http://www.nature.com/jcbfm/journal/v35/n3/full/jcbfm2014218a.html
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Abstract
Cannabinoids
(CBs) show promise as neuroprotectants with some agents already
licensed in humans for other conditions. We systematically reviewed CBs
in preclinical stroke to guide further experimental protocols. We
selected controlled studies assessing acute administration of CBs for
experimental stroke, identified through systematic searches. Data were
extracted on lesion volume, outcome and quality, and analyzed using
random effect models. Results are expressed as standardized mean
difference (SMD) with 95% confidence intervals
(CIs). In all, 144 experiments (34 publications) assessed CBs on infarct
volume in 1,473 animals. Cannabinoids reduced infarct volume in
transient (SMD −1.41 (95% CI −1.71), −1.11)
P<0.00001) and permanent (−1.67 (−2.08, −1.27), P<0.00001)
ischemia and in all subclasses: endocannabinoids (−1.72 (−2.62, −0.82), P=0.0002), CB1/CB2 ligands (−1.75 (−2.19, −1.31), P<0.00001), CB2 ligands (−1.65 (−2.09, −1.22), P<0.00001), cannabidiol (−1.20 (−1.63, −0.77), P<0.00001), Δ9-tetrahydrocannabinol
(−1.43 (−2.01, −0.86), P<0.00001), and HU-211 (−2.90 (−4.24, −1.56),
P<0.0001). Early and late neuroscores significantly improved with CB
use (−1.27 (−1.58, −0.95), P<0.00001; −1.63 (−2.64, −0.62),
P<0.002 respectively) and there was no effect on survival.
Statistical heterogeneity and publication bias was present, median study
quality was 4 (range 1 to 6/8). Overall, CBs
significantly reduced infarct volume and improve functional outcome in
experimental stroke. Further studies in aged, female and larger animals,
with other co-morbidities are required.
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