Page 57 - AN-3-2

Advanced Neurology Inflammation in diabetic stroke: Pathogenesis

stroke fatigue. Brain inflammation also suppresses the Conflict of interest
84
synthesis of monoamine neurotransmitters, e.g., serotonin,
dopamine, and norepinephrine, which are required for The authors declare that they have no conflicts of interest.
mood stability, resulting in post-stroke depression. Post- Author contributions
84
stroke fatigue and depression appear to be unrelated to
stroke size and disability. It has been reported that major Conceptualization: Liqun Zhang, Yun Xu
83
depressive disorders are more prevalent in patients with Writing – original draft: Liqun Zhang, Ying Chen, Jingxian
diabetes than in the general population. One study has Xu
84
shown that in response to a potent cytokine inducer, namely Writing – review & editing: All authors
lipopolysaccharide, the db/db mice under experiment
produced more IL-1β and less IL-1 receptor antagonist, Ethics approval and consent to participate
and showed more pronounced sickness behavior compared Not applicable.
with their non-diabetic counterparts. 85
After stroke, the risk of dementia at 1 year was reported Consent for publication
34% in patients with severe stroke (NIHSS >10) and 8% Not applicable.
in those with minor stroke (NIHSS <3). Overall, the
86
prevalence of dementia is brought forward by 25 years in Availability of data
those with stroke compared with those without stroke. Not applicable.
86
A population-based cohort study showed that diabetes
is associated with an increased risk of post-stroke References
dementia. An earlier onset of post-stroke dementia is 1. GBD 2016 Lifetime Risk of Stroke Collaborators, Feigin VL,
87
likely due to brain ischemic brain damage, whereas a later Nguyen G, et al. Global, regional, and country-specific
onset is more likely due to a neurodegenerative process. lifetime risks of stroke, 1990 and 2016. N Engl J Med.
B lymphocyte-mediated autoimmunity after the release of 2018;379(25):2429-2437.
central nervous system-derived antigens from dead and doi: 10.1056/NEJMoa1804492
damaged cells is a possible contributing factor. A study
88
has shown that elevated TNF-α and IL-1β are associated 2. Emerging Risk Factors Collaboration, Sarwar N, Gao P, et al.
with neuronal death, suggesting a key link between pro- Diabetes mellitus, fasting blood glucose concentration, and
inflammatory cytokines and amyloid pathology of vascular risk of vascular disease: A collaborative meta-analysis of 102
prospective studies. Lancet. 2010;375(9733):2215-2222.
dementia. 89
doi: 10.1016/S0140-6736(10)60484-9
8. Concluding remark 3. Soriano-Reixach MM, Vivanco-Hidalgo RM, Ois A,
Inflammation plays an important role in ischemic stroke. Rodriguez-Campello A, Roquer J. Interaction of sex and
In patients with type 2 diabetes, chronic low-grade diabetes on outcome after ischemic stroke. Front Neurol.
inflammation caused by hyperglycemia increases the risk 2018;9:250.
of ischemic stroke, and the imbalance of pro- and anti- doi: 10.3389/fneur.2018.00250
inflammatory responses worsens ischemic brain damage 4. Available from: https://www.cdc.gov/diabetes/basics/quick-
and increases the risks of post-stroke infection, resulting in facts.html
poor clinical outcome after ischemic stroke. Many aspects
regarding the pathophysiology of ischemic brain injury, 5. Ogurtsova K, da Rocha Fernandes JD, Huang Y, et al. IDF
especially in diabetes, remain to be fully deciphered. diabetes atlas: Global estimates for the prevalence of diabetes
Further studies are warranted to deeply investigate the for 2015 and 2040. Diabetes Res Clin Pract. 2017;128:40-50.
pathophysiology of ischemic brain injury in diabetic doi: 10.1016/j.diabres.2017.03.024
context to explore potential treatment strategies and 6. Lloyd-Jones D, Adams R, Carnethon M, et al. Heart disease
targets. and stroke statistics--2009 update: A report from the
American Heart Association Statistics Committee and Stroke
Acknowledgments Statistics Subcommittee. Circulation. 2009;119(3):e21-e181.
None. doi: 10.1161/CIRCULATIONAHA.108.191261

Funding 7. Deb P, Sharma S, Hassan KM. Pathophysiologic
mechanisms of acute ischemic stroke: An overview with
None. emphasis on therapeutic significance beyond thrombolysis.

Volume 3 Issue 2 (2024) 7 doi: 10.36922/an.1683