{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:18:22Z","timestamp":1787671102708,"version":"build-2736575974"},"reference-count":205,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Neurol"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Gastrointestinal (GI) complications are seen in over 50% of ischemic stroke survivors; the most common complications are dysphagia, constipation, and GI bleeding. The bidirectional relationship of the gut\u2013brain axis and stroke has recently gained traction, wherein stroke contributes to gut dysbiosis (alterations in the normal host intestinal microbiome) and gut dysbiosis perpetuates poor functional neurologic outcomes in stroke. It is postulated that the propagation of proinflammatory cells and gut metabolites (including trimethylamine N-oxide and short-chain fatty acids) from the GI tract to the central nervous system play a central role in gut\u2013brain axis dysfunction. In this review, we discuss the known GI complications in acute ischemic stroke, our current knowledge from experimental stroke models for gut\u2013brain axis dysfunction in stroke, and emerging therapeutics that target the gut\u2013brain axis.<\/jats:p>","DOI":"10.1055\/s-0043-1771470","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T23:02:55Z","timestamp":1691708575000},"page":"609-625","source":"Crossref","is-referenced-by-count":19,"title":["Gastrointestinal Dysfunction in Stroke"],"prefix":"10.1055","volume":"43","author":[{"given":"Heather Y.F.","family":"Yong","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Calgary, Calgary, Canada"},{"name":"Cumming School of Medicine, University of Calgary, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravind","family":"Ganesh","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Calgary, Calgary, Canada"},{"name":"Cumming School of Medicine, University of Calgary, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Camara-Lemarroy","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Calgary, Calgary, Canada"},{"name":"Cumming School of Medicine, University of Calgary, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/S1474-4422(21)00252-0","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"20","author":"GBD 2019 Stroke Collaborators","year":"2021","journal-title":"Lancet Neurol"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1177\/17474930211065917","article-title":"World Stroke Organization (WSO): Global Stroke Fact Sheet 2022","volume":"17","author":"V L Feigin","year":"2022","journal-title":"Int J Stroke"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/1471-2318-14-41","article-title":"Age-based prediction of incidence of complications during inpatient stroke rehabilitation: a retrospective longitudinal cohort study","volume":"14","author":"C M Chen","year":"2014","journal-title":"BMC Geriatr"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jns.2014.08.027","article-title":"Gastrointestinal complications after ischemic stroke","volume":"346","author":"C R Camara-Lemarroy","year":"2014","journal-title":"J Neurol Sci"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1055\/s-2008-1040984","article-title":"Gastrointestinal dysfunction in stroke","volume":"16","author":"T Ullman","year":"1996","journal-title":"Semin Neurol"},{"issue":"07","key":"ref6","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1111\/j.1572-0241.2006.00540.x","article-title":"Pathophysiological changes of the gastrointestinal tract in ischemic stroke","volume":"101","author":"B J Schaller","year":"2006","journal-title":"Am J Gastroenterol"},{"issue":"12","key":"ref7","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1111\/j.1468-1331.2008.02310.x","article-title":"Impact of neurological and medical complications on 3-month outcomes in acute ischaemic stroke","volume":"15","author":"K S Hong","year":"2008","journal-title":"Eur J Neurol"},{"issue":"28","key":"ref8","doi-asserted-by":"crossref","first-page":"e16312","DOI":"10.1097\/MD.0000000000016312","article-title":"Factors affecting the occurrence of gastrointestinal bleeding in acute ischemic stroke patients","volume":"98","author":"J Fu","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1038\/nature08821","article-title":"A human gut microbial gene catalogue established by metagenomic sequencing","volume":"464","author":"J Qin","year":"2010","journal-title":"Nature"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1044673","DOI":"10.3389\/fendo.2022.1044673","article-title":"Gut bacteriome, mycobiome and virome alterations in rheumatoid arthritis","volume":"13","author":"S Dagar","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1037330","DOI":"10.3389\/fimmu.2022.1037330","article-title":"Ischemic stroke and concomitant gastrointestinal complications- a fatal combination for patient recovery","volume":"13","author":"A A Tuz","year":"2022","journal-title":"Front Immunol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.bbi.2013.12.015","article-title":"The role of microbiome in central nervous system disorders","volume":"38","author":"Y Wang","year":"2014","journal-title":"Brain Behav Immun"},{"issue":"11","key":"ref13","doi-asserted-by":"crossref","first-page":"2101","DOI":"10.1111\/j.1532-5415.2009.02526.x","article-title":"Effect of dysphasia and dysphagia on inpatient mortality and hospital length of stay: a database study","volume":"57","author":"V Guyomard","year":"2009","journal-title":"J Am Geriatr Soc"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"e0148424","DOI":"10.1371\/journal.pone.0148424","article-title":"Dysphagia in acute stroke: incidence, burden and impact on clinical outcome","volume":"11","author":"M Arnold","year":"2016","journal-title":"PLoS One"},{"issue":"06","key":"ref15","doi-asserted-by":"crossref","first-page":"e023175","DOI":"10.1161\/JAHA.121.023175","article-title":"Development and validation of prediction models for severe complications after acute ischemic stroke: a study based on the Stroke Registry of Northwestern Germany","volume":"11","author":"A K Bonkhoff","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"e13338","DOI":"10.1111\/nmo.13338","article-title":"Prevalence, risk factors and complications of oropharyngeal dysphagia in stroke patients: a cohort study","volume":"e13338","author":"L Rofes","year":"2018","journal-title":"Neurogastroenterol Motil"},{"issue":"12","key":"ref17","doi-asserted-by":"crossref","first-page":"2756","DOI":"10.1161\/01.STR.0000190056.76543.eb","article-title":"Dysphagia after stroke: incidence, diagnosis, and pulmonary complications","volume":"36","author":"R Martino","year":"2005","journal-title":"Stroke"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"823189","DOI":"10.3389\/fneur.2022.823189","article-title":"Post-stroke dysphagia: prognosis and treatment - a systematic review of RCT on interventional treatments for dysphagia following subacute stroke","volume":"13","author":"P Balcerak","year":"2022","journal-title":"Front Neurol"},{"issue":"06","key":"ref19","doi-asserted-by":"crossref","first-page":"e0270096","DOI":"10.1371\/journal.pone.0270096","article-title":"Risk factors of dysphagia in patients with ischemic stroke: a meta-analysis and systematic review","volume":"17","author":"C Yang","year":"2022","journal-title":"PLoS One"},{"issue":"05","key":"ref20","first-page":"308","article-title":"Management of dysphagia in stroke patients","volume":"7","author":"R Shaker","year":"2011","journal-title":"Gastroenterol Hepatol (N Y)"},{"issue":"04","key":"ref21","doi-asserted-by":"crossref","first-page":"747","DOI":"10.3233\/NRE-172192","article-title":"Effects of resistance expiratory muscle strength training in elderly patients with dysphagic stroke","volume":"41","author":"M J Eom","year":"2017","journal-title":"NeuroRehabilitation"},{"issue":"06","key":"ref22","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1177\/0269215516652446","article-title":"Respiratory muscle strength training and neuromuscular electrical stimulation in subacute dysphagic stroke patients: a randomized controlled trial","volume":"31","author":"A Guill\u00e9n-Sol\u00e0","year":"2017","journal-title":"Clin Rehabil"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1589\/jpts.29.609","article-title":"Effects of expiratory muscle strength training on swallowing function in acute stroke patients with dysphagia","volume":"29","author":"J H Moon","year":"2017","journal-title":"J Phys Ther Sci"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"104521","DOI":"10.1016\/j.archoralbio.2019.104521","article-title":"Tongue stretching exercises improve tongue motility and oromotor function in patients with dysphagia after stroke: a preliminary randomized controlled trial","volume":"108","author":"N K Hwang","year":"2019","journal-title":"Arch Oral Biol"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/joor.12461","article-title":"Tongue-to-palate resistance training improves tongue strength and oropharyngeal swallowing function in subacute stroke survivors with dysphagia","volume":"44","author":"H D Kim","year":"2017","journal-title":"J Oral Rehabil"},{"issue":"03","key":"ref26","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/1460-6984.12453","article-title":"Effect of effortful swallowing training on tongue strength and oropharyngeal swallowing function in stroke patients with dysphagia: a double-blind, randomized controlled trial","volume":"54","author":"H S Park","year":"2019","journal-title":"Int J Lang Commun Disord"},{"issue":"01","key":"ref27","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S1474-4422(05)70252-0","article-title":"Behavioural intervention for dysphagia in acute stroke: a randomised controlled trial","volume":"5","author":"G Carnaby","year":"2006","journal-title":"Lancet Neurol"},{"issue":"10","key":"ref28","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1111\/joor.13068","article-title":"Capsaicin combined with ice stimulation improves swallowing function in patients with dysphagia after stroke: a randomised controlled trial","volume":"47","author":"F Cui","year":"2020","journal-title":"J Oral Rehabil"},{"issue":"01","key":"ref29","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/PL00009543","article-title":"Pharmacological treatment of dysphagia in stroke","volume":"13","author":"I Perez","year":"1998","journal-title":"Dysphagia"},{"issue":"05","key":"ref30","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s11655-012-1140-9","article-title":"Clinical study on Tongyan spray for post-stroke dysphagia patients: a randomized controlled trial","volume":"18","author":"X G Feng","year":"2012","journal-title":"Chin J Integr Med"},{"issue":"04","key":"ref31","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1111\/joor.12928","article-title":"Exercise-based swallowing intervention (McNeill Dysphagia Therapy) with adjunctive NMES to treat dysphagia post-stroke: a double-blind placebo-controlled trial","volume":"47","author":"G D Carnaby","year":"2020","journal-title":"J Oral Rehabil"},{"issue":"04","key":"ref32","doi-asserted-by":"crossref","first-page":"734","DOI":"10.4103\/neuroindia.NI_377_16","article-title":"The effect of sensory level electrical stimulation of the masseter muscle in early stroke patients with dysphagia: a randomized controlled study","volume":"65","author":"E K Umay","year":"2017","journal-title":"Neurol India"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"153","DOI":"10.5535\/arm.2014.38.2.153","article-title":"The effect of early neuromuscular electrical stimulation therapy in acute\/subacute ischemic stroke patients with Dysphagia","volume":"38","author":"K W Lee","year":"2014","journal-title":"Ann Rehabil Med"},{"issue":"10","key":"ref34","doi-asserted-by":"crossref","first-page":"2547","DOI":"10.1016\/j.jstrokecerebrovasdis.2014.05.031","article-title":"Functional outcome in acute stroke patients with oropharyngeal dysphagia after swallowing therapy","volume":"23","author":"K L Huang","year":"2014","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"01","key":"ref35","doi-asserted-by":"crossref","first-page":"40","DOI":"10.5507\/bp.2017.043","article-title":"Electrical stimulation of hyoid muscles in post-stroke dysphagia","volume":"162","author":"P Konecny","year":"2018","journal-title":"Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub"},{"issue":"05","key":"ref36","doi-asserted-by":"crossref","first-page":"592","DOI":"10.5535\/arm.2014.38.5.592","article-title":"Effect of low-frequency rTMS and NMES on subacute unilateral hemispheric stroke with dysphagia","volume":"38","author":"K B Lim","year":"2014","journal-title":"Ann Rehabil Med"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s00455-005-9009-0","article-title":"Evaluating oral stimulation as a treatment for dysphagia after stroke","volume":"21","author":"M L Power","year":"2006","journal-title":"Dysphagia"},{"issue":"10","key":"ref38","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/S1474-4422(18)30255-2","article-title":"Pharyngeal electrical stimulation for early decannulation in tracheotomised patients with neurogenic dysphagia after stroke (PHAST-TRAC): a prospective, single-blinded, randomised trial","volume":"17","author":"R Dziewas","year":"2018","journal-title":"Lancet Neurol"},{"issue":"06","key":"ref39","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1161\/STROKEAHA.115.012455","article-title":"Pharyngeal electrical stimulation for treatment of dysphagia in subacute stroke: a randomized controlled trial","volume":"47","author":"P M Bath","year":"2016","journal-title":"Stroke"},{"issue":"04","key":"ref40","first-page":"303","article-title":"Effects of transcranial direct current stimulation (tDCS) on post-stroke dysphagia","volume":"30","author":"E J Yang","year":"2012","journal-title":"Restor Neurol Neurosci"},{"issue":"04","key":"ref41","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1161\/STROKEAHA.110.602128","article-title":"Noninvasive brain stimulation may improve stroke-related dysphagia: a pilot study","volume":"42","author":"S Kumar","year":"2011","journal-title":"Stroke"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1177\/1545968318782743","article-title":"Dual transcranial direct current stimulation for poststroke dysphagia: a randomized controlled trial","volume":"32","author":"V Pingue","year":"2018","journal-title":"Neurorehabil Neural Repair"},{"issue":"02","key":"ref43","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/ana.25151","article-title":"Randomized trial of transcranial direct current stimulation for poststroke dysphagia","volume":"83","author":"S Suntrup-Krueger","year":"2018","journal-title":"Ann Neurol"},{"issue":"01","key":"ref44","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.brs.2016.08.005","article-title":"Effects of bilateral repetitive transcranial magnetic stimulation on post-stroke dysphagia","volume":"10","author":"E Park","year":"2017","journal-title":"Brain Stimul"},{"issue":"03","key":"ref45","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1111\/j.1600-0404.2008.01093.x","article-title":"Treatment of post-stroke dysphagia with repetitive transcranial magnetic stimulation","volume":"119","author":"E M Khedr","year":"2009","journal-title":"Acta Neurol Scand"},{"issue":"02","key":"ref46","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/MRR.0000000000000336","article-title":"The effect of repetitive transcranial magnetic stimulation combined with traditional dysphagia therapy on poststroke dysphagia: a pilot double-blinded randomized-controlled trial","volume":"42","author":"M Tarameshlu","year":"2019","journal-title":"Int J Rehabil Res"},{"issue":"05","key":"ref47","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1136\/jnnp.2009.188482","article-title":"Therapeutic role of rTMS on recovery of dysphagia in patients with lateral medullary syndrome and brainstem infarction","volume":"81","author":"E M Khedr","year":"2010","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"03","key":"ref48","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1016\/j.clinph.2015.11.045","article-title":"Repetitive transcranial magnetic stimulation for rehabilitation of poststroke dysphagia: a randomized, double-blind clinical trial","volume":"127","author":"J Du","year":"2016","journal-title":"Clin Neurophysiol"},{"issue":"08","key":"ref49","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.1161\/STROKEAHA.115.009617","article-title":"Diagnosis of stroke-associated pneumonia: recommendations from the pneumonia in stroke consensus group","volume":"46","author":"C J Smith","year":"2015","journal-title":"Stroke"},{"issue":"38","key":"ref50","doi-asserted-by":"crossref","first-page":"e27321","DOI":"10.1097\/MD.0000000000027321","article-title":"Stroke-associated pneumonia: a bibliometric analysis of worldwide trends from 2003 to 2020","volume":"100","author":"Y Chen","year":"2021","journal-title":"Medicine (Baltimore)"},{"issue":"11","key":"ref51","first-page":"e19912","article-title":"Stroke and pneumonia: mechanisms, risk factors, management, and prevention","volume":"13","author":"I Grossmann","year":"2021","journal-title":"Cureus"},{"key":"ref52","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1016\/S0140-6736(15)00126-9","article-title":"Prophylactic antibiotics after acute stroke for reducing pneumonia in patients with dysphagia (STROKE-INF): a prospective, cluster-randomised, open-label, masked endpoint, controlled clinical trial","volume":"386","author":"L Kalra","year":"2015","journal-title":"Lancet"},{"issue":"11","key":"ref53","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1038\/nm.4194","article-title":"Translocation and dissemination of commensal bacteria in post-stroke infection","volume":"22","author":"D Stanley","year":"2016","journal-title":"Nat Med"},{"key":"ref54","doi-asserted-by":"crossref","first-page":"2689","DOI":"10.2147\/IDR.S258420","article-title":"Effect of statins on the risk of poststroke pneumonia: National Population-Based Cohort Study","volume":"13","author":"T J Song","year":"2020","journal-title":"Infect Drug Resist"},{"issue":"01","key":"ref55","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/j.1747-4949.2012.00864.x","article-title":"Reduced risk of poststroke pneumonia in thrombolyzed stroke patients with continued statin treatment","volume":"10","author":"J F Scheitz","year":"2015","journal-title":"Int J Stroke"},{"issue":"05","key":"ref56","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1007\/s00455-018-9897-4","article-title":"Cilostazol is effective to prevent stroke-associated pneumonia in patients receiving tube feeding","volume":"33","author":"S Netsu","year":"2018","journal-title":"Dysphagia"},{"issue":"02","key":"ref57","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1161\/STROKEAHA.114.006639","article-title":"Safety and effect of metoclopramide to prevent pneumonia in patients with stroke fed via nasogastric tubes trial","volume":"46","author":"A Warusevitane","year":"2015","journal-title":"Stroke"},{"issue":"05","key":"ref58","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s00455-019-10061-6","article-title":"Factors associated with risk of stroke-associated pneumonia in patients with dysphagia: a systematic review","volume":"35","author":"S A Eltringham","year":"2020","journal-title":"Dysphagia"},{"key":"ref59","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.jocn.2017.06.068","article-title":"Association between gastrointestinal bleeding and 3-year mortality in patients with acute, first-ever ischemic stroke","volume":"44","author":"Y F Chou","year":"2017","journal-title":"J Clin Neurosci"},{"issue":"04","key":"ref60","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1159\/000229018","article-title":"Gastrointestinal hemorrhage after acute ischemic stroke and its risk factors in Asians","volume":"62","author":"H L Hsu","year":"2009","journal-title":"Eur Neurol"},{"issue":"12","key":"ref61","first-page":"643","article-title":"Complications in stroke patients: a study carried out at the Rehabilitation Medicine Service, Changi General Hospital","volume":"44","author":"V S Doshi","year":"2003","journal-title":"Singapore Med J"},{"issue":"07","key":"ref62","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.03.044","article-title":"Gastrointestinal bleeding in acute ischemic stroke: a population-based analysis of hospitalizations in the United States","volume":"25","author":"K Rumalla","year":"2016","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"02","key":"ref63","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1159\/000365245","article-title":"Gastrointestinal bleeding in acute ischemic stroke: recent trends from the Fukuoka Stroke Registry","volume":"4","author":"T Ogata","year":"2014","journal-title":"Cerebrovasc Dis Extra"},{"issue":"09","key":"ref64","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1212\/01.wnl.0000319689.48946.25","article-title":"Gastrointestinal bleeding after acute ischemic stroke","volume":"71","author":"M J O'Donnell","year":"2008","journal-title":"Neurology"},{"issue":"02","key":"ref65","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1136\/svn-2019-000314","article-title":"Gastrointestinal bleeding during acute ischaemic stroke hospitalisation increases the risk of stroke recurrence","volume":"5","author":"W Du","year":"2020","journal-title":"Stroke Vasc Neurol"},{"issue":"11","key":"ref66","doi-asserted-by":"crossref","first-page":"2146","DOI":"10.1161\/01.STR.25.11.2146","article-title":"Gastrointestinal bleeding in stroke","volume":"25","author":"E F Wijdicks","year":"1994","journal-title":"Stroke"},{"issue":"03","key":"ref67","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1161\/01.STR.27.3.421","article-title":"Gastrointestinal hemorrhage after acute stroke","volume":"27","author":"R J Davenport","year":"1996","journal-title":"Stroke"},{"key":"ref68","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1186\/1471-230X-14-130","article-title":"Risk score to predict gastrointestinal bleeding after acute ischemic stroke","volume":"14","author":"R Ji","year":"2014","journal-title":"BMC Gastroenterol"},{"key":"ref69","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.regpep.2009.11.008","article-title":"The protective effects of calcitonin gene-related peptide on gastric mucosa injury after cerebral ischemia reperfusion in rats","volume":"160","author":"G Feng","year":"2010","journal-title":"Regul Pept"},{"issue":"04","key":"ref70","doi-asserted-by":"crossref","first-page":"574","DOI":"10.3748\/wjg.v12.i4.574","article-title":"Role of gastric oxidative stress and nitric oxide in formation of hemorrhagic erosion in rats with ischemic brain","volume":"12","author":"C R Hung","year":"2006","journal-title":"World J Gastroenterol"},{"issue":"12","key":"ref71","doi-asserted-by":"crossref","first-page":"2383","DOI":"10.1007\/BF02100132","article-title":"Brain ischemia and gastric mucosal damage in spontaneously hypertensive rats: the role of arterial vagal adrenoceptors","volume":"41","author":"K Kawakubo","year":"1996","journal-title":"Dig Dis Sci"},{"key":"ref72","volume-title":"TPA Therapy","author":"R E Hughes","year":"2022"},{"key":"ref73","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1016\/S0140-6736(09)60503-1","article-title":"Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials","volume":"373","author":"C Baigent","year":"2009","journal-title":"Lancet"},{"issue":"09","key":"ref74","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1016\/j.cgh.2011.05.020","article-title":"Low doses of acetylsalicylic acid increase risk of gastrointestinal bleeding in a meta-analysis","volume":"9","author":"A Lanas","year":"2011","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"07","key":"ref75","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1056\/NEJMoa010746","article-title":"Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation","volume":"345","author":"S Yusuf","year":"2001","journal-title":"N Engl J Med"},{"issue":"02","key":"ref76","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.jacc.2021.10.028","article-title":"Magnetically controlled capsule endoscopy for assessment of antiplatelet therapy-induced gastrointestinal injury","volume":"79","author":"Y Han","year":"2022","journal-title":"J Am Coll Cardiol"},{"issue":"07","key":"ref77","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1111\/jth.13697","article-title":"Bleeding risk of antiplatelet drugs compared with oral anticoagulants in older patients with atrial fibrillation: a systematic review and meta-analysis","volume":"15","author":"M Melkonian","year":"2017","journal-title":"J Thromb Haemost"},{"key":"ref78","doi-asserted-by":"crossref","first-page":"h1585","DOI":"10.1136\/bmj.h1585","article-title":"Risk of gastrointestinal bleeding associated with oral anticoagulants: population based retrospective cohort study","volume":"350","author":"H Y Chang","year":"2015","journal-title":"BMJ"},{"issue":"01","key":"ref79","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s12325-022-02333-9","article-title":"Risk and management of bleeding complications with direct oral anticoagulants in patients with atrial fibrillation and venous thromboembolism: a narrative review","volume":"40","author":"S Ballestri","year":"2023","journal-title":"Adv Ther"},{"issue":"02","key":"ref80","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s10557-021-07232-9","article-title":"Severe bleeding risk of direct oral anticoagulants versus vitamin K antagonists for stroke prevention and treatment in patients with atrial fibrillation: a systematic review and network meta-analysis","volume":"37","author":"W Xu","year":"2023","journal-title":"Cardiovasc Drugs Ther"},{"issue":"01","key":"ref81","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7326\/0003-4819-152-1-201001050-00179","article-title":"Continuation of low-dose aspirin therapy in peptic ulcer bleeding: a randomized trial","volume":"152","author":"J J Sung","year":"2010","journal-title":"Ann Intern Med"},{"issue":"11","key":"ref82","doi-asserted-by":"crossref","first-page":"3698","DOI":"10.1007\/s10620-020-06728-y","article-title":"Anticoagulant reversal in gastrointestinal bleeding: review of treatment guidelines","volume":"66","author":"T J Milling","year":"2021","journal-title":"Dig Dis Sci"},{"key":"ref83","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/S0140-6736(17)30770-5","article-title":"Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events: a population-based cohort study","volume":"390","author":"L Li","year":"2017","journal-title":"Lancet"},{"issue":"06","key":"ref84","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1007\/s10620-018-5399-3","article-title":"Endoscopy is relatively safe in patients with acute ischemic stroke and gastrointestinal hemorrhage","volume":"64","author":"M T Siddiqui","year":"2019","journal-title":"Dig Dis Sci"},{"issue":"25","key":"ref85","doi-asserted-by":"crossref","first-page":"e7225","DOI":"10.1097\/MD.0000000000007225","article-title":"Incidence of constipation in stroke patients: a systematic review and meta-analysis","volume":"96","author":"J Li","year":"2017","journal-title":"Medicine (Baltimore)"},{"issue":"11","key":"ref86","first-page":"624","article-title":"Poststroke constipation in the rehabilitation ward: incidence, clinical course and associated factors","volume":"54","author":"C J Lin","year":"2013","journal-title":"Singapore Med J"},{"key":"ref87","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.jocn.2022.10.014","article-title":"Risk factors for constipation in patients with acute and subacute ischemic stroke: a retrospective cohort study","volume":"106","author":"Y Sun","year":"2022","journal-title":"J Clin Neurosci"},{"issue":"03","key":"ref88","doi-asserted-by":"crossref","first-page":"337","DOI":"10.5535\/arm.2011.35.3.337","article-title":"Bowel function in acute stroke patients","volume":"35","author":"J H Yi","year":"2011","journal-title":"Ann Rehabil Med"},{"key":"ref89","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.jns.2013.11.036","article-title":"Autonomic dysfunction in different subtypes of post-acute ischemic stroke","volume":"337","author":"L Xiong","year":"2014","journal-title":"J Neurol Sci"},{"key":"ref90","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.jns.2014.12.007","article-title":"Autonomic dysfunction in acute ischemic stroke: an underexplored therapeutic area?","volume":"348","author":"S De Raedt","year":"2015","journal-title":"J Neurol Sci"},{"issue":"01","key":"ref91","doi-asserted-by":"crossref","first-page":"105","DOI":"10.14309\/ajg.0000000000000479","article-title":"Poststroke constipation is associated with impaired rectal sensation","volume":"115","author":"J Cheng","year":"2020","journal-title":"Am J Gastroenterol"},{"issue":"11","key":"ref92","doi-asserted-by":"crossref","first-page":"2549","DOI":"10.1161\/01.STR.0000144684.46826.62","article-title":"Treatment of constipation and fecal incontinence in stroke patients: randomized controlled trial","volume":"35","author":"D Harari","year":"2004","journal-title":"Stroke"},{"key":"ref93","doi-asserted-by":"crossref","first-page":"755432","DOI":"10.3389\/fneur.2021.755432","article-title":"Current incidence and risk factors of fecal incontinence after acute stroke affecting functionally independent people","volume":"12","author":"G Lucente","year":"2021","journal-title":"Front Neurol"},{"issue":"01","key":"ref94","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1161\/01.STR.0000044169.54676.F5","article-title":"New-onset fecal incontinence after stroke: prevalence, natural history, risk factors, and impact","volume":"34","author":"D Harari","year":"2003","journal-title":"Stroke"},{"issue":"12","key":"ref95","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1111\/j.1532-5415.2006.00987.x","article-title":"Isolated urinary, fecal, and double incontinence: prevalence and degree of soiling in stroke survivors","volume":"54","author":"K Brittain","year":"2006","journal-title":"J Am Geriatr Soc"},{"issue":"06","key":"ref96","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/j.rehab.2019.12.007","article-title":"Urinary and fecal incontinence in stroke survivors followed in general practice: a retrospective cohort study","volume":"63","author":"L Jacob","year":"2020","journal-title":"Ann Phys Rehabil Med"},{"issue":"01","key":"ref97","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1161\/01.STR.28.1.58","article-title":"Prevalence and risk factors of incontinence after stroke. The Copenhagen Stroke Study","volume":"28","author":"H Nakayama","year":"1997","journal-title":"Stroke"},{"issue":"08","key":"ref98","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1111\/j.1532-5415.1985.tb04618.x","article-title":"Incidence and correlates of incontinence in stroke patients","volume":"33","author":"J C Brocklehurst","year":"1985","journal-title":"J Am Geriatr Soc"},{"key":"ref99","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jneuroim.2014.08.616","article-title":"Endothelin-1 overexpression exacerbate experimental allergic encephalomyelitis","volume":"276","author":"Y Guo","year":"2014","journal-title":"J Neuroimmunol"},{"issue":"01","key":"ref100","first-page":"CD002115","article-title":"Management of faecal incontinence and constipation in adults with central neurological diseases","author":"M Coggrave","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"01","key":"ref101","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1741-2358.2009.00330.x","article-title":"Oral health-related quality of life in hospitalised stroke patients","volume":"28","author":"M Schimmel","year":"2011","journal-title":"Gerodontology"},{"issue":"01","key":"ref102","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1600-0528.2006.00370.x","article-title":"Can caregivers be used in assessing oral health-related quality of life among patients hospitalized for acute medical conditions?","volume":"36","author":"H W Zhu","year":"2008","journal-title":"Community Dent Oral Epidemiol"},{"key":"ref103","doi-asserted-by":"crossref","first-page":"528056","DOI":"10.3389\/fneur.2020.528056","article-title":"Oral health, oral microbiota, and incidence of stroke-associated pneumonia - a prospective observational study","volume":"11","author":"F Cieplik","year":"2020","journal-title":"Front Neurol"},{"issue":"01","key":"ref104","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1186\/s12903-022-02259-2","article-title":"Oral health status and its associated factors among post-stroke inpatients: a cross-sectional study in Hungary","volume":"22","author":"J Moldvai","year":"2022","journal-title":"BMC Oral Health"},{"issue":"04","key":"ref105","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1161\/STROKEAHA.111.000076","article-title":"Dental prophylaxis and periodontal treatment are protective factors to ischemic stroke","volume":"44","author":"Y L Lee","year":"2013","journal-title":"Stroke"},{"issue":"01","key":"ref106","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1902\/annals.1998.3.1.161","article-title":"The relationship between dental disease and cerebral vascular accident in elderly United States veterans","volume":"3","author":"W J Loesche","year":"1998","journal-title":"Ann Periodontol"},{"issue":"01","key":"ref107","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/joor.12229","article-title":"Oral care post stroke: a scoping review","volume":"42","author":"C Kwok","year":"2015","journal-title":"J Oral Rehabil"},{"key":"ref108","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/1471-2377-14-122","article-title":"Changes of liver enzymes and bilirubin during ischemic stroke: mechanisms and possible significance","volume":"14","author":"A Muscari","year":"2014","journal-title":"BMC Neurol"},{"issue":"04","key":"ref109","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1007\/s12975-019-00763-2","article-title":"Stroke induces prolonged changes in lipid metabolism, the liver and body composition in mice","volume":"11","author":"M J Haley","year":"2020","journal-title":"Transl Stroke Res"},{"issue":"08","key":"ref110","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1001\/jamaneurol.2017.0923","article-title":"Association between cirrhosis and stroke in a nationally representative cohort","volume":"74","author":"N S Parikh","year":"2017","journal-title":"JAMA Neurol"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.atherosclerosis.2017.05.030","article-title":"Cirrhosis patients' stroke risks and adverse outcomes: two nationwide studies","volume":"263","author":"H Y Wu","year":"2017","journal-title":"Atherosclerosis"},{"issue":"01","key":"ref112","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/MCG.0000000000001201","article-title":"Risk of stroke in liver cirrhosis: a systematic review and meta-analysis","volume":"54","author":"K Zheng","year":"2020","journal-title":"J Clin Gastroenterol"},{"issue":"01","key":"ref113","doi-asserted-by":"crossref","first-page":"72","DOI":"10.2185\/jrm.2956","article-title":"Acute pancreatitis is a very rare comorbidity of acute ischemic stroke","volume":"13","author":"K Ota","year":"2018","journal-title":"J Rural Med"},{"key":"ref114","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.atherosclerosis.2019.12.010","article-title":"Reduced bile acid excretion is an independent risk factor for stroke and mortality: a prospective follow-up study","volume":"293","author":"G Charach","year":"2020","journal-title":"Atherosclerosis"},{"issue":"01","key":"ref115","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s12944-021-01620-8","article-title":"Increased admission serum total bile acids can be associated with decreased 3-month mortality in patients with acute ischemic stroke","volume":"21","author":"L Huang","year":"2022","journal-title":"Lipids Health Dis"},{"key":"ref116","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/1742-2094-11-50","article-title":"Tauroursodeoxycholic acid reduces glial cell activation in an animal model of acute neuroinflammation","volume":"11","author":"N Yanguas-Cas\u00e1s","year":"2014","journal-title":"J Neuroinflammation"},{"issue":"04","key":"ref117","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1097\/00004647-200204000-00010","article-title":"Neuroprotection by a bile acid in an acute stroke model in the rat","volume":"22","author":"C M Rodrigues","year":"2002","journal-title":"J Cereb Blood Flow Metab"},{"issue":"10","key":"ref118","doi-asserted-by":"crossref","first-page":"6087","DOI":"10.1073\/pnas.1031632100","article-title":"Tauroursodeoxycholic acid reduces apoptosis and protects against neurological injury after acute hemorrhagic stroke in rats","volume":"100","author":"C M Rodrigues","year":"2003","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"02","key":"ref119","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1142\/S0192415X07004813","article-title":"Administration of tauroursodeoxycholic acid (TUDCA) reduces apoptosis following myocardial infarction in rat","volume":"35","author":"A L Rivard","year":"2007","journal-title":"Am J Chin Med"},{"issue":"04","key":"ref120","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1177\/1747493016677983","article-title":"IRMA study: prevalence of subdiaphragmatic visceral infarction in ischemic stroke and atrial fibrillation","volume":"12","author":"D Weisenburger-Lile","year":"2017","journal-title":"Int J Stroke"},{"issue":"05","key":"ref121","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1161\/STROKEAHA.106.476804","article-title":"Prevalence and determinants of subdiaphragmatic visceral infarction in patients with fatal stroke","volume":"38","author":"H Abboud","year":"2007","journal-title":"Stroke"},{"issue":"13","key":"ref122","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1212\/WNL.0b013e3181d76aaa","article-title":"Prevalence of subdiaphragmatic visceral infarction in cardioembolic stroke","volume":"74","author":"T Slaoui","year":"2010","journal-title":"Neurology"},{"issue":"02","key":"ref123","doi-asserted-by":"crossref","first-page":"277","DOI":"10.5853\/jos.2020.03972","article-title":"Determinants of visceral infarction in acute cardioembolic stroke due to atrial fibrillation","volume":"23","author":"S I Sohn","year":"2021","journal-title":"J Stroke"},{"issue":"03","key":"ref124","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1161\/STROKEAHA.117.020035","article-title":"Relationship between visceral infarction and ischemic stroke subtype","volume":"49","author":"C Finn","year":"2018","journal-title":"Stroke"},{"issue":"03","key":"ref125","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1159\/000508826","article-title":"Relationship between presence of visceral infarction and functional outcome among patients with acute ischemic stroke","volume":"49","author":"P Piran","year":"2020","journal-title":"Cerebrovasc Dis"},{"issue":"01","key":"ref126","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5853\/jos.2019.02278","article-title":"Cancer-related stroke: an emerging subtype of ischemic stroke with unique pathomechanisms","volume":"22","author":"O Y Bang","year":"2020","journal-title":"J Stroke"},{"issue":"05","key":"ref127","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1038\/nm.4068","article-title":"Commensal microbiota affects ischemic stroke outcome by regulating intestinal \u03b3\u03b4 T cells","volume":"22","author":"C Benakis","year":"2016","journal-title":"Nat Med"},{"issue":"28","key":"ref128","doi-asserted-by":"crossref","first-page":"7428","DOI":"10.1523\/JNEUROSCI.1114-16.2016","article-title":"Microbiota dysbiosis controls the neuroinflammatory response after stroke","volume":"36","author":"V Singh","year":"2016","journal-title":"J Neurosci"},{"issue":"01","key":"ref129","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1038\/s41598-017-18904-8","article-title":"An insight into intestinal mucosal microbiota disruption after stroke","volume":"8","author":"D Stanley","year":"2018","journal-title":"Sci Rep"},{"issue":"05","key":"ref130","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1161\/STROKEAHA.121.036800","article-title":"Gut microbiota and their metabolites in stroke: a double-edged sword","volume":"53","author":"A Peh","year":"2022","journal-title":"Stroke"},{"issue":"07","key":"ref131","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1038\/nn.4030","article-title":"Host microbiota constantly control maturation and function of microglia in the CNS","volume":"18","author":"D Erny","year":"2015","journal-title":"Nat Neurosci"},{"key":"ref132","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1016\/j.molimm.2011.02.002","article-title":"Influence of gut microbiota on mouse B2 B cell ontogeny and function","volume":"48","author":"J Hansson","year":"2011","journal-title":"Mol Immunol"},{"issue":"05","key":"ref133","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1038\/nri2515","article-title":"The gut microbiota shapes intestinal immune responses during health and disease","volume":"9","author":"J L Round","year":"2009","journal-title":"Nat Rev Immunol"},{"issue":"02","key":"ref134","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1093\/intimm\/dxab039","article-title":"Vagus nerve-mediated intestinal immune regulation: therapeutic implications of inflammatory bowel diseases","volume":"34","author":"Y Mikami","year":"2022","journal-title":"Int Immunol"},{"issue":"02","key":"ref135","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1038\/nn.4476","article-title":"Interactions between the microbiota, immune and nervous systems in health and disease","volume":"20","author":"T C Fung","year":"2017","journal-title":"Nat Neurosci"},{"issue":"01","key":"ref136","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/ana.25250","article-title":"Age-related changes in the gut microbiota influence systemic inflammation and stroke outcome","volume":"84","author":"M S Spychala","year":"2018","journal-title":"Ann Neurol"},{"issue":"08","key":"ref137","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1177\/0271678X18780130","article-title":"The gut microbiome primes a cerebroprotective immune response after stroke","volume":"38","author":"V Singh","year":"2018","journal-title":"J Cereb Blood Flow Metab"},{"key":"ref139","doi-asserted-by":"crossref","first-page":"397","DOI":"10.3389\/fneur.2019.00397","article-title":"Stroke dysbiosis index (SDI) in gut microbiome are associated with brain injury and prognosis of stroke","volume":"10","author":"G H Xia","year":"2019","journal-title":"Front Neurol"},{"issue":"03","key":"ref140","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1159\/000205514","article-title":"Differential affection of intestinal immune cell populations after cerebral ischemia in mice","volume":"16","author":"O Schulte-Herbr\u00fcggen","year":"2009","journal-title":"Neuroimmunomodulation"},{"issue":"04","key":"ref141","doi-asserted-by":"crossref","first-page":"R979","DOI":"10.1152\/ajpregu.90825.2008","article-title":"Colonic bacterial translocation as a possible factor in stress-worsening experimental stroke outcome","volume":"296","author":"J R Caso","year":"2009","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"issue":"05","key":"ref142","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1161\/STROKEAHA.115.011800","article-title":"Depletion of cultivatable gut microbiota by broad-spectrum antibiotic pretreatment worsens outcome after murine stroke","volume":"47","author":"K Winek","year":"2016","journal-title":"Stroke"},{"issue":"01","key":"ref143","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1186\/s12866-019-1552-1","article-title":"Change of intestinal microbiota in cerebral ischemic stroke patients","volume":"19","author":"N Li","year":"2019","journal-title":"BMC Microbiol"},{"issue":"06","key":"ref144","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1161\/STROKEAHA.120.029262","article-title":"Distinct commensal bacterial signature in the gut is associated with acute and long-term protection from ischemic stroke","volume":"51","author":"C Benakis","year":"2020","journal-title":"Stroke"},{"key":"ref145","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.bbi.2016.04.003","article-title":"Brain injury induces specific changes in the caecal microbiota of mice via altered autonomic activity and mucoprotein production","volume":"57","author":"A Houlden","year":"2016","journal-title":"Brain Behav Immun"},{"issue":"02","key":"ref146","doi-asserted-by":"crossref","first-page":"e21201","DOI":"10.1096\/fj.202001117R","article-title":"The gut microbiome contributes to blood-brain barrier disruption in spontaneously hypertensive stroke prone rats","volume":"35","author":"J W Nelson","year":"2021","journal-title":"FASEB J"},{"issue":"02","key":"ref147","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1152\/physiolgenomics.00081.2016","article-title":"Alterations in the gut microbiota can elicit hypertension in rats","volume":"49","author":"S Adnan","year":"2017","journal-title":"Physiol Genomics"},{"issue":"03","key":"ref148","doi-asserted-by":"crossref","first-page":"e117","DOI":"10.1161\/STROKEAHA.109.571299","article-title":"Infectious burden and carotid plaque thickness: the northern Manhattan study","volume":"41","author":"M S Elkind","year":"2010","journal-title":"Stroke"},{"issue":"01","key":"ref149","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1001\/archneurol.2009.271","article-title":"Infectious burden and risk of stroke: the northern Manhattan study","volume":"67","author":"M S Elkind","year":"2010","journal-title":"Arch Neurol"},{"issue":"06","key":"ref150","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1038\/s41569-022-00825-3","article-title":"The oral microbiome in the pathophysiology of cardiovascular disease","volume":"20","author":"A Tonelli","year":"2023","journal-title":"Nat Rev Cardiol"},{"issue":"02","key":"ref151","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1161\/01.STR.0000110789.20526.9D","article-title":"Periodontal disease as a risk factor for ischemic stroke","volume":"35","author":"A J Grau","year":"2004","journal-title":"Stroke"},{"issue":"03","key":"ref152","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1111\/ger.12271","article-title":"Oral flora in acute stroke patients: a prospective exploratory observational study","volume":"34","author":"E Boaden","year":"2017","journal-title":"Gerodontology"},{"issue":"01","key":"ref153","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1161\/01.STR.0000109041.89959.4C","article-title":"Preventive antibacterial treatment improves the general medical and neurological outcome in a mouse model of stroke","volume":"35","author":"C Meisel","year":"2004","journal-title":"Stroke"},{"issue":"01","key":"ref154","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s40168-022-01364-2","article-title":"Mining the microbiota to identify gut commensals modulating neuroinflammation in a mouse model of multiple sclerosis","volume":"10","author":"P Bianchimano","year":"2022","journal-title":"Microbiome"},{"key":"ref155","doi-asserted-by":"crossref","first-page":"107685","DOI":"10.1016\/j.neuropharm.2019.107685","article-title":"Gut microbiota depletion from early adolescence alters adult immunological and neurobehavioral responses in a mouse model of multiple sclerosis","volume":"157","author":"M Zeraati","year":"2019","journal-title":"Neuropharmacology"},{"issue":"05","key":"ref156","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1136\/svn-2021-001231","article-title":"Long-term modification of gut microbiota by broad-spectrum antibiotics improves stroke outcome in rats","volume":"7","author":"C Liu","year":"2022","journal-title":"Stroke Vasc Neurol"},{"issue":"09","key":"ref157","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1177\/1747493018798557","article-title":"Post-stroke infections and preventive antibiotics in stroke: update of clinical evidence","volume":"13","author":"J D Vermeij","year":"2018","journal-title":"Int J Stroke"},{"issue":"08","key":"ref158","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1038\/nm.1999","article-title":"Pivotal role of cerebral interleukin-17-producing gamma delta T cells in the delayed phase of ischemic brain injury","volume":"15","author":"T Shichita","year":"2009","journal-title":"Nat Med"},{"issue":"44","key":"ref159","doi-asserted-by":"crossref","first-page":"17350","DOI":"10.1523\/JNEUROSCI.4901-12.2013","article-title":"Boosting regulatory T cells limits neuroinflammation in permanent cortical stroke","volume":"33","author":"A Liesz","year":"2013","journal-title":"J Neurosci"},{"issue":"07","key":"ref160","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1038\/nm.2399","article-title":"The immunology of stroke: from mechanisms to translation","volume":"17","author":"C Iadecola","year":"2011","journal-title":"Nat Med"},{"issue":"18","key":"ref161","doi-asserted-by":"crossref","first-page":"3793","DOI":"10.1182\/blood-2012-02-412726","article-title":"Neutralization of the IL-17 axis diminishes neutrophil invasion and protects from ischemic stroke","volume":"120","author":"M Gelderblom","year":"2012","journal-title":"Blood"},{"issue":"04","key":"ref162","first-page":"194","article-title":"Bacterial translocation in experimental stroke: what happens to the gut barrier?","volume":"111","author":"N Tascilar","year":"2010","journal-title":"Bratisl Lek Listy"},{"issue":"18","key":"ref163","doi-asserted-by":"crossref","first-page":"6696","DOI":"10.1073\/pnas.1405634111","article-title":"Endoscopic photoconversion reveals unexpectedly broad leukocyte trafficking to and from the gut","volume":"111","author":"A M Morton","year":"2014","journal-title":"Proc Natl Acad Sci U S A"},{"key":"ref164","first-page":"1315797","article-title":"Exploratory investigation of intestinal structure and function after stroke in mice","volume":"2021","author":"D Ye","year":"2021","journal-title":"Mediators Inflamm"},{"key":"ref165","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.bbi.2021.05.008","article-title":"Stroke affects intestinal immune cell trafficking to the central nervous system","volume":"96","author":"D Brea","year":"2021","journal-title":"Brain Behav Immun"},{"issue":"01","key":"ref166","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1186\/s12974-020-01833-1","article-title":"Age-dependent involvement of gut mast cells and histamine in post-stroke inflammation","volume":"17","author":"M P Blasco","year":"2020","journal-title":"J Neuroinflammation"},{"issue":"01","key":"ref167","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s13760-018-0940-x","article-title":"D-lactate and intestinal fatty acid-binding protein are elevated in serum in patients with acute ischemic stroke","volume":"121","author":"C R Camara-Lemarroy","year":"2021","journal-title":"Acta Neurol Belg"},{"issue":"05","key":"ref168","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1007\/s00401-012-0949-9","article-title":"Commensal gut flora and brain autoimmunity: a love or hate affair?","volume":"123","author":"K Berer","year":"2012","journal-title":"Acta Neuropathol"},{"issue":"39","key":"ref169","doi-asserted-by":"crossref","first-page":"2948","DOI":"10.1093\/eurheartj\/ehx342","article-title":"Gut microbe-generated metabolite trimethylamine-N-oxide as cardiovascular risk biomarker: a systematic review and dose-response meta-analysis","volume":"38","author":"G G Schiattarella","year":"2017","journal-title":"Eur Heart J"},{"issue":"09","key":"ref170","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.1161\/ATVBAHA.118.311023","article-title":"Gut microbiota-dependent trimethylamine N-oxide predicts risk of cardiovascular events in patients with stroke and is related to proinflammatory monocytes","volume":"38","author":"A Haghikia","year":"2018","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"06","key":"ref171","doi-asserted-by":"crossref","first-page":"BSR20190515","DOI":"10.1042\/BSR20190515","article-title":"Serum levels of trimethylamine-N-oxide in patients with ischemic stroke","volume":"39","author":"M Rexidamu","year":"2019","journal-title":"Biosci Rep"},{"issue":"08","key":"ref172","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1111\/ene.14253","article-title":"Trimethylamine-N-oxide is elevated in the acute phase after ischaemic stroke and decreases within the first days","volume":"27","author":"C Schneider","year":"2020","journal-title":"Eur J Neurol"},{"issue":"08","key":"ref173","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1007\/s10571-019-00714-3","article-title":"Prognostic value of plasma trimethylamine N-oxide levels in patients with acute ischemic stroke","volume":"39","author":"Q Zhai","year":"2019","journal-title":"Cell Mol Neurobiol"},{"issue":"07","key":"ref174","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/j.chom.2021.05.002","article-title":"Gut microbes impact stroke severity via the trimethylamine N-oxide pathway","volume":"29","author":"W Zhu","year":"2021","journal-title":"Cell Host Microbe"},{"key":"ref175","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1126\/science.1241165","article-title":"The microbial metabolites, short-chain fatty acids, regulate colonic Treg cell homeostasis","volume":"341","author":"P M Smith","year":"2013","journal-title":"Science"},{"key":"ref176","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.3389\/fmicb.2018.01995","article-title":"Role of short chain fatty acids in controlling Tregs and immunopathology during mucosal infection","volume":"9","author":"N Bhaskaran","year":"2018","journal-title":"Front Microbiol"},{"issue":"05","key":"ref177","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.nutres.2008.02.012","article-title":"Butyrate and trichostatin A attenuate nuclear factor kappaB activation and tumor necrosis factor alpha secretion and increase prostaglandin E2 secretion in human peripheral blood mononuclear cells","volume":"28","author":"M Usami","year":"2008","journal-title":"Nutr Res"},{"issue":"09","key":"ref178","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/j.jnutbio.2010.07.009","article-title":"Suppressive effect of short-chain fatty acids on production of proinflammatory mediators by neutrophils","volume":"22","author":"M A Vinolo","year":"2011","journal-title":"J Nutr Biochem"},{"issue":"17","key":"ref179","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1161\/CIRCULATIONAHA.119.043081","article-title":"Deficiency of prebiotic fiber and insufficient signaling through gut metabolite-sensing receptors leads to cardiovascular disease","volume":"141","author":"D M Kaye","year":"2020","journal-title":"Circulation"},{"key":"ref180","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.neulet.2016.02.009","article-title":"Butyrate, neuroepigenetics and the gut microbiome: Can a high fiber diet improve brain health?","volume":"625","author":"M W Bourassa","year":"2016","journal-title":"Neurosci Lett"},{"issue":"10","key":"ref181","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1161\/CIRCULATIONAHA.116.024545","article-title":"High-fiber diet and acetate supplementation change the gut microbiota and prevent the development of hypertension and heart failure in hypertensive mice","volume":"135","author":"F Z Marques","year":"2017","journal-title":"Circulation"},{"issue":"05","key":"ref182","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1523\/JNEUROSCI.1359-19.2019","article-title":"Short-chain fatty acids improve poststroke recovery via immunological mechanisms","volume":"40","author":"R Sadler","year":"2020","journal-title":"J Neurosci"},{"issue":"04","key":"ref183","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1161\/CIRCRESAHA.119.316448","article-title":"Gut microbiota-derived short-chain fatty acids promote poststroke recovery in aged mice","volume":"127","author":"J Lee","year":"2020","journal-title":"Circ Res"},{"key":"ref184","doi-asserted-by":"crossref","first-page":"104403","DOI":"10.1016\/j.phrs.2019.104403","article-title":"Transplantation of fecal microbiota rich in short chain fatty acids and butyric acid treat cerebral ischemic stroke by regulating gut microbiota","volume":"148","author":"R Chen","year":"2019","journal-title":"Pharmacol Res"},{"key":"ref185","doi-asserted-by":"crossref","first-page":"4","DOI":"10.3389\/fcimb.2019.00004","article-title":"Higher risk of stroke is correlated with increased opportunistic pathogen load and reduced levels of butyrate-producing bacteria in the gut","volume":"9","author":"X Zeng","year":"2019","journal-title":"Front Cell Infect Microbiol"},{"issue":"08","key":"ref186","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1038\/s41575-019-0157-3","article-title":"The role of short-chain fatty acids in microbiota-gut-brain communication","volume":"16","author":"B Dalile","year":"2019","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"ref187","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1038\/s41586-021-03852-1","article-title":"Cells of the human intestinal tract mapped across space and time","volume":"597","author":"R Elmentaite","year":"2021","journal-title":"Nature"},{"issue":"06","key":"ref188","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1210\/en.2019-00073","article-title":"Reg3 proteins as gut hormones?","volume":"160","author":"J H Shin","year":"2019","journal-title":"Endocrinology"},{"issue":"01","key":"ref189","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/j.1365-2249.2010.04150.x","article-title":"Gut hormones: emerging role in immune activation and inflammation","volume":"161","author":"W I Khan","year":"2010","journal-title":"Clin Exp Immunol"},{"issue":"08","key":"ref190","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1007\/s11894-019-0701-x","article-title":"Gastroduodenal injury: role of protective factors","volume":"21","author":"G M Galura","year":"2019","journal-title":"Curr Gastroenterol Rep"},{"issue":"01","key":"ref191","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1111\/jnc.15520","article-title":"Antimicrobial protein REG3A and signaling networks are predictive of stroke outcomes","volume":"160","author":"M Sands","year":"2022","journal-title":"J Neurochem"},{"issue":"10","key":"ref192","doi-asserted-by":"crossref","first-page":"e77732","DOI":"10.1371\/journal.pone.0077732","article-title":"Trefoil factor 3 as an endocrine neuroprotective factor from the liver in experimental cerebral ischemia\/reperfusion injury","volume":"8","author":"S Q Liu","year":"2013","journal-title":"PLoS One"},{"issue":"07","key":"ref193","doi-asserted-by":"crossref","first-page":"5097","DOI":"10.1128\/AEM.00075-06","article-title":"Enhancement of in vitro growth of pathogenic bacteria by norepinephrine: importance of inoculum density and role of transferrin","volume":"72","author":"P M O'Donnell","year":"2006","journal-title":"Appl Environ Microbiol"},{"issue":"10","key":"ref194","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1089\/neu.2008.0847","article-title":"Induction of pancreatitis-associated protein (PAP) family members in neurons after traumatic brain injury","volume":"26","author":"K Ampo","year":"2009","journal-title":"J Neurotrauma"},{"issue":"04","key":"ref195","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1136\/neurintsurg-2020-016118","article-title":"Proteomic changes in intracranial blood during human ischemic stroke","volume":"13","author":"B Maglinger","year":"2021","journal-title":"J Neurointerv Surg"},{"issue":"24","key":"ref196","doi-asserted-by":"crossref","first-page":"e018984","DOI":"10.1161\/JAHA.120.018984","article-title":"Screening of multiple biomarkers associated with ischemic stroke in atrial fibrillation","volume":"9","author":"Z Hijazi","year":"2020","journal-title":"J Am Heart Assoc"},{"issue":"17","key":"ref197","doi-asserted-by":"crossref","first-page":"e25657","DOI":"10.1097\/MD.0000000000025657","article-title":"Effect of probiotics on the nutritional status of severe stroke patients with nasal feeding that receive enteral nutrition: a protocol for systematic review and meta-analysis of randomized controlled trials","volume":"100","author":"X Liu","year":"2021","journal-title":"Medicine (Baltimore)"},{"issue":"04","key":"ref198","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1038\/s41430-021-00986-3","article-title":"Effect of early enteral nutrition combined with probiotics in patients with stroke: a meta-analysis of randomized controlled trials","volume":"76","author":"X Chen","year":"2022","journal-title":"Eur J Clin Nutr"},{"issue":"01","key":"ref199","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1038\/s41398-022-01922-0","article-title":"Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders","volume":"12","author":"J Horn","year":"2022","journal-title":"Transl Psychiatry"},{"key":"ref200","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.12659\/MSM.906533","article-title":"Impact of early high-protein diet on neurofunctional recovery in rats with ischemic stroke","volume":"24","author":"M Ji","year":"2018","journal-title":"Med Sci Monit"},{"issue":"03","key":"ref201","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1159\/000514136","article-title":"Impact of Mediterranean diet prior to stroke on the prognosis of patients undergoing endovascular treatment","volume":"50","author":"C Garc\u00eda-Cabo","year":"2021","journal-title":"Cerebrovasc Dis"},{"key":"ref202","doi-asserted-by":"crossref","first-page":"1043446","DOI":"10.3389\/fnins.2022.1043446","article-title":"Research advances in the application of vagus nerve electrical stimulation in ischemic stroke","volume":"16","author":"K Cheng","year":"2022","journal-title":"Front Neurosci"},{"key":"ref203","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.neurobiolaging.2016.03.030","article-title":"Vagus nerve stimulation during rehabilitative training enhances recovery of forelimb function after ischemic stroke in aged rats","volume":"43","author":"S A Hays","year":"2016","journal-title":"Neurobiol Aging"},{"key":"ref204","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/S0140-6736(21)00475-X","article-title":"Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke (VNS-REHAB): a randomised, blinded, pivotal, device trial","volume":"397","author":"J Dawson","year":"2021","journal-title":"Lancet"},{"issue":"02","key":"ref205","first-page":"20","article-title":"Fecal microbiota transplantation is safe and tolerable in patients with multiple sclerosis: a pilot randomized controlled trial","volume":"8","author":"K F Al","year":"2022","journal-title":"Mult Scler J Exp Transl Clin"},{"issue":"05","key":"ref206","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1038\/s41575-019-0261-4","article-title":"Epithelial toll-like receptors and their role in gut homeostasis and disease","volume":"17","author":"J F Burgue\u00f1o","year":"2020","journal-title":"Nat Rev Gastroenterol Hepatol"}],"container-title":["Seminars in Neurology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1771470.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T21:48:42Z","timestamp":1702936122000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1771470"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":205,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2023,9,13]]},"published-print":{"date-parts":[[2023,8]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1771470","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0271-8235","1098-9021"],"issn-type":[{"value":"0271-8235","type":"print"},{"value":"1098-9021","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8]]}}}