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Peer-reviewedCC BYFrontiers in neurology

Cognitive impairment after cerebral ischemia-reperfusion injury: a neuroecosystem perspective.

  • Jiangbo Xie1
  • Tingting Zhang2,3
  • Jinmei Zhang4
  • Liping Zhang5
  • Tao Huang6
  • Wenhua Bi1
  • Manli Zhao1
6 affiliations
  1. 1Department of Neurology, Weifang Hospital of Traditional Chinese Medicine, Shandong Second Medical University, Weifang, China.
  2. 2Department of Rehabilitation, Fujian Medical University, Fuzhou, China.
  3. 3Department of Rehabilitation, Weifang Hospital of Traditional Chinese Medicine, Shandong Second Medical University, Weifang, China.
  4. 4Department of Endocrinology, Weifang Hospital of Traditional Chinese Medicine, Shandong Second Medical University, Weifang, China.
  5. 5Clinical Integration of Traditional Chinese and Western Medicine, Shandong Second Medical University, Weifang, China.
  6. 6Department of Neurosurgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
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Abstract

Post-stroke cognitive impairment (PSCI) is a common and debilitating neurological complication following cerebral ischemia-reperfusion injury (CIRI). The traditional neuron-centered view cannot fully explain its delayed onset, pathological heterogeneity, and functional plasticity. This review proposes a novel neuroecosystem framework based on the neurovascular-immune-glial (NIG) triad, including a systematic evaluation of the dynamic crosstalk among the neurovascular unit (NVU), neuronal networks, and glial-immune microenvironment. Pathological events, including ferroptosis, neuroinflammation, white matter damage, and gut-brain axis dysfunction, are reinterpreted as manifestations of neuroecosystem collapse, rather than isolated lesions. We further summarize cutting-edge tools, such as spatial omics and in vivo dynamic imaging for framework validation, and clarify how therapeutic strategies are shifting from single neuronal protection to overall ecosystem restoration. Finally, we discuss current limitations in knowledge and future research directions, aiming to provide new insights for mechanistic exploration and clinical intervention of PSCI.

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Cite

BibTeXRIS
BibTeX
@article{xie2026cognitive,
  title = {{Cognitive impairment after cerebral ischemia-reperfusion injury: a neuroecosystem perspective.}},
  author = {Jiangbo Xie and Tingting Zhang and Jinmei Zhang and Liping Zhang and Tao Huang and Wenhua Bi and Manli Zhao},
  journal = {Frontiers in neurology},
  year = {2026},
  month = sep,
  doi = {10.3389/fneur.2026.1912737},
  url = {https://europepmc.org/article/MED/42840724},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Cognitive impairment after cerebral ischemia-reperfusion injury: a neuroecosystem perspective.
AU  - Jiangbo Xie
AU  - Tingting Zhang
AU  - Jinmei Zhang
AU  - Liping Zhang
AU  - Tao Huang
AU  - Wenhua Bi
AU  - Manli Zhao
PY  - 2026
DA  - 2026/09/22
JO  - Frontiers in neurology
DO  - 10.3389/fneur.2026.1912737
UR  - https://europepmc.org/article/MED/42840724
AB  - Post-stroke cognitive impairment (PSCI) is a common and debilitating neurological complication following cerebral ischemia-reperfusion injury (CIRI). The traditional neuron-centered view cannot fully explain its delayed onset, pathological heterogeneity, and functional plasticity. This review proposes a novel neuroecosystem framework based on the neurovascular-immune-glial (NIG) triad, including a systematic evaluation of the dynamic crosstalk among the neurovascular unit (NVU), neuronal networks, and glial-immune microenvironment. Pathological events, including ferroptosis, neuroinflammation, white matter damage, and gut-brain axis dysfunction, are reinterpreted as manifestations of neuroecosystem collapse, rather than isolated lesions. We further summarize cutting-edge tools, such as spatial omics and in vivo dynamic imaging for framework validation, and clarify how therapeutic strategies are shifting from single neuronal protection to overall ecosystem restoration. Finally, we discuss current limitations in knowledge and future research directions, aiming to provide new insights for mechanistic exploration and clinical intervention of PSCI.
SN  - 1664-2295
ER  -