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Published on: March 15, 2024
Implications of Circadian Rhythm in Stroke Occurrence: Certainties and Possibilities
Dana Marieta Fodor1, Monica Mihaela Marta2, Lăcrămioara Perju-Dumbravă1
1Department of Neuroscience, "Iuliu Haţieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Insights
Stroke events show a daily pattern, peaking in the morning due to biological rhythms. Understanding this circadian variation is key for stroke prevention and treatment.
Area of Science:
- Neuroscience
- Chronobiology
- Cardiovascular Medicine
Background:
- Stroke occurrence exhibits a distinct circadian rhythm, with a peak in morning hours.
- This temporal pattern applies to various stroke subtypes, including cerebral infarction and intracerebral hemorrhage.
- Circadian variations in physiological factors like blood pressure and prothrombotic states contribute to this pattern.
Purpose of the Study:
- To review literature on circadian variations in cerebrovascular events.
- To explore the impact of circadian rhythm disruption on stroke risk and outcomes.
- To survey information on chronotherapy and chronoprophylaxis for stroke.
Main Methods:
- Literature review of physiological, cellular, and molecular circadian changes.
- Analysis of studies on stroke onset timing and risk factors.
- Examination of research on chronotherapy and neurorehabilitation.
Main Results:
- Stroke incidence follows a circadian pattern, influenced by both internal biological clocks and external factors.
- Disruption of the internal clock may elevate stroke risk and affect neurological recovery.
- Evidence suggests potential benefits of timing medical interventions to circadian rhythms.
Conclusions:
- Circadian rhythms play a significant role in stroke occurrence and potentially influence patient outcomes.
- Further research into chronotherapy and chronoprophylaxis could optimize stroke prevention and management.
- Understanding the internal clock's influence is crucial for improving neurorehabilitation strategies.
Abstract:
Stroke occurrence is not randomly distributed over time but has circadian rhythmicity with the highest frequency of onset in the morning hours. This specific temporal pattern is valid for all subtypes of cerebral infarction and intracerebral hemorrhage. It also correlates with the circadian variation of some exogenous factors such as orthostatic changes, physical activity, sleep-awake cycle, as well as with endogenous factors including dipping patterns of blood pressure, or morning prothrombotic and hypofibrinolytic states with underlying cyclic changes in the autonomous system and humoral activity. Since the internal clock is responsible for these circadian biological changes, its disruption may increase the risk of stroke occurrence and influence neuronal susceptibility to injury and neurorehabilitation. This review aims to summarize the literature data on the circadian variation of cerebrovascular events according to physiological, cellular, and molecular circadian changes, to survey the available information on the chronotherapy and chronoprophylaxis of stroke and its risk factors, as well as to discuss the less reviewed impact of the circadian rhythm in stroke onset on patient outcome and functional status after stroke.
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