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However, the chronology and topological changes in collateral circulation in T2DM is not yet defined. Here, we describe the spatial and temporal blood flow dynamics and vessel diameter changes in pial arteries and veins and leukocyte-endothelial adhesion following middle cerebral artery (MCA) stroke using two-photon microscopy in awake control and T2DM mice. Relative to control mice, T2DM mice already exhibited smaller pial vessels with reduced flow velocity prior to stroke. Following stroke, T2DM mice displayed persistently reduced blood flow in pial arteries and veins, resulting in a poor recovery of downstream penetrating arterial flow and a sustained deficit in microvascular flow. There was also persistent increase of leukocyte adhesion to the endothelium of veins, coincided with elevated neutrophils infiltration into brain parenchyma in T2DM mice compared to control mice after stroke. Our data suggest that T2DM-induced increase in inflammation and chronic remodeling of leptomeningeal vessels may contribute to the observed hemodynamics deficiency after stroke and subsequent poor stroke outcome.<\/jats:p>","DOI":"10.1177\/0271678x251338203","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T06:22:28Z","timestamp":1748499748000},"page":"1684-1701","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Type 2 diabetes abates retrograde collateral flow and promotes leukocyte adhesion following ischemic stroke"],"prefix":"10.1177","volume":"45","author":[{"given":"Yoshimichi","family":"Sato","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA"},{"name":"SFVAMC, San Francisco, CA, USA"},{"name":"Tohoku University Graduate School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuya","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA"},{"name":"SFVAMC, San Francisco, CA, USA"},{"name":"Tohoku University Graduate School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Kanoke","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA"},{"name":"SFVAMC, San Francisco, CA, USA"},{"name":"Tohoku University Graduate School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer Y","family":"Sun","sequence":"additional","affiliation":[{"name":"Institute of Ophthalmology, University College London, London, UK"},{"name":"Department of Physiology, University of California San Francisco, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Nishijima","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA"},{"name":"SFVAMC, San Francisco, CA, USA"},{"name":"Tohoku University Graduate School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruikang K","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Engineering and School of Medicine, University of Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Stryker","sequence":"additional","affiliation":[{"name":"Department of Physiology, University of California San Francisco, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidenori","family":"Endo","sequence":"additional","affiliation":[{"name":"Tohoku University Graduate School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4420-4382","authenticated-orcid":false,"given":"Jialing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA"},{"name":"SFVAMC, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/cells11182823"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010508"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2022.02306"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.1.163"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12932"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-016-9583-9"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011258"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105380"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00019501-200508000-00004"},{"key":"e_1_3_4_11_2","article-title":"The impact of diabetes mellitus and admission hyperglycemia on clinical outcomes after recanalization therapies for acute ischemic stroke: STAY ALIVE national prospective registry","volume":"12","author":"Kalmar PJ","year":"2022","unstructured":"Kalmar PJ, Tarkanyi G, Karadi ZN, et\u00a0al. 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