Mechanisms and biomarkers of poststroke cognitive impairment
Abstract
Poststroke cognitive impairment is a common neurological complication in stroke patients, characterized by progressive cognitive decline ranging from mild cognitive impairment to vascular dementia, significantly impacting patients' quality of life and long-term prognosis. Recent studies have gradually unveiled the multidimensional pathophysiological mechanisms underlying post-stroke cognitive impairment. This review provides a detailed introduction to the mechanisms and biomarkers of poststroke cognitive impairment. At the molecular level, the development of poststroke cognitive impairment involves multi-level and interconnected pathophysiological changes. Among these, the activation of neuroinflammation and oxidative stress damage are considered key initiating factors. Concurrently, the accumulation of reactive oxygen species induced by oxidative stress can further promote the occurrence of poststroke cognitive impairment. Increased blood-brain barrier permeability, along with the infiltration of peripheral inflammatory cells and the entry of toxic substances into the brain, exacerbates neural damage. In terms of neurotransmitter systems, the imbalance between excitatory and inhibitory neurotransmitter systems directly affects synaptic plasticity and the integration of neural networks. Structurally, the integrity of white matter microstructure is compromised, manifesting as myelin loss and axonal transport impairment. These multi-level pathological changes interact through…
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