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Following oral exposure, accumulating evidence suggests that MPs can disrupt gut microbial homeostasis, impair intestinal epithelial barrier integrity, and engage the gut\u2010brain axis (GBA), thereby promoting systemic and central inflammatory responses. These interconnected processes are linked to blood\u2010brain barrier (BBB) dysfunction, cerebral microvascular impairment, and neurovascular alterations that are biologically relevant to stroke susceptibility. Evidence derived largely from animal and in vitro models, together with emerging epidemiological observations, supports the biological plausibility that microplastic (MP) exposure may contribute to neurovascular vulnerability through mechanisms involving endothelial inflammation, pro\u2010thrombotic signaling, and atherosclerotic progression. However, substantial heterogeneity in exposure paradigms, particle characteristics, and analytical methodologies limits direct causal inference and translational interpretation in humans. Future research should prioritize standardized exposure frameworks and integrate multi\u2010omics approaches with artificial intelligence (AI)\u2010assisted analysis to better define exposure\u2013response relationships and mechanistic pathways underlying MP\u2010associated cerebrovascular alterations. Such efforts are essential for improving risk assessment and informing evidence\u2010based strategies for environmental neurovascular health.<\/jats:p>","DOI":"10.1002\/advs.202520278","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T12:08:31Z","timestamp":1768219711000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["From the Gut to the Brain: Microplastic\u2010Associated Neurovascular Dysfunction and Implications for Stroke Risk"],"prefix":"10.1002","volume":"13","author":[{"given":"Hongxing","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Rehabilitation School of Medicine Chongqing University Three Gorges Hospital Chongqing University  Chongqing China"},{"name":"Xinjiang Key Laboratory of Neurological Disorder Research The Second Affiliated Hospital of Xinjiang Medical University  Urumgi 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