Early General Hypothermia Improves Motor Function after Spinal Cord Injury in Rats; a Systematic Review and Meta-Analysis
Archives of Academic Emergency Medicine,
Vol. 8 No. 1 (2020),
1 January 2020
,
Page e80
https://doi.org/10.22037/aaem.v8i1.739
Abstract
Introduction: There is still controversy about the effect of early hypothermia on the outcome of spinal cord injury (SCI). The aim of this review article is to investigate the effect of local or general hypothermia on improving the locomotion after traumatic SCI.
Methods: Electronic databases (Medline and Embase) were searched from inception until May 7, 2018. Two independent reviewers screened and summarized the relevant experimental studies on hypothermia efficacy in traumatic SCI. The data were analyzed and the findings were presented as pooled standardized mean difference (SMD) and 95% confidence interval (95% CI).
Results: 20 papers containing 30 separate experiments were included in meta-analysis. The onset of hypothermia varied between 0 and 240 minutes after SCI. Administration of hypothermia has a positive effect on locomotion following SCI (SMD=0.56 95% CI: 0.18-0.95, p=0.004). Subgroup analysis showed that general hypothermia improves locomotion recovery (SMD =0.89, 95% CI: 0.42 to 1.36; p <0.0001), while local hypothermia does not have a significant effect on motor recovery (SMD=0.20, 95 % CI: -0.36-0.76, p=0.478). In addition, general hypothermia was found to affect motor recovery only if its duration was between 2 and 8 hours (SMD=0.89; p<0.0001) and the target temperature for induction of hypothermia was between 32 and 35° C (SMD=0.83; p<0.0001).
Conclusion: We found that general hypothermia improves locomotion after SCI in rats. Duration of induction and the target temperature are two essential considerations for general therapeutic hypothermia.
- Spinal Cord Injuries; Hypothermia; Movement Disorders; Rats
How to Cite
References
Yousefifard M, Rahimi-Movaghar V, Baikpour M, Ghelichkhani P, Hosseini M, Jafari A, et al. Early versus late spinal decompression surgery in treatment of traumatic spinal cord injuries; a systematic review and meta-analysis. Emergency. 2017;5(1).
Evaniew N, Belley-Côté EP, Fallah N, Noonan VK, Rivers CS, Dvorak MF. Methylprednisolone for the treatment of patients with acute spinal cord injuries: A systematic review and meta-analysis. Journal of neurotrauma. 2016;33(5):468-81.
Magnuson DS, Dietrich WD. Introduction to the Special Issue on Locomotor Rehabilitation after Spinal Cord Injury. Journal of Neurotrauma. 2017;34(9):1711-2.
Janzadeh A, Sarveazad A, Yousefifard M, Dameni S, Samani FS, Mokhtarian K, et al. Combine effect of Chondroitinase ABC and low level laser (660nm) on spinal cord injury model in adult male rats. Neuropeptides. 2017.
Mojarad N, Janzadeh A, Yousefifard M, Nasirinezhad F. The role of low level laser therapy on neuropathic pain relief and interleukin-6 expression following spinal cord injury: An experimental study. Journal of chemical neuroanatomy. 2017.
Sarveazad A, Babahajian A, Bakhtiari M, Soleimani M, Behnam B, Yari A, et al. The combined application of human adipose derived stem cells and Chondroitinase ABC in treatment of a spinal cord injury model. Neuropeptides. 2017;61:39-47.
Yousefifard M, Nasirinezhad F, Shardi Manaheji H, Janzadeh A, Hosseini M, Keshavarz M. Human bone marrow-derived and umbilical cord-derived mesenchymal stem cells for alleviating neuropathic pain in a spinal cord injury model. Stem cell research & therapy. 2016;7:36.
Yousefifard M, Rahimi-Movaghar V, Nasirinezhad F, Baikpour M, Safari S, Saadat S, et al. Neural stem/progenitor cell transplantation for spinal cord injury treatment; A systematic review and meta-analysis. Neuroscience. 2016;322:377-97.
Hosseini M, Karami Z, Janzadenh A, Jameie SB, Haji Mashhadi Z, Yousefifard M, et al. The Effect of Intrathecal Administration of Muscimol on Modulation of Neuropathic Pain Symptoms Resulting from Spinal Cord Injury; an Experimental Study. Emergency (Tehran, Iran). 2014;2(4):151-7.
Nasirinezhad F, Hosseini M, Karami Z, Yousefifard M, Janzadeh A. Spinal 5-HT3 receptor mediates nociceptive effect on central neuropathic pain; possible therapeutic role for tropisetron. The journal of spinal cord medicine. 2016;39(2):212-9.
Kim F, Nichol G, Maynard C, Hallstrom A, Kudenchuk PJ, Rea T, et al. Effect of prehospital induction of mild hypothermia on survival and neurological status among adults with cardiac arrest: a randomized clinical trial. Jama. 2014;311(1):45-52.
Srinivasakumar P, Zempel J, Wallendorf M, Lawrence R, Inder T, Mathur A. Therapeutic hypothermia in neonatal hypoxic ischemic encephalopathy: electrographic seizures and magnetic resonance imaging evidence of injury. The Journal of pediatrics. 2013;163(2):465-70.
Reinboth BS, Köster C, Abberger H, Prager S, Bendix I, Felderhoff-Müser U, et al. Endogenous hypothermic response to hypoxia reduces brain injury: implications for modeling hypoxic-ischemic encephalopathy and therapeutic hypothermia in neonatal mice. Experimental neurology. 2016;283:264-75.
Karvellas CJ, Todd Stravitz R, Battenhouse H, Lee WM, Schilsky ML. Therapeutic hypothermia in acute liver failure: a multicenter retrospective cohort analysis. Liver Transplantation. 2015;21(1):4-12.
Karibe H, Sato K, Shimizu H, Tominaga T, Koshu K, Yoshimoto T. Intraoperative mild hypothermia ameliorates postoperative cerebral blood flow impairment in patients with aneurysmal subarachnoid hemorrhage. Neurosurgery. 2000;47(3):594-601.
Chen J, Zhang Z, Liu J, Zhou R, Zheng X, Chen T, et al. Acellular spinal cord scaffold seeded with bone marrow stromal cells protects tissue and promotes functional recovery in spinal cord-injured rats. J Neurosci Res. 2014;92(3):307-17.
Hong JM, Lee JS, Song HJ, Jeong HS, Choi HA, Lee K. Therapeutic hypothermia after recanalization in patients with acute ischemic stroke. Stroke. 2014;45(1):134-40.
Wei S, Sun J, Li J, Wang L, Hall CL, Dix TA, et al. Acute and delayed protective effects of pharmacologically induced hypothermia in an intracerebral hemorrhage stroke model of mice. Neuroscience. 2013;252:489-500.
Andrews PJ, Sinclair HL, Rodriguez A, Harris BA, Battison CG, Rhodes JK, et al. Hypothermia for Intracranial Hypertension after Traumatic Brain Injury. The New England journal of medicine. 2015;373(25):2403-12.
Beca J, McSharry B, Erickson S, Yung M, Schibler A, Slater A, et al. Hypothermia for Traumatic Brain Injury in Children-A Phase II Randomized Controlled Trial. Critical care medicine. 2015;43(7):1458-66.
Wang J, Pearse DD. Therapeutic Hypothermia in Spinal Cord Injury: The Status of Its Use and Open Questions. International journal of molecular sciences. 2015;16(8):16848-79.
Seo JY, Kim YH, Kim JW, Kim SI, Ha KY. Effects of Therapeutic Hypothermia on Apoptosis and Autophagy After Spinal Cord Injury in Rats. Spine. 2015;40(12):883-90.
Wang D, Zhang J. Effects of hypothermia combined with neural stem cell transplantation on recovery of neurological function in rats with spinal cord injury. Molecular medicine reports. 2015;11(3):1759-67.
Albin MS, White RJ, Acosta-Rua G, Yashon D. Study of functional recovery produced by delayed localized cooling after spinal cord injury in primates. Journal of Neurosurgery. 1968;29(2):113-20.
Ducker TB, Hamit HF. Experimental treatments of acute spinal cord injury. Journal of neurosurgery. 1969;30(6):693-7.
Salzano RP, Ellison LH, Altonji PF, Richter J, Deckers PJ. Regional deep hypothermia of the spinal cord protects against ischemic injury during thoracic aortic cross-clamping. The Annals of thoracic surgery. 1994;57(1):65-71.
Rokkas CK, Cronin CS, Nitta T, Helfrich LR, Lobner DC, Choi DW, et al. Profound systemic hypothermia inhibits the release of neurotransmitter amino acids in spinal cord ischemia. The Journal of thoracic and cardiovascular surgery. 1995;110(1):27-35.
Batchelor PE, Skeers P, Antonic A, Wills TE, Howells DW, Macleod MR, et al. Systematic review and meta-analysis of therapeutic hypothermia in animal models of spinal cord injury. PloS one. 2013;8(8):e71317.
Dididze M, Green B, Dietrich WD, Vanni S, Wang M, Levi A. Systemic hypothermia in acute cervical spinal cord injury: a case-controlled study. Spinal cord. 2013;51(5):395.
Cappuccino A, Bisson LJ, Carpenter B, Snyder K, Cappuccino H. Systemic Hypothermia as Treatment for an Acute Cervical Spinal Cord Injury in a Professional Football Player: 9-Year Follow-Up. American journal of orthopedics (Belle Mead, NJ). 2017;46(2):E79-e82.
Levi AD, Casella G, Green BA, Dietrich WD, Vanni S, Jagid J, et al. Clinical outcomes using modest intravascular hypothermia after acute cervical spinal cord injury. Neurosurgery. 2010;66(4):670-7.
Lo TP, Cho KS, Garg MS, Lynch MP, Marcillo AE, Koivisto DL, et al. Systemic hypothermia improves histological and functional outcome after cervical spinal cord contusion in rats. Journal of Comparative Neurology. 2009;514(5):433-48.
Maybhate A, Hu C, Bazley FA, Yu Q, Thakor NV, Kerr CL, et al. Potential long-term benefits of acute hypothermia after spinal cord injury: assessments with somatosensory-evoked potentials. Critical care medicine. 2012;40(2):573-9.
Batchelor PE, Kerr NF, Gatt AM, Aleksoska E, Cox SF, Ghasem-Zadeh A, et al. Hypothermia prior to decompression: buying time for treatment of acute spinal cord injury. Journal of Neurotrauma. 2010;27(8):1357-68.
Morizane K, Ogata T, Morino T, Horiuchi H, Yamaoka G, Hino M, et al. A novel thermoelectric cooling device using Peltier modules for inducing local hypothermia of the spinal cord: the effect of local electrically controlled cooling for the treatment of spinal cord injuries in conscious rats. Neuroscience Research. 2012;72(3):279-82.
Lo TP, Jr., Cho KS, Garg MS, Lynch MP, Marcillo AE, Koivisto DL, et al. Systemic hypothermia improves histological and functional outcome after cervical spinal cord contusion in rats. Journal of Comparative Neurology. 2009;514(5):433-48.
Teh DBL, Chua SM, Prasad A, Kakkos I, Jiang W, Yue M, et al. Neuroprotective assessment of prolonged local hypothermia post contusive spinal cord injury in rodent model. Spine Journal: Official Journal of the North American Spine Society. 2018;18(3):507-14.
Yousefifard M, Movaghar VR, Baikpour M, Ghelichkhani P, Hosseini M, Jafari AM, et al. Early versus Late Decompression for Traumatic Spinal Cord Injuries; a Systematic Review and Meta-analysis. Emergency. 2016;4.
Hosseini M, Yousefifard M, Aziznejad H, Nasirinezhad F. The Effect of Bone Marrow–Derived Mesenchymal Stem Cell Transplantation on Allodynia and Hyperalgesia in Neuropathic Animals: A Systematic Review with Meta-Analysis. Biology of Blood and Marrow Transplantation. 2015;21(9):1537-44.
Izadi A, Yousefifard M, Nakhjavan-Shahraki B, Baikpour M, Mirzay Razaz J, Hosseini M. Diagnostic Value of Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Detection of Pediatric Acute Kidney Injury; a Systematic Review and Meta-Analysis. International Journal of Pediatrics. 2016;4(11):3875-95.
Izadi A, Yousefifard M, Nakhjavan-Shahraki B, Baikpour M, Mirzay Razaz J, Ataei N, et al. Value of Plasma/Serum Neutrophil Gelatinase-Associated Lipocalin in Detection of Pediatric Acute Kidney Injury; a Systematic Review and Meta-Analysis. International Journal of Pediatrics. 2016;4(11):3815-36.
Hassanzadeh‐Rad A, Yousefifard M, Katal S, Asady H, Fard‐Esfahani A, Moghadas Jafari A, et al. The value of 18F‐fluorodeoxyglucose positron emission tomography for prediction of treatment response in gastrointestinal stromal tumors: a systematic review and meta‐analysis. Journal of gastroenterology and hepatology. 2016;31(5):929-35.
Nakhjavan-Shahraki B, Yousefifard M, Oraii A, Sarveazad A, Hosseini M. Meta-analysis of neuron specific enolase in predicting pediatric brain injury outcomes. EXCLI J. 2017;16:995-1008.
Drevon D, Fursa SR, Malcolm AL. Intercoder Reliability and Validity of WebPlotDigitizer in Extracting Graphed Data. Behavior modification. 2017;41(2):323-39.
Cheriyan T, Ryan DJ, Weinreb JH, Cheriyan J, Paul JC, Lafage V, et al. Spinal cord injury models: a review. Spinal Cord. 2014;52(8):588-95.
Hassannejad Z, Sharif-Alhoseini M, Shakouri-Motlagh A, Vahedi F, Zadegan SA, Mokhatab M, et al. Potential variables affecting the quality of animal studies regarding pathophysiology of traumatic spinal cord injuries. Spinal Cord. 2016;54(8):579-83.
Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. Bmj. 1997;315(7109):629-34.
Casas CE, Herrera LP, Prusmack C, Ruenes G, Marcillo A, Guest JD. Effects of epidural hypothermic saline infusion on locomotor outcome and tissue preservation after moderate thoracic spinal cord contusion in rats. Journal of Neurosurgery Spine. 2005;2(3):308-18.
Dimar JR, 2nd, Shields CB, Zhang YP, Burke DA, Raque GH, Glassman SD. The role of directly applied hypothermia in spinal cord injury. Spine. 2000;25(18):2294-302.
Grulova I, Slovinska L, Nagyova M, Cizek M, Cizkova D. The effect of hypothermia on sensory-motor function and tissue sparing after spinal cord injury.[Erratum appears in Spine J. 2014 Mar 1;14(3):A8]. Spine Journal: Official Journal of the North American Spine Society. 2013;13(12):1881-91.
Ha KY, Kim YH. Neuroprotective effect of moderate epidural hypothermia after spinal cord injury in rats. Spine. 2008;33(19):2059-65.
Hosier H, Peterson D, Tsymbalyuk O, Keledjian K, Smith BR, Ivanova S, et al. A Direct Comparison of Three Clinically Relevant Treatments in a Rat Model of Cervical Spinal Cord Injury. Journal of Neurotrauma. 2015;32(21):1633-44.
Kao CH, Chio CC, Lin MT, Yeh CH. Body cooling ameliorating spinal cord injury may be neurogenesis-, anti-inflammation- and angiogenesis-associated in rats. Journal of Trauma-Injury Infection & Critical Care. 2011;70(4):885-93.
Karamouzian S, Akhtarshomar S, Saied A, Gholamhoseinian A. Effects of methylprednisolone on neuroprotective effects of delay hypothermia on spinal cord injury in rat. Asian Spine Journal. 2015;9(1):1-6.
Morochovic R, Chuda M, Talanova J, Cibur P, Kitka M, Vanicky I. Local transcutaneous cooling of the spinal cord in the rat: effects on long-term outcomes after compression spinal cord injury. International Journal of Neuroscience. 2008;118(4):555-68.
Ok JH, Kim YH, Ha KY. Neuroprotective effects of hypothermia after spinal cord injury in rats: comparative study between epidural hypothermia and systemic hypothermia. Spine. 2012;37(25):E1551-9.
Westergren H, Farooque M, Olsson Y, Holtz A. Motor function changes in the rat following severe spinal cord injury. Does treatment with moderate systemic hypothermia improve functional outcome? Acta Neurochirurgica. 2000;142(5):567-73.
Xu X, Li N, Zhu L, Zhou Y, Cheng H. Beneficial effects of local profound hypothermia and the possible mechanism after experimental spinal cord injury in rats. Journal of Spinal Cord Medicine. 2016;39(2):220-8.
Yu CG, Jimenez O, Marcillo AE, Weider B, Bangerter K, Dietrich WD, et al. Beneficial effects of modest systemic hypothermia on locomotor function and histopathological damage following contusion-induced spinal cord injury in rats. Journal of Neurosurgery. 2000;93(1 Suppl):85-93.
Barbosa MO, Cristante AF, Santos GB, Ferreira R, Marcon RM, Barros Filho TE. Neuroprotective effect of epidural hypothermia after spinal cord lesion in rats. Clinics (Sao Paulo, Brazil). 2014;69(8):559-64.
Seo JY, Kim YH, Kim JW, Kim SI, Ha KY. Effects of Therapeutic Hypothermia on Apoptosis and Autophagy After Spinal Cord Injury in Rats. Spine. 2015;40(12):883-90.
Topuz K, Colak A, Cemil B, Kutlay M, Demircan MN, Simsek H, et al. Combined hyperbaric oxygen and hypothermia treatment on oxidative stress parameters after spinal cord injury: an experimental study. Archives of Medical Research. 2010;41(7):506-12.
Morino T, Ogata T, Takeba J, Yamamoto H. Microglia inhibition is a target of mild hypothermic treatment after the spinal cord injury. Spinal cord. 2008;46(6):425.
Hansebout RR, Lamont RN, Kamath MV. The effects of local cooling on canine spinal cord blood flow. Canadian journal of neurological sciences. 1985;12(2):83-7.
Alkabie S, Boileau AJ. The Role of Therapeutic Hypothermia After Traumatic Spinal Cord Injury--A Systematic Review. World neurosurgery. 2016;86:432-49.
O’Toole JE, Wang MC, Kaiser MG. Hypothermia and human spinal cord injury: updated position statement and evidence based recommendations from the AANS/CNS Joint Section on Disorders of the Spine Peripheral Nerves. 2014.
Westergren H, Farooque M, Olsson Y, Holtz A. Spinal cord blood flow changes following systemic hypothermia and spinal cord compression injury: an experimental study in the rat using Laser-Doppler flowmetry. Spinal cord. 2001;39(2):74.
- Abstract Viewed: 385 times
- pdf Downloaded: 169 times
