AUTHOR=Wei Shufei , Cheng Lin , Shen Chunxiao , Li Zefen , Teng Jiahui , Wang Liangliang , Zhang Xiaorong TITLE=Necroptosis in vascular cognitive impairment: mechanisms and therapeutic potential JOURNAL=Frontiers in Aging Neuroscience VOLUME=Volume 17 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2025.1599773 DOI=10.3389/fnagi.2025.1599773 ISSN=1663-4365 ABSTRACT=Cerebral ischemia and hypoxia play key roles in the occurrence and development of vascular cognitive impairment (VCI). However, the pathophysiology of VCI remains unclear. Necroptosis is a non-cysteine-dependent form of cell death mediated by serine/threonine kinases receptor-interacting protein kinase-1 and -3 and mixed lineage kinase domain-like protein. A search of PubMed and Web of Science was conducted using terms related to VCI and necroptosis. Necroptosis is important in neuroinflammation, neuronal loss, blood–brain barrier dysfunction, and demyelination. Cerebral ischemia activates the necroptotic pathway, and necroptosis inhibitors have a significant inhibitory effect on brain injury. This review focuses on the pathogenesis of VCI and clarifies the core regulatory mechanism of necroptosis in vascular dementia, which lays a scientific foundation for cognitive impairment prevention and treatment by targeting necroptosis in VCI.