Structural Characteristics Of Gut Microbiota And Its Correlation With Metabolism And Inflammation In Patients With Post-stroke Cognitive Impairment

Background:Post-stroke cognitive impairment is one of the important complications of stroke,characterized by patchy cognitive impairment and fluctuating course,and has a negative impact on physical,psychological,social function and life of stroke patients,and affects the overall survival(OS)of patients.The brain axis of the gut microbiota has become one of the focuses of neuroscience.The gut microbiota has important effects on the brain through neural networks,neuroendocrine system and immune system.In recent years,the results of studies related to gut flora and cognitive disorders such as Parkinson’s syndrome have been gradually reported,but there is no study on the correlation between post-stroke cognitive impairment and gut flora.This study focuses on the structure of post-stroke cognitive impairment and gut flora and its correlation with metabolism and inflammation to provide a basis for the prognosis and prevention of post-stroke cognitive impairment.Methods:A total of 225 adult acute ischemic stroke patients with onset within 7 days in the general neurology ward were included in this study for screening and collection of clinical indicators of cognitive function and long-term,3-monthly followup.All subjects had their first fresh stool and fasting blood collected at admission and during follow-up,and all stools were sequenced by 16srRNA to indicate intra-group differences and inter-group differences by alpha and beta diversity,respectively.Next,the concentration of short-chain fatty acids,a metabolite of the flora,in the stool was measured by meteorological mass spectrometry,and the concentration of inflammatory factors in the patients’ serum was measured by immunoblotting.Results:We found that the intestinal microbiota of patients with impaired cognitive function within 3-12 months after onset,i.e.,patients with post-stroke cognitive impairment and patients without post-stroke cognitive impairment,were different during the onset of acute stroke.The main differences were decreased a diversity index and enrichment of pro-inflammatory shigella.The decreased level of liver function and inflammatory state in patients with post-stroke cognitive impairment were correlated with AKK bacteria and microphylum verrucum,and the levels of inflammatory factor NF-κB and cognitive-related factor bACEl were significantly higher in patients with post-stroke cognitive impairment than those without post-stroke cognitive impairment.Conclusions:The diversity of intestinal flora in patients with post-stroke cognitive impairment and those without post-stroke cognitive impairment decreased at the onset of acute stroke,and decreased more in patients with post-stroke cognitive impairment.Serum inflammatory factor NF-κB and cognitive-related factor bACE1 were significantly increased in patients with post-stroke cognitive impairment.Reduced levels of liver function in patients were associated with intestinal AKK bacteria.This study provides new ideas for the treatment and prognosis of cognitive impairment after stroke.