Effect of Exercise Interventions on Kainate Induced Status Epilepticus and Associated Co-morbidities; A Systematic Review and Meta-Analysis

Purpose To conduct a systematic review and meta-analysis of studies testing the effect of exercise in Kainic-acid (KA) induced status-epilepticus (SE) and to quantify the efficacy of exercise strategies in the prognosis of SE and co-morbidities. Methods Two authors searched online databases (Pubmed and Web of Science) independently for studies testing the efficacy of exercise programs in KA-induced SE models. Reviewers autonomously extracted data on models used, exercise interventions and prognosis in all reported outcomes (behavioral, histological, biochemical and cognitive outcomes). All studies were summarized and relevant outcomes’ data were pooled by means of a meta-analysis. Results Among 14 selected studies; Quantitative analysis of studies with pre-SE exercise interventions showed significant reduction in mortality rate among 76 animals of four studies (RR = 0.57, [95% CI 0.34, 0.95], p = 0.03, I 2 = 57%) and seizure rating score among three studies (n = 56) with MD = − 1.04, [95% CI − 2.07, − 0.00], p = 0.05, I 2 = 71%. Three studies (n = 62) presented with improved anti-oxidant enzymes’ profile (SMD = 0.75, [95% CI 0.55, 2.31], p = 0.0008, I 2 = 44%) as a result of exercise intervention. Same intervention failed to show any significant measure for BDNF level and neuroprotection assessed through neuronal number in different brain areas with MD = − 1.22, [95% CI − 136.66, 134.22], p = 0.99, I 2 = 0% and SMD = − 0.05, [95% CI − 0.62, 0.52], p = 0.86, I 2 = 61% respectively. Qualitative review concluded in the reduction of median seizure score, depression and anxiety-like behaviors with improved cognitive performances in pre-SE exercised animals while improved memory and learning capabilities with increased neurogenesis were observed in post-SE exercised models. Conclusions Exercise before SE reduces behavioral seizures and oxidative stress with improvements in cognitive abilities. Post-SE exercise enhances learning and memory with neurogenesis in KA models. More extensive research on morphological and biochemical profiles is needed to explore underlying mechanisms.