{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T13:01:51Z","timestamp":1784811711418,"version":"3.55.0"},"reference-count":127,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Hum. Neurosci."],"abstract":"<jats:p>Ischemic stroke (IS) prognosis is frequently compromised by secondary systemic and neuropsychiatric complications extending beyond the initial brain injury. The hypothalamic\u2013pituitary\u2013adrenal (HPA) axis, the primary neuroendocrine regulator, plays a pivotal yet underappreciated role in the pathogenesis of these sequelae. This review analyzes the adverse impact of HPA axis dysregulation on post-stroke outcomes across disease phases. In the acute phase, maladaptive glucocorticoid surges and circadian disruption drive metabolic disturbances, blood\u2013brain barrier (BBB) breakdown leading to hemorrhagic transformation, and stroke-induced immunodepression that predisposes patients to pneumonia. In the chronic phase, persistent HPA hyperactivity, driven by impaired negative feedback and glucocorticoid receptors (GRs) resistance, induces structural remodeling in emotional and cognitive circuits. This serves as a shared pathophysiological mechanism underpinning post-stroke depression, anxiety, and cognitive impairment. Consequently, elucidating these neuroendocrine-immune interactions provides a novel pathophysiological framework for understanding post-stroke multidimensional complications.<\/jats:p>","DOI":"10.3389\/fnhum.2026.1836343","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T12:15:31Z","timestamp":1784808931000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Central neuroendocrine dysregulation in ischaemic stroke sequelae: pathophysiological mechanisms\u2014a narrative review"],"prefix":"10.3389","volume":"20","author":[{"given":"Han","family":"Gong","sequence":"first","affiliation":[{"name":"Beijing Key Laboratory for Biomaterials and Neural Regeneration, National Medical Innovation Platform for Industry-Education Integration in Advanced Medical Devices (Interdiscipline of Medicine and Engineering), School of Biological Science and Medical Engineering, Beihang University","place":["Beijing, China"]},{"name":"China Rehabilitation Research Center","place":["Beijing, China"]},{"name":"China Rehabilitation Science Institute","place":["Beijing, China"]},{"name":"School of Rehabilitation Sciences and Engineering, University of Health and Rehabilitation Sciences","place":["Qingdao, China"]},{"name":"Beijing International Cooperation Bases for Science and Technology on Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Rehabilitation, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang-Zheng","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Medicine, Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Sheng","family":"Rao","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory for Biomaterials and Neural Regeneration, National Medical Innovation Platform for Industry-Education Integration in Advanced Medical Devices (Interdiscipline of Medicine and Engineering), School of Biological Science and Medical Engineering, Beihang University","place":["Beijing, China"]},{"name":"Beijing International Cooperation Bases for Science and Technology on Biomaterials and Neural Regeneration, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Xia","family":"Du","sequence":"additional","affiliation":[{"name":"China Rehabilitation Research Center","place":["Beijing, China"]},{"name":"China Rehabilitation Science Institute","place":["Beijing, China"]},{"name":"School of Rehabilitation, Capital Medical University","place":["Beijing, China"]},{"name":"School of Rehabilitation Medicine, Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"148589","DOI":"10.1016\/j.ijbiomac.2025.148589","article-title":"Neuronal nitric oxide synthase (nNOS) uncoupling in ischemic stroke: mechanisms of oxidative\/nitrosative stress and opportunities for neuroprotection: a review","volume":"332","author":"Anwar","year":"2025","journal-title":"Int. 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