilizing dopaminergic neurotransmission via the inhibition of kinases such as ABL1, PINK1, and CDK5. Additionally, it activates the CREB/PGC-1α signaling pathway, which is involved in mitochondrial function and neuroprotection, thereby improving cognitive function and reducing anxiety-like behaviors. The precise mechanisms of action remain incompletely understood, particularly regarding its interactions with other neurotransmitter systems.