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
Acta Neurochirurgica,
Journal Year:
2025,
Volume and Issue:
167(1)
Published: March 24, 2025
To
evaluate
metformin's
efficacy
in
locomotion
recovery,
alleviating
neuropathic
pain,
and
modulating
underlying
molecular
mechanisms
Spinal
Cord
Injury
(SCI)
rodent
models
through
a
systematic
review
meta-analysis.
We
conducted
comprehensive
literature
search
across
Medline,
Embase,
Scopus,
Web
of
Science
from
inception
to
May
2024.
included
studies
that
utilized
traumatic
SCI
treated
with
metformin
versus
untreated
controls.
Data
on
locomotor
related
secondary
injury
were
extracted.
Standardized
mean
differences
(SMDs)
synthesized
as
the
pooled
effect
sizes.
Twenty-three
comprising
1,567
animals
met
inclusion
criteria.
Metformin
significantly
enhanced
function
(SMD
=
2.23,
95%
CI:
1.74,
2.73,
p
<
0.001)
improved
both
mechanical
allodynia
1.18;
CI,
0.35
2.00;
0.005)
thermal
hyperalgesia
2.40;
1.65
3.16;
0.001).
It
reduces
inflammation,
oxidative
stress,
microglial
activation,
astrogliosis
promotes
myelination
autophagy
flux
via
activating
adenosine
monophosphate-activated
protein
kinase
(AMPK)
signaling
pathway.
This
resulted
decreased
apoptosis
lesion
size
increased
tissue
preservation
neuronal
survival.
Subgroup
analyses
indicated
greater
improvements
when
was
administered
acute
(<
3
days
injury)
phase
(meta-regression
coefficient
1.65;
0.37
2.93;
0.011).
shows
significant
therapeutic
benefits
for
models,
promoting
recovery
pain.
These
results
underscore
its
translational
potential
clinical
management.
Language: Английский
Overview of Metformin and Neurodegeneration: A Comprehensive Review
Pharmaceuticals,
Journal Year:
2025,
Volume and Issue:
18(4), P. 486 - 486
Published: March 28, 2025
This
comprehensive
review
examines
the
therapeutic
potential
of
metformin,
a
well-established
diabetes
medication,
in
treating
neurodegenerative
disorders.
Originally
used
as
first-line
treatment
for
type
2
diabetes,
recent
studies
have
begun
investigating
metformin’s
effects
beyond
metabolic
disorders,
particularly
its
neuroprotective
capabilities
against
conditions
like
Parkinson’s
disease,
Alzheimer’s
Huntington’s
and
multiple
sclerosis.
Key
findings
demonstrate
that
operate
through
pathways:
AMPK
activation
enhancing
cellular
energy
metabolism
autophagy;
upregulation
antioxidant
defenses;
suppression
inflammation;
inhibition
protein
aggregation;
improvement
mitochondrial
function.
These
mechanisms
collectively
address
common
pathological
features
neurodegeneration
neuroinflammation,
including
oxidative
stress,
accumulation,
dysfunction.
Clinical
preclinical
evidence
supporting
association
with
improved
cognitive
performance,
reduced
risk
dementia,
modulation
hallmarks
diseases
is
critically
evaluated.
While
metformin
shows
promise
agent,
this
emphasizes
need
further
investigation
to
fully
understand
optimal
applications
diseases.
Language: Английский