Iron metabolism dysregulation and post-stroke cognitive impairment: mechanisms and therapeutic perspectives

Post-stroke cognitive impairment (PSCI) is a frequent neurological consequence of acute stroke. It manifests as persistent deficits in cognitive function for at least 6 months following cerebral infarction and substantially diminishes patients’ quality of life. Currently, its specific pathogenesis remains unclear. In recent years, increasing attention has been directed toward the contribution of disrupted iron metabolism to the development of PSCI. Acute stroke can cause iron metabolism disorder in the central nervous system and result in iron deposition, which causes damage to nerve cells through mechanisms such as ferroptosis, thereby leading to cognitive decline. Therefore, studies on the treatment of PSCI by regulating this mechanism have emerged. This review summarizes recent advances in the mechanisms linking iron metabolism dysregulation to PSCI and highlights emerging therapeutic strategies, offering new insights for improving its diagnosis and management.