脑卒中后痴呆与认知障碍的模型和机制。

Frontiers in stroke Pub Date : 2025-01-01 Epub Date: 2025-05-08 DOI:10.3389/fstro.2025.1563924
Romeesa Khan, Patrick Devlin, Akihiko Urayama, Rodney M Ritzel
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引用次数: 0

摘要

中风是全球死亡和残疾的主要原因,具有重大的长期影响,如中风后认知障碍(PSCI)。PSCI影响了多达三分之一的中风幸存者,大大增加了他们患痴呆的风险,尤其是在复发性中风之后。尽管在急性脑卒中治疗方面取得了进展,但PSCI的发病机制仍然知之甚少。新出现的证据表明,PSCI是由血管损伤、神经退行性病理和慢性炎症等复杂的相互作用引起的。本文综述了PSCI的流行病学和临床特征,强调了年龄、教育程度、血管完整性和合并症(如糖尿病)的作用。此外,我们研究了利用啮齿动物模型来阐明PSCI的时间过程和生物学机制的实验结果。值得注意的贡献包括转基因阿尔茨海默病(AD)小鼠模型的见解,揭示了血管和淀粉样蛋白病理如何加速中风后的认知衰退。此外,神经炎症和免疫反应的研究,如涉及TREM2的研究,强调了炎症通路在PSCI中的重要性。通过整合临床和实验结果,本文献综述提供了对PSCI机制的全面了解,为开发有针对性的诊断工具和治疗干预措施提供了基础,以减轻卒中的长期认知影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Models and mechanisms of post-stroke dementia and cognitive impairment.

Models and mechanisms of post-stroke dementia and cognitive impairment.

Stroke is a leading cause of death and disability globally, with significant long-term impacts such as post-stroke cognitive impairment (PSCI). PSCI affects up to one-third of stroke survivors, substantially increasing their risk of dementia, especially after recurrent strokes. Despite advances in acute stroke treatments, the mechanisms underlying PSCI remain poorly understood. Emerging evidence highlights that PSCI arises from a complex interplay of vascular damage, neurodegenerative pathologies, and chronic inflammation. This review explores the epidemiology and clinical characteristics of PSCI, emphasizing the role of age, education, vascular integrity, and comorbidities such as diabetes. Additionally, we examine experimental findings that utilize rodent models to elucidate the time course and biological mechanisms of PSCI. Notable contributions include insights from transgenic Alzheimer's disease (AD) mouse models, revealing how vascular and amyloid pathologies accelerate cognitive decline post-stroke. Moreover, studies on neuroinflammation and immune responses, such as those involving TREM2, underscore the significance of inflammatory pathways in PSCI. By integrating clinical and experimental findings, this literature review provides a comprehensive understanding of PSCI mechanisms, offering a foundation for developing targeted diagnostic tools and therapeutic interventions to mitigate the long-term cognitive effects of stroke.

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