mTOR activation facilitates locomotor recovery in rats with spinal cord injuries: a meta-analysis

mTOR activation is a therapeutic strategy for improving the functional outcomes in patients with spinal cord injuries (SCI). The effects of mTOR activation on motor recovery in rats with SCI were evaluated. Randomized controlled trials comparing mTOR activation and vehicle treatments published up to 20 May 2019 were searched in English databases (PubMed, Embase, and Web of Science). A quality assessment was performed using the CAMARADES checklist. Two investigators independently extracted the related data. The results were analyzed using STATA 12.0 and RevMan 5.3 software. Subgroup analyses were performed to assess the heterogeneity. A sensitivity analysis was performed to assess the robustness of our analysis. Nine studies examining 246 rats satisfied the inclusion criteria. According to the combined results, the total Basso Beattie Bresnahan (BBB) scores were significantly higher in the mTOR activated groups compared with the SCI + saline groups. The heterogeneity of the total BBB scores was high after 1-6 weeks. A drug subgroup analysis suggested that the heterogeneity of the miRNA drug subgroup was lower than it was in the same group at 1 week (I-2 = 84%), 2 weeks (I-2 = 68%), 3 weeks (I-2 = 13%), and 4 weeks (I-2 = 38%). Based on the sensitivity analysis, the results were stable. Regarding publication bias, the mTOR activation improved functional outcomes by 15% in the experimental SCI models, thus indicating it is a feasible strategy for the pharmacological augmentation of neurorehabilitation of SCI in humans.