showed that TLR4 activation occurs during NEC, an endogenous TLR4 ligand, high mobility group box 1 (HMGB1) is released from the intestinal and activates TLR4 on microglia, leading to the accumulation of reactive oxygen species (ROS), loss of oligodendrocyte progenitor cells (OPCs), dysmyelination, and cognitive impairments. Here, TLR4 is linked to Cognitive impairment.