Early General Hypothermia Improves Motor Function after Spinal Cord Injury in Rats; a Systematic Review and Meta-Analysis

There is still controversy about the effect of early hypothermia on the outcome of spinal cord in-jury (SCI). The aim of this review article is to investigate the effect of local or general hypothermia on improvingthe locomotion after traumatic SCI.

Electronic databases (Medline and Embase) were searched frominception until May 7, 2018. Two independent reviewers screened and summarized the relevant experimentalstudies on hypothermia efficacy in traumatic SCI. The data were analyzed and the findings were presented aspooled standardized mean difference (SMD) and 95% confidence interval (95% CI).

20 papers contain-ing 30 separate experiments were included in meta-analysis. The onset of hypothermia varied between 0 and 240minutes after SCI. Administration of hypothermia has a positive effect on locomotion following SCI (SMD=0.5695% CI: 0.18-0.95, p=0.004). Subgroup analysis showed that general hypothermia improves locomotion recov-ery (SMD =0.89, 95% CI: 0.42 to 1.36; p <0.0001), while local hypothermia does not have a significant effect onmotor recovery (SMD=0.20, 95 % CI: -0.36-0.76, p=0.478). In addition, general hypothermia was found to affectmotor recovery only if its duration was between 2 and 8 hours (SMD=0.89; p<0.0001) and the target temperaturefor induction of hypothermia was between 32 and 35◦C C (SMD=0.83; p<0.0001).

We found thatgeneral hypothermia improves locomotion after SCI in rats. Duration of induction and the target temperatureare two essential considerations for general therapeutic hypothermia.