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IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Acta Neurochirurgica Pub Date : 2025-03-24 DOI:10.1007/s00701-025-06487-7

Mohammadhossein Vazirizadeh-Mahabadi, Amir Azimi, Mobina Yarahmadi, Hamed Zarei, Fateme Tahmasbi, Amirali Zarrin, Mahmoud Yousefifard, Vafa Rahimi-Movaghar

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引用次数: 0

摘要

目的通过系统综述和荟萃分析，评估二甲双胍在脊髓损伤（SCI）啮齿动物模型中恢复运动、减轻神经病理性疼痛和调节潜在分子机制的功效。方法我们对 Medline、Embase、Scopus 和 Web of Science 上从开始到 2024 年 5 月的文献进行了全面检索。我们纳入了使用二甲双胍治疗创伤性 SCI 啮齿动物模型和未治疗对照组的研究。我们提取了有关运动恢复、神经性疼痛以及与继发性损伤相关的分子机制的数据。结果有23项研究（包括1,567只动物）符合纳入标准。二甲双胍能明显增强运动功能（SMD = 2.23，95% CI：1.74，2.73，p < 0.001），改善机械异感（SMD = 1.18；95% CI，0.35 至 2.00；p = 0.005）和热超痛（SMD = 2.40；95% CI，1.65 至 3.16；p < 0.001）。它能减少炎症、氧化应激、小胶质细胞活化和星形胶质细胞增生，并通过激活单磷酸腺苷激活蛋白激酶（AMPK）信号通路促进髓鞘化和自噬通量。这减少了细胞凋亡和病变大小，提高了组织保存率和神经元存活率。亚组分析表明，在损伤的急性期（损伤后 3 天）服用二甲双胍可改善运动能力（元回归系数 = 1.65；95% CI，0.37 至 2.93；p = 0.011）。这些结果凸显了二甲双胍在临床 SCI 治疗中的转化潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Metformin’s therapeutic potential in spinal cord injury: a systematic review and meta-analysis on locomotor recovery, neuropathic pain alleviation, and modulation of secondary injury mechanisms

Objective

To evaluate metformin’s efficacy in locomotion recovery, alleviating neuropathic pain, and modulating underlying molecular mechanisms in Spinal Cord Injury (SCI) rodent models through a systematic review and meta-analysis.

Methods

We conducted a comprehensive literature search across Medline, Embase, Scopus, and Web of Science from inception to May 2024. We included studies that utilized rodent models of traumatic SCI treated with metformin versus untreated controls. Data on locomotor recovery, neuropathic pain, and molecular mechanisms related to secondary injury were extracted. Standardized mean differences (SMDs) were synthesized as the pooled effect sizes.

Results

Twenty-three studies comprising 1,567 animals met the inclusion criteria. Metformin significantly enhanced locomotor function (SMD = 2.23, 95% CI: 1.74, 2.73, p < 0.001) and improved both mechanical allodynia (SMD = 1.18; 95% CI, 0.35 to 2.00; p = 0.005) and thermal hyperalgesia (SMD = 2.40; 95% CI, 1.65 to 3.16; p < 0.001). It reduces inflammation, oxidative stress, microglial activation, and astrogliosis and promotes myelination and autophagy flux via activating the adenosine monophosphate-activated protein kinase (AMPK) signaling pathway. This resulted in decreased apoptosis and lesion size and increased tissue preservation and neuronal survival. Subgroup analyses indicated greater locomotor improvements when metformin was administered in the acute (< 3 days of injury) phase of the injury (meta-regression coefficient = 1.65; 95% CI, 0.37 to 2.93; p = 0.011).

Conclusion

Metformin shows significant therapeutic benefits for SCI in rodent models, promoting locomotor recovery and alleviating neuropathic pain. These results underscore its translational potential for clinical SCI management.

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来源期刊

Acta Neurochirurgica 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

342

审稿时长

1 months

期刊介绍： The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.