Host-Microbial Cometabolite Ursodeoxycholic Acid Protects Against Poststroke Cognitive Impairment

Area of Science:

• Neuroscience
• Microbiome research
• Metabolomics

Background:

• Poststroke cognitive impairment (PSCI) is a common, often underdiagnosed, consequence of stroke.
• Previous research indicated ursodeoxycholic acid (UDCA) ameliorates stroke-induced brain damage in mice.
• This study investigates UDCA's predictive value for PSCI risk.

Purpose of the Study:

• To evaluate the predictive value of UDCA for poststroke cognitive impairment (PSCI) risk.
• To identify biomarkers for PSCI in patients with acute ischemic stroke.
• To explore the neuroprotective role of UDCA in stroke and PSCI.

Main Methods:

• Recruited 202 mild acute ischemic stroke patients and 63 large-artery stenosis patients.
• Utilized machine learning to develop a predictive model for PSCI.
• Conducted animal studies using mice subjected to middle cerebral artery occlusion.

Main Results:

• Patients developing PSCI showed reduced plasma UDCA levels and altered gut microbiota.
• A predictive model incorporating UDCA, microbiota, age, education, and white matter lesions showed high accuracy (AUC 0.904 internal, 0.838 external).
• UDCA administration in mice improved cognitive function by reducing neuroinflammation and apoptosis.

Conclusions:

• UDCA shows potential as a biomarker for predicting PSCI risk.
• UDCA may play a neuroprotective role in PSCI.
• Early identification and intervention targeting UDCA could aid PSCI prevention and treatment.