{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T12:49:56Z","timestamp":1774356596226,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"2024 Annual Project of Key Research Projects under the Medical Science and Technology Plan of Henan Province"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"DOI":"10.1186\/s12883-026-04738-3","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T10:23:29Z","timestamp":1771237409000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of serum HMGB1 and TLR4 levels with early-onset post-stroke depression in type 2 diabetes: a prospective cohort study"],"prefix":"10.1186","volume":"26","author":[{"given":"Congcong","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Yi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhou","family":"Su","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanshuang","family":"Hao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojun","family":"Tian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"4738_CR1","doi-asserted-by":"publisher","first-page":"530","DOI":"10.3389\/fpsyt.2018.00530","volume":"9","author":"F Bartoli","year":"2018","unstructured":"Bartoli F, Di Brita C, Crocamo C, Clerici M, Carr\u00e0 G. Early post-stroke depression and mortality: Meta-analysis and meta-regression. Front Psychiatry. 2018;9:530. https:\/\/doi.org\/10.3389\/fpsyt.2018.00530.","journal-title":"Front Psychiatry"},{"issue":"3","key":"4738_CR2","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1007\/s00415-021-10597-4","volume":"269","author":"J Guo","year":"2022","unstructured":"Guo J, Wang J, Sun W, Liu X. The advances of post-stroke depression: 2021 update. J Neurol. 2022;269(3):1236\u201349. https:\/\/doi.org\/10.1007\/s00415-021-10597-4.","journal-title":"J Neurol"},{"key":"4738_CR3","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.genhosppsych.2020.06.011","volume":"66","author":"GC Medeiros","year":"2020","unstructured":"Medeiros GC, Roy D, Kontos N, Beach SR. Post-stroke depression: A 2020 updated review. Gen Hosp Psychiatry. 2020;66:70\u201380. https:\/\/doi.org\/10.1016\/j.genhosppsych.2020.06.011.","journal-title":"Gen Hosp Psychiatry"},{"issue":"8","key":"4738_CR4","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1016\/j.cpr.2011.08.001","volume":"31","author":"BN Renn","year":"2011","unstructured":"Renn BN, Feliciano L, Segal DL. The bidirectional relationship of depression and diabetes: A systematic review. Clin Psychol Rev. 2011;31(8):1239\u201346. https:\/\/doi.org\/10.1016\/j.cpr.2011.08.001.","journal-title":"Clin Psychol Rev"},{"issue":"11","key":"4738_CR5","doi-asserted-by":"publisher","first-page":"2315","DOI":"10.1007\/s00125-020-05247-9","volume":"63","author":"AFJ Geraets","year":"2020","unstructured":"Geraets AFJ, K\u00f6hler S, Muzambi R, et al. The association of hyperglycaemia and insulin resistance with incident depressive symptoms over 4 years of follow-up: the Maastricht study. Diabetologia. 2020;63(11):2315\u201328. https:\/\/doi.org\/10.1007\/s00125-020-05247-9.","journal-title":"Diabetologia"},{"issue":"2","key":"4738_CR6","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1007\/s00125-020-05301-6","volume":"64","author":"AL Carr","year":"2021","unstructured":"Carr AL, Sluiman AJ, Grecian SM, et al. Depression as a risk factor for dementia in older people with type 2 diabetes and the mediating effect of inflammation. Diabetologia. 2021;64(2):448\u201357. https:\/\/doi.org\/10.1007\/s00125-020-05301-6.","journal-title":"Diabetologia"},{"key":"4738_CR7","doi-asserted-by":"publisher","first-page":"596362","DOI":"10.3389\/fphar.2020.596362","volume":"11","author":"Y Lu","year":"2021","unstructured":"Lu Y, An T, Tian H, et al. Depression with comorbid diabetes: what evidence exists for treatments using traditional Chinese medicine and natural products? Front Pharmacol. 2021;11:596362. https:\/\/doi.org\/10.3389\/fphar.2020.596362.","journal-title":"Front Pharmacol"},{"issue":"12","key":"4738_CR8","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1038\/s41577-023-00894-6","volume":"23","author":"D Tang","year":"2023","unstructured":"Tang D, Kang R, Zeh HJ, Lotze MT. The multifunctional protein HMGB1: 50 years of discovery. Nat Rev Immunol. 2023;23(12):824\u201341. https:\/\/doi.org\/10.1038\/s41577-023-00894-6.","journal-title":"Nat Rev Immunol"},{"issue":"5","key":"4738_CR9","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1007\/s00125-020-05105-8","volume":"63","author":"J Zhang","year":"2020","unstructured":"Zhang J, Chen L, Wang F, et al. Extracellular HMGB1 exacerbates autoimmune progression and recurrence of type 1 diabetes by impairing regulatory T cell stability. Diabetologia. 2020;63(5):987\u20131001. https:\/\/doi.org\/10.1007\/s00125-020-05105-8.","journal-title":"Diabetologia"},{"key":"4738_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2016\/2543268","volume":"2016","author":"Y Wang","year":"2016","unstructured":"Wang Y, Zhong J, Zhang X, et al. The role of HMGB1 in the pathogenesis of type 2 diabetes. J Diabetes Res. 2016;2016:1\u201311. https:\/\/doi.org\/10.1155\/2016\/2543268.","journal-title":"J Diabetes Res"},{"issue":"5","key":"4738_CR11","doi-asserted-by":"publisher","first-page":"3131","DOI":"10.1007\/s10072-021-05571-x","volume":"43","author":"W Shan","year":"2022","unstructured":"Shan W, Xu L, Qiu Z, et al. Increased high-mobility group box 1 levels are associated with depression after acute ischemic stroke. Neurol Sci. 2022;43(5):3131\u20137. https:\/\/doi.org\/10.1007\/s10072-021-05571-x.","journal-title":"Neurol Sci"},{"key":"4738_CR12","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1016\/j.bbi.2016.09.017","volume":"59","author":"YJ Lian","year":"2017","unstructured":"Lian YJ, Gong H, Wu TY, et al. Ds-HMGB1 and fr-HMGB induce depressive behavior through neuroinflammation in contrast to nonoxid-HMGB1. Brain Behav Immun. 2017;59:322\u201332. https:\/\/doi.org\/10.1016\/j.bbi.2016.09.017.","journal-title":"Brain Behav Immun"},{"issue":"2","key":"4738_CR13","doi-asserted-by":"publisher","first-page":"326","DOI":"10.3390\/molecules24020326","volume":"24","author":"L Liu","year":"2019","unstructured":"Liu L, Dong Y, Shan X, Li L, Xia B, Wang H. Anti-depressive effectiveness of Baicalin in vitro and in vivo. Molecules. 2019;24(2):326. https:\/\/doi.org\/10.3390\/molecules24020326.","journal-title":"Molecules"},{"issue":"6","key":"4738_CR14","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1007\/s00109-024-02441-9","volume":"102","author":"TT Oo","year":"2024","unstructured":"Oo TT. Ischemic stroke and diabetes: A TLR4-mediated neuroinflammatory perspective. J Mol Med. 2024;102(6):709\u201317. https:\/\/doi.org\/10.1007\/s00109-024-02441-9.","journal-title":"J Mol Med"},{"issue":"2","key":"4738_CR15","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1007\/s13105-018-0626-0","volume":"74","author":"S Jovanovi\u0107 Stojanov","year":"2018","unstructured":"Jovanovi\u0107 Stojanov S, Martinovi\u0107 V, Bogojevi\u0107 D, et al. Modulation of diabetes-related liver injury by the HMGB1\/TLR4 inflammatory pathway. J Physiol Biochem. 2018;74(2):345\u201358. https:\/\/doi.org\/10.1007\/s13105-018-0626-0.","journal-title":"J Physiol Biochem"},{"key":"4738_CR16","doi-asserted-by":"publisher","unstructured":"Liu L, Li Z, Zhou H et al. Chinese stroke association guidelines for clinical management of ischaemic cerebrovascular diseases: executive summary and 2023 update. Stroke Vasc Neurol. 2023;8(6):e3. Published 2023 Dec 29. https:\/\/doi.org\/10.1136\/svn-2023-002998","DOI":"10.1136\/svn-2023-002998"},{"issue":"7","key":"4738_CR17","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1161\/01.str.20.7.864","volume":"20","author":"T Brott","year":"1989","unstructured":"Brott T, Adams HP Jr, Olinger CP, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):864\u201370. https:\/\/doi.org\/10.1161\/01.str.20.7.864.","journal-title":"Stroke"},{"key":"4738_CR18","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1016\/j.jad.2017.06.045","volume":"221","author":"Y Zhang","year":"2017","unstructured":"Zhang Y, He J, rong, H Liang, bin, et al. Diabetes mellitus is associated with late-onset post-stroke depression. J Affect Disord. 2017;221:222\u20136. https:\/\/doi.org\/10.1016\/j.jad.2017.06.045.","journal-title":"J Affect Disord"},{"issue":"2","key":"4738_CR19","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.neuron.2020.06.002","volume":"107","author":"E Beurel","year":"2020","unstructured":"Beurel E, Toups M, Nemeroff CB. The bidirectional relationship of depression and inflammation: double trouble. Neuron. 2020;107(2):234\u201356. https:\/\/doi.org\/10.1016\/j.neuron.2020.06.002.","journal-title":"Neuron"},{"issue":"4","key":"4738_CR20","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1016\/S2213-8587(19)30405-X","volume":"8","author":"TT Van Sloten","year":"2020","unstructured":"Van Sloten TT, Sedaghat S, Carnethon MR, Launer LJ, Stehouwer CDA. Cerebral microvascular complications of type 2 diabetes: Stroke, cognitive dysfunction, and depression. Lancet Diabetes Endocrinol. 2020;8(4):325\u201336. https:\/\/doi.org\/10.1016\/S2213-8587(19)30405-X.","journal-title":"Lancet Diabetes Endocrinol"},{"key":"4738_CR21","doi-asserted-by":"publisher","first-page":"104829","DOI":"10.1016\/j.neubiorev.2022.104829","volume":"142","author":"Y Wang","year":"2022","unstructured":"Wang Y, Zhu L, Tan X, Cheng Y, Wang X, Fang S. Higher levels of peripheral blood glucose in the acute stage of stroke increase the risk of post-stroke depression: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2022;142:104829. https:\/\/doi.org\/10.1016\/j.neubiorev.2022.104829.","journal-title":"Neurosci Biobehav Rev"},{"key":"4738_CR22","doi-asserted-by":"publisher","first-page":"644095","DOI":"10.3389\/fcvm.2021.644095","volume":"8","author":"HM Al-kuraishy","year":"2021","unstructured":"Al-kuraishy HM, Al-Gareeb AI, Alblihed M, Guerreiro SG, Cruz-Martins N, Batiha GES. COVID-19 in relation to hyperglycemia and diabetes mellitus. Front Cardiovasc Med. 2021;8:644095. https:\/\/doi.org\/10.3389\/fcvm.2021.644095.","journal-title":"Front Cardiovasc Med"},{"issue":"2","key":"4738_CR23","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1093\/cvr\/cvn039","volume":"78","author":"G Spinetti","year":"2008","unstructured":"Spinetti G, Kraenkel N, Emanueli C, Madeddu P. Diabetes and vessel wall remodelling: from mechanistic insights to regenerative therapies. Cardiovasc Res. 2008;78(2):265\u201373. https:\/\/doi.org\/10.1093\/cvr\/cvn039.","journal-title":"Cardiovasc Res"},{"issue":"8","key":"4738_CR24","doi-asserted-by":"publisher","first-page":"3031","DOI":"10.1111\/dom.15630","volume":"26","author":"WY Khawagi","year":"2024","unstructured":"Khawagi WY, Al-kuraishy HM, Hussein NR, et al. Depression and type 2 diabetes: A causal relationship and mechanistic pathway. Diabetes Obes Metab. 2024;26(8):3031\u201344. https:\/\/doi.org\/10.1111\/dom.15630.","journal-title":"Diabetes Obes Metab"},{"issue":"5","key":"4738_CR25","doi-asserted-by":"publisher","first-page":"442","DOI":"10.2174\/1573399815666191024085838","volume":"16","author":"A Berbudi","year":"2020","unstructured":"Berbudi A, Rahmadika N, Tjahjadi AI, Ruslami R. Type 2 diabetes and its impact on the immune system. Curr Diabetes Rev. 2020;16(5):442\u20139. https:\/\/doi.org\/10.2174\/1573399815666191024085838.","journal-title":"Curr Diabetes Rev"},{"issue":"3","key":"4738_CR26","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1176\/appi.ajp.2015.15030363","volume":"173","author":"RG Robinson","year":"2016","unstructured":"Robinson RG, Jorge RE. Post-stroke depression: A review. Am J Psychiatry. 2016;173(3):221\u201331. https:\/\/doi.org\/10.1176\/appi.ajp.2015.15030363.","journal-title":"Am J Psychiatry"},{"key":"4738_CR27","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.neuro.2022.09.006","volume":"93","author":"TT Oo","year":"2022","unstructured":"Oo TT, Pratchayasakul W, Chattipakorn N, Chattipakorn SC. Emerging roles of toll-like receptor 4 in chemotherapy-induced neurotoxicity. Neurotoxicology. 2022;93:112\u201327. https:\/\/doi.org\/10.1016\/j.neuro.2022.09.006.","journal-title":"Neurotoxicology"},{"key":"4738_CR28","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.bbi.2015.12.012","volume":"53","author":"Y Cheng","year":"2016","unstructured":"Cheng Y, Pardo M, Armini RDS, et al. Stress-induced neuroinflammation is mediated by GSK3-dependent TLR4 signaling that promotes susceptibility to depression-like behavior. Brain Behav Immun. 2016;53:207\u201322. https:\/\/doi.org\/10.1016\/j.bbi.2015.12.012.","journal-title":"Brain Behav Immun"},{"issue":"8","key":"4738_CR29","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1517\/14728222.2011.575360","volume":"15","author":"JA Nogueira-Machado","year":"2011","unstructured":"Nogueira-Machado JA, Volpe CMDO, Veloso CA, Chaves MM. HMGB1, TLR and RAGE: A functional tripod that leads to diabetic inflammation. Expert Opin Ther Targets. 2011;15(8):1023\u201335. https:\/\/doi.org\/10.1517\/14728222.2011.575360.","journal-title":"Expert Opin Ther Targets"},{"issue":"6","key":"4738_CR30","doi-asserted-by":"publisher","first-page":"8641","DOI":"10.1096\/fj.202000242R","volume":"34","author":"Z Zhu","year":"2020","unstructured":"Zhu Z, Peng X, Li X, et al. HMGB1 impairs endothelium-dependent relaxation in diabetes through TLR4\/eNOS pathway. FASEB J. 2020;34(6):8641\u201352. https:\/\/doi.org\/10.1096\/fj.202000242R.","journal-title":"FASEB J"},{"key":"4738_CR31","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1146\/annurev-immunol-030409-101323","volume":"29","author":"U Andersson","year":"2011","unstructured":"Andersson U, Tracey KJ. HMGB1 is a therapeutic target for sterile inflammation and infection. Annu Rev Immunol. 2011;29:139\u201362. https:\/\/doi.org\/10.1146\/annurev-immunol-030409-101323.","journal-title":"Annu Rev Immunol"}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-026-04738-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-026-04738-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-026-04738-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T11:51:09Z","timestamp":1774353069000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12883-026-04738-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4738"],"URL":"https:\/\/doi.org\/10.1186\/s12883-026-04738-3","relation":{},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,16]]},"assertion":[{"value":"20 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki (as revised in 2013).The study protocol was reviewed and approved by the ethics committee of The First Affiliated Hospital of Henan Medical University (IRB approval number: EC-024-523) and conformed to the ethical standards for medical research involving human subjects. Participants provided written informed consent prior to taking part in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent for the use of clinical data and biological samples in research and subsequent publication was obtained from all participants prior to enrollment.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"181"}}