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

Spinal cord injury (SCI) is a serious condition resulting from mechanical trauma, leading to motor and sensory function loss. Current treatments often result in suboptimal recovery, necessitating new therapeutic strategies. Metformin, typically used for type II diabetes, has shown potential in mitigating neurological disorders due to its anti-inflammatory and anti-oxidative properties. It activates the AMPK pathway, crucial for cellular energy homeostasis and oxidative stress response. This study investigates metformin's effectiveness in SCI treatment, focusing on locomotor recovery, pain reduction, and underlying biomedical pathways like inflammation and oxidative stress. It analyzes data from multiple rodent model studies to evaluate these effects.

• 1
  Metformin significantly enhances locomotor function after SCI in rodent models. It also improves mechanical allodynia and thermal hyperalgesia, indicating pain alleviation.
• 2
  Metformin reduces inflammation, oxidative stress, microglial activation, and astrogliosis. It also promotes myelination and autophagy flux via the AMPK signaling pathway, leading to decreased apoptosis and lesion size.
• 3
  Subgroup analyses show greater locomotor improvements when metformin is administered in the acute phase (less than 3 days post-injury), highlighting the importance of early intervention.