Circadian rhythms in ischemic stroke: From pathogenesis to chronotherapy

Area of Science:

• Neuroscience
• Chronobiology
• Cardiovascular Medicine

Background:

• Circadian rhythms, regulated by the biological clock, are increasingly recognized for their significant role in ischemic stroke pathophysiology.
• These rhythms influence key stroke risk factors such as blood pressure, glucose metabolism, lipid homeostasis, and atrial fibrillation.

Purpose of the Study:

• To systematically review the influence of circadian rhythms on stroke risk factors and recovery.
• To explore the mechanistic basis of circadian influence across different stroke phases.
• To assess the potential of chronobiology-informed interventions for ischemic stroke.

Main Methods:

• Systematic literature review focusing on circadian rhythms and ischemic stroke.
• Analysis of preclinical and clinical studies on chronobiology and stroke pathophysiology.
• Evaluation of current and potential chronotherapy strategies.

Main Results:

• Circadian rhythms modulate stroke risk factors and influence metabolic, excitotoxic, oxidative, and inflammatory processes post-stroke.
• Chronobiology impacts neuroinflammation, glial scar formation, and neural remodeling during recovery.
• Existing stroke interventions like thrombolysis and rehabilitation may be optimized by considering circadian timing.

Conclusions:

• Circadian rhythms are critical determinants of ischemic stroke onset, progression, and recovery.
• Chronotherapy holds promise for developing personalized, precision medicine approaches to ischemic stroke.
• Addressing challenges in circadian assessment and intervention translation is crucial for clinical application.