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RESEARCH ARTICLE
Year : 2020  |  Volume : 15  |  Issue : 3  |  Page : 537-547

Effect of docosahexaenoic acid on the recovery of motor function in rats with spinal cord injury: a meta-analysis


1 Institute of Spine Disease, Longhua Hospital, Shanghai University of Traditional Chinese Medicine; Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education (Shanghai University of Traditional Chinese Medicine); Shanghai University of Traditional Chinese Medicine, Shanghai, China
2 Institute of Spine Disease, Longhua Hospital, Shanghai University of Traditional Chinese Medicine; Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education (Shanghai University of Traditional Chinese Medicine), Shanghai, China
3 Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education (Shanghai University of Traditional Chinese Medicine); Shanghai University of Traditional Chinese Medicine; Rehabilitation Medicine College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
4 Department of Orthopedics and Traumatology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
5 Institute of Spine Disease, Longhua Hospital, Shanghai University of Traditional Chinese Medicine; Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education (Shanghai University of Traditional Chinese Medicine); Shanghai University of Traditional Chinese Medicine; Rehabilitation Medicine College, Shanghai University of Traditional Chinese Medicine, Shanghai, China

Correspondence Address:
Xue-Jun Cui
Institute of Spine Disease, Longhua Hospital, Shanghai University of Traditional Chinese Medicine; Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education (Shanghai University of Traditional Chinese Medicine), Shanghai
China
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Source of Support: This work was supported by the National Natural Science Foundation of China, No. 81704096, 81603635, 81873317 (to MY, JY, XJC); Shanghai Science and Technology Commission - Key Project of Traditional Chinese Medicine, No. 16401970100 (to YJW); the Shanghai Traditional Chinese Medicine Medical Center of Chronic Disease of China, No. 2017ZZ01010 (to YJW); the National Thirteenth Five-Year Science and Technology Major Special Project for New Drug Innovation and Development of China, No. 2017ZX09304001 (to YJW); the Program for Innovative Research Team of Ministry of Science and Technology of China, No. 2015RA4002 (to YJW); the “Innovation Team” Development Projects of China, No. IRT1270 (to YJW); the Three Years Action to Accelerate the Development of Traditional Chinese Medicine Plan of China, No. ZY(2018-2020)-CCCX-3003 (to YJW), Conflict of Interest: None


DOI: 10.4103/1673-5374.266065

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Objective: Studies have shown that docosahexaenoic acid (DHA) has a beneficial effect in the treatment of spinal cord injury. A meta-analysis was used to study the effect of DHA on the neurological recovery in the rat spinal cord injury model, and the relationship between the recovery of motor function after spinal cord injury and the time and method of administration and the dose of DHA. Data source: Published studies on the effect of DHA on spinal cord injury animal models from seven databases were searched from their inception to January 2019, including PubMed, MEDLINE, EMBASE, the China National Knowledge Infrastructure, Wanfang, VIP, and SinoMed databases. The search terms included “spinal cord injury” “docosahexaenoic acid”, and “rats”. Data selection: Studies that evaluated the influence of DHA in rat models of spinal cord injury for locomotor functional recovery were included. The intervention group included any form of DHA treatment and the control group included treatment with normal saline, vehicle solution or no treatment. The Systematic Review Centre for Laboratory animal Experimentation’s risk of bias assessment tool was used for the quality assessment of the included studies. Literature inclusion, quality evaluation and data extraction were performed by two researchers. Meta-analysis was then conducted on all studies that met the inclusion criteria. Statistical analysis was performed on the data using RevMan 5.1.2. software. Outcome measures: The primary outcome measure was the score on the Basso, Beattie, and Bresnahan scale. Secondary outcome measures were the sloping plate test, balance beam test, stair test and grid exploration test. Results: A total of 12 related studies were included, 3 of which were of higher quality and the remaining 9 were of lower quality. The highest mean Basso, Beattie, and Bresnahan scale score occurred at 42 days after DHA treatment in spinal cord injury rats. At 21 days after treatment, the mean difference in Basso, Beattie, Bresnahan scores between the DHA group and the control group was the most significant (pooled MD = 4.14; 95% CI = 3.58–4.70; P < 0.00001). In the subgroup analysis, improvement in the Basso, Beattie, and Bresnahan scale score was more significant in rats administered DHA intravenously (pooled MD = 2.74; 95% CI = 1.41–4.07; P < 0.0001) and subcutaneously (pooled MD = 2.99; 95% CI = 2.29–3.69; P < 0.00001) than in the groups administered DHA orally (pooled MD = 3.04; 95% CI = –1.01 to 7.09; P = 0.14). Intravenous injection of DHA at 250 nmol/kg (pooled MD = 2.94; 95% CI = 2.47–3.41; P < 0.00001] and 1000 nmol/kg [pooled MD = 3.60; 95% CI = 2.66–4.54; P < 0.00001) significantly improved the Basso, Beattie, and Bresnahan scale score in rats and promoted the recovery of motor function. Conclusion: DHA can promote motor functional recovery after spinal cord injury in rats. The administration of DHA by intravenous or subcutaneous injection is more effective than oral administration of DHA. Intravenous injection of DHA at doses of 250 nmol/kg or 1000 nmol/kg is beneficial. Because of the small number and the low quality of the included studies, more high-quality research is needed in future to substantiate the results.


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