Abstract

Unfortunately, over 40% of stroke victims have pre-existing diabetes which not only increases their risk of stroke up to 2-6 fold, but also worsens both functional recovery and the severity of cognitive impairment. Our lab has recently linked the chronic inflammation that persists in diabetic animals to their poor functional outcomes and exacerbated cognitive impairment, also known as post-stroke cognitive impairment (PSCI). Although we have shown that the development of PSCI in diabetes is associated with the upregulation and activation of pro-inflammatory microglia, we have not established a direct causation between the two. We tested the hypothesis that microglia depletion in the post-stroke recovery period prevents sustained inflammation and attenuates PSCI in diabetes. Methods: Diabetes was induced by a high fat diet (HFD) and low dose streptozotocin (STZ) combination. At 13 weeks of age, diabetic animals received bilateral intracerebroventricular (ICV) injections of short hairpin RNA (shRNA) lentiviral particles targeted at the colony stimulating factor 1 receptor (CSF1R), a key factor for microglia survival. After 14 days, animals were subjected to 60 min middle cerebral artery occlusion (MCAO) or sham surgery. Novel object recognition (NOR), and 2-trial Y-maze were utilized to evaluate cognitive function. Brains were analyzed by flow cytometry (B-D slice containing the prefrontal cortex through the hippocampus) and immunohistochemistry (B slice) 3 weeks post-MCAO. Results: CSF1R silencing resulted in a drastic 94% knockdown of residential microglia to relieve inflammation and decrease the macrophage infiltration by 74%. This also led to improved myelination of white matter in the brain and improved cognition in diabetic animals. Conclusion: Neuroinflammation, through microglial and macrophage polarization, is largely responsible for the development of PSCI in diabetes.

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