TNF and Cognitive impairment: Furthermore, inflammatory reaction plays an important role in the pathological process of cognitive impairment after cerebral infarction.24 Cerebral ischemia can lead to the activation of endothelial cells, which can accelerate the release of IL-6, TNF-α and other inflammatory factors.25 Kamnaksh et al.26 have documented in their research that increased expression levels of IL-6 and TNF-α in the cerebrospinal fluid would indicate higher severity of the condition in patients with vascular cognitive impairment.