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Abstract
The brain is a complex organ, fundamentally changing across the day to perform basic functions like sleep, thought, and regulating whole-body physiology. This requires a complex symphony of nutrients, hormones, ions, neurotransmitters and more to be properly distributed across the brain to maintain homeostasis throughout 24 hours. These solutes are distributed both by the blood and by cerebrospinal fluid. Cerebrospinal fluid contents are distinct from the general circulation because of regulation at brain barriers including the choroid plexus, glymphatic system, and blood-brain barrier. In this review, we discuss the overlapping circadian (≈24-hour) rhythms in brain fluid biology and at the brain barriers. Our goal is for the reader to gain both a fundamental understanding of brain barriers alongside an understanding of the interactions between these fluids and the circadian timing system. Ultimately, this review will provide new insight into how alterations in these finely tuned clocks may lead to pathology.
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Affiliation(s)
- Velia S Vizcarra
- Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Ryann M Fame
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Lauren M Hablitz
- Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY, 14642, USA
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Korostovtseva LS, Kolomeichuk SN. Circadian Factors in Stroke: A Clinician's Perspective. Cardiol Ther 2023; 12:275-295. [PMID: 37191897 DOI: 10.1007/s40119-023-00313-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/27/2023] [Indexed: 05/17/2023] Open
Abstract
Stroke remains one of the leading causes of mortality and long-term and permanent disability worldwide despite technological innovations and developments in pharmacotherapy. In the last few decades, the growing data have evidenced the role of the circadian system in brain vulnerability to damage, the development and evolution of stroke, and short-term and long-term recovery. On the other hand, the stroke itself can affect the circadian system via direct injury of specific brain structures involved in circadian regulation (i.e., hypothalamus, retinohypothalamic tracts, etc.) and impairment of endogenous regulatory mechanisms, metabolic derangement, and a neurogenic inflammatory response in acute stroke. Moreover, the disruption of circadian rhythms can occur or exacerbate as a result of exogenous factors related to hospitalization itself, the conditions in the intensive care unit and the ward (light, noise, etc.), medication (sedatives and hypnotics), and loss of external factors entraining the circadian rhythms. In the acute phase of stroke, patients demonstrate abnormal circadian variations in circadian biomarkers (melatonin, cortisol), core body temperature, and rest-activity patterns. The approaches aimed at the restoration of disrupted circadian patterns include pharmacological (melatonin supplementation) and non-medication (bright light therapy, shifting feeding schedules, etc.) interventions; however, their effects on short- and long-term recovery after stroke are not well understood.
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Affiliation(s)
- Lyudmila S Korostovtseva
- Sleep Laboratory, Research Department for Hypertension, Almazov National Medical Research Centre, 2 Akkuratov Str., St Petersburg, 197341, Russia.
| | - Sergey N Kolomeichuk
- Sleep Laboratory, Research Department for Hypertension, Almazov National Medical Research Centre, 2 Akkuratov Str., St Petersburg, 197341, Russia
- Laboratory of Genetics Institute of Biology, Karelian Research Centre, Russian Academy of Sciences, Almazov National Medical Research Centre, St Petersburg, Russia
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Opolskaya SV, Skibitsky VV, Fendrikova AV, Zabolotskich TB, Skibitsky AV. Cardioprotective potential of chronopharmacotherapy in patients with arterial hypertension who had a transient ischemic attack. KARDIOLOGIIA 2021; 61:33-41. [PMID: 34882076 DOI: 10.18087/cardio.2021.11.n1854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/29/2021] [Indexed: 06/13/2023]
Abstract
Aim Analysis of the cardioprotective effectivity of chronopharmacotherapy in patients with arterial hypertension (AH) after transient ischemic attack (TIA).Material and methods 174 patients with AH and TIA were evaluated. All patients were randomized to three groups based on the dosing schedule of chronopharmacotherapy: group 1 (n=59), patients receiving indapamide retard 1.5 mg and valsartan 160 mg, both in the morning; group 2 (n=58), indapamide retard 1.5 mg in the morning and valsartan 160 mg in the evening; group 3 (n=57), indapamide retard 1.5 mg in the morning and valsartan 80 mg in the morning and evening. Echocardiography (EchoCG) (ALOKA SSD 2500, Japan) was performed for all patients at baseline and at 12 months of the treatment. Statistical analysis of results was performed with the Statistica 12.0 (StatSoftInc, USA) software.Results Before the treatment, EchoCG parameters did not significantly differ between the patient groups. After 12 months of the treatment, positive changes in the end-systolic dimension (ESD), interventricular septal thickness (IVST), thickness of the left ventricular posterior wall (TLVPW), LV myocardial mass (LVMM), LVMM index (LVMMI), ejection fraction (EF), ratio of transmitral early peak flow velocity and late filling flow velocity (E/A), and isovolumetric velocity relaxation time (IVRT) were more pronounced in the group of sartan evening dosing (group 2) than in the group of sartan single morning dosing (group 1) (p<0.05). In group 3, the changes in ESD, IVST, TLVPW, LVMM, LVMMI, EF, E/A ratio, deceleration time (DT) of LV, and IVRT were significantly greater than those in group 1, whereas the dynamics of ESD, IVST, TLVPW, LVMM, LVMMI, E/A ratio, and DT were better in group 3 than in group 2 (p<0.05). In addition, a significantly greater number of patients with normalized LV geometry was registered in group 3 compared to groups 1 and 2 (p<0.05). The number of patients with normal LV diastolic function after the treatment was also significantly greater in group 3 than in group 1 (p<0.05) and comparable with group 2.Conclusion The morning dosing of indapamide retard and the b.i.d. dosing of valsartan provided more pronounced beneficial changes in major EcoCG indexes and improvement of LV geometry and diastolic function than the sartan single dosing only in the morning or evening in combination with the diuretic.
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Affiliation(s)
- S V Opolskaya
- Kuban State Medical University of the Ministry of Health of Russia, Krasnodar, Russia
| | - V V Skibitsky
- Kuban State Medical University of the Ministry of Health of Russia, Krasnodar, Russia
| | - A V Fendrikova
- Kuban State Medical University of the Ministry of Health of Russia, Krasnodar, Russia
| | - T B Zabolotskich
- Kuban State Medical University of the Ministry of Health of Russia, Krasnodar, Russia
| | - A V Skibitsky
- Kuban State Medical University of the Ministry of Health of Russia, Krasnodar, Russia
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Roy K, Maji D, Deb I. Increase of Cry 1 expression is a common phenomenon of the disturbed circadian clock in ischemic stroke and opioid addiction. Biochem Biophys Res Commun 2021; 558:8-13. [PMID: 33894675 DOI: 10.1016/j.bbrc.2021.04.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
Increasing evidences suggest the involvement of disrupted circadian clock in various pathologies including stroke and substance abuse. Here we took an attempt to do a comparative study on the regulation of circadian clock gene expression under two pathological circumstances - Opioid addiction and Ischemic stroke in the same cell line model (human neuroblastoma SH-SY5Y cells). To mimic in vivo ischemic stroke condition cells were placed in a hypoxia chamber and incubated for 10 h in balanced salt solution lacking glucose, aerated with an anaerobic gas mixture (95% N2 and 5% C02). For opioid addiction cells were treated with morphine sulphate at 10 μM dose for 48 h. We found that although circadian clock gets disturbed in both states, pattern of alteration of clock gene expressions were different and change was more severe in ischemic stroke than addiction. Interestingly, increase in expression of Cry1 showed as a common factor to both the diseases. This paper also emphasizes the interconnection between the severities of neuronal injury induced by ischemic stroke or opioid abuse to circadian system. Finally, this study will further enrich our knowledge towards the pattern of circadian rhythm disturbances under different pathological states.
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Affiliation(s)
- Kaninika Roy
- Department of Biochemistry, University of Calcutta, Kolkata, India
| | - Daytee Maji
- Department of Biochemistry, University of Calcutta, Kolkata, India
| | - Ishani Deb
- Department of Biochemistry, University of Calcutta, Kolkata, India.
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Liu JA, Walton JC, DeVries AC, Nelson RJ. Disruptions of Circadian Rhythms and Thrombolytic Therapy During Ischemic Stroke Intervention. Front Neurosci 2021; 15:675732. [PMID: 34177452 PMCID: PMC8222607 DOI: 10.3389/fnins.2021.675732] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/11/2021] [Indexed: 11/24/2022] Open
Abstract
Several endogenous and exogenous factors interact to influence stroke occurrence, in turn contributing to discernable daily distribution patterns in the frequency and severity of cerebrovascular events. Specifically, strokes that occur during the morning tend to be more severe and are associated with elevated diastolic blood pressure, increased hospital stay, and worse outcomes, including mortality, compared to strokes that occur later in the day. Furthermore, disrupted circadian rhythms are linked to higher risk for stroke and play a role in stroke outcome. In this review, we discuss the interrelation among core clock genes and several factors contributing to ischemic outcomes, sources of disrupted circadian rhythms, the implications of disrupted circadian rhythms in foundational stroke scientific literature, followed by a review of clinical implications. In addition to highlighting the distinct daily pattern of onset, several aspects of physiology including immune response, endothelial/vascular and blood brain barrier function, and fibrinolysis are under circadian clock regulation; disrupted core clock gene expression patterns can adversely affect these physiological processes, leading to a prothrombotic state. Lastly, we discuss how the timing of ischemic onset increases morning resistance to thrombolytic therapy and the risk of hemorrhagic transformation.
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Affiliation(s)
- Jennifer A Liu
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - James C Walton
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - A Courtney DeVries
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States.,Department of Medicine, Division of Oncology/Hematology, West Virginia University, Morgantown, WV, United States.,West Virginia University Cancer Institute, West Virginia University, Morgantown, WV, United States
| | - Randy J Nelson
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
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FODOR DM, STANESCU IC, TOHANEAN N, PERJU-DUMBRAVA L. The influence of circadian variation in ischemic stroke onset on the evolution of cognitive status. BALNEO RESEARCH JOURNAL 2020. [DOI: 10.12680/balneo.2020.321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. It is already known and accepted that cerebrovascular disease onset has a temporal variation pattern, the best documented being the circadian variation pattern, with a frequency peak in the morning and a second lower peak during afternoon. The impact of this circadian variation on post-stroke cognitive status has been little studied.
Materials and method. The study included a cohort of 63 patients with ischemic stroke, admitted to the Neurology Departments I and II of the Rehabilitation Hospital in Cluj-Napoca between 1 June 2008 and 1 June 2009, who were evaluated for their cognitive status over 2 years, during 5 successive visits. The onset time of ischemic stroke was assigned to one of the six-hour intervals: 00.01-06.00 (night), 06.01-12.00 (morning), 12.01-18.00 (afternoon), and 18.01-24.00 (evening). Statistical analysis was performed using Excel Microsoft, descriptive and ANOVA test.
Results and conclusions. The circadian variation pattern of stroke onset is confirming in our study the known incidence pattern of ischemic stroke, with the morning peak. There are differences in the evolution during dynamics of the MMSE score depending on the time of the day when stroke occurs. Patients with stroke onset during the night have seems to have a less favorable cognitive evolution in the second year after ischemic stroke compared to patients with stroke onset during the other intervals of the day.
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Affiliation(s)
- Dana Marieta FODOR
- Neuroscience Department ,”Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Ioana Cristina STANESCU
- Neuroscience Department ,”Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Nicoleta TOHANEAN
- Neuroscience Department ,”Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca, Romania
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Beker MC, Caglayan B, Yalcin E, Caglayan AB, Turkseven S, Gurel B, Kelestemur T, Sertel E, Sahin Z, Kutlu S, Kilic U, Baykal AT, Kilic E. Time-of-Day Dependent Neuronal Injury After Ischemic Stroke: Implication of Circadian Clock Transcriptional Factor Bmal1 and Survival Kinase AKT. Mol Neurobiol 2018; 55:2565-2576. [PMID: 28421530 DOI: 10.1007/s12035-017-0524-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 04/06/2017] [Indexed: 12/14/2022]
Abstract
Occurrence of stroke cases displays a time-of-day variation in human. However, the mechanism linking circadian rhythm to the internal response mechanisms against pathophysiological events after ischemic stroke remained largely unknown. To this end, temporal changes in the susceptibility to ischemia/reperfusion (I/R) injury were investigated in mice in which the ischemic stroke induced at four different Zeitgeber time points with 6-h intervals (ZT0, ZT6, ZT12, and ZT18). Besides infarct volume and brain swelling, neuronal survival, apoptosis, ischemia, and circadian rhythm related proteins were examined using immunohistochemistry, Western blot, planar surface immune assay, and liquid chromatography-mass spectrometry tools. Here, we present evidence that midnight (ZT18; 24:00) I/R injury in mice resulted in significantly improved infarct volume, brain swelling, neurological deficit score, neuronal survival, and decreased apoptotic cell death compared with ischemia induced at other time points, which were associated with increased expressions of circadian proteins Bmal1, PerI, and Clock proteins and survival kinases AKT and Erk-1/2. Moreover, ribosomal protein S6, mTOR, and Bad were also significantly increased, while the levels of PRAS40, negative regulator of AKT and mTOR, and phosphorylated p53 were decreased at this time point compared to ZT0 (06:00). Furthermore, detailed proteomic analysis revealed significantly decreased CSKP, HBB-1/2, and HBA levels, while increased GNAZ, NEGR1, IMPCT, and PDE1B at midnight as compared with early morning. Our results indicate that nighttime I/R injury results in less severe neuronal damage, with increased neuronal survival, increased levels of survival kinases and circadian clock proteins, and also alters the circadian-related proteins.
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Affiliation(s)
- Mustafa Caglar Beker
- Regenerative and Restorative Medical Research Center, Istanbul Medipol University, Ekinciler Cad. 19, TR-34810, Istanbul, Turkey
- Department of Physiology, Istanbul Medipol University, 34810, Istanbul, Turkey
- Department of Physiology, Necmettin Erbakan University, 42060, Konya, Turkey
| | - Berrak Caglayan
- Regenerative and Restorative Medical Research Center, Istanbul Medipol University, Ekinciler Cad. 19, TR-34810, Istanbul, Turkey
- Department of Physiology, Istanbul Medipol University, 34810, Istanbul, Turkey
| | - Esra Yalcin
- Regenerative and Restorative Medical Research Center, Istanbul Medipol University, Ekinciler Cad. 19, TR-34810, Istanbul, Turkey
- Department of Physiology, Istanbul Medipol University, 34810, Istanbul, Turkey
| | - Ahmet Burak Caglayan
- Regenerative and Restorative Medical Research Center, Istanbul Medipol University, Ekinciler Cad. 19, TR-34810, Istanbul, Turkey
- Department of Physiology, Istanbul Medipol University, 34810, Istanbul, Turkey
- Department of Physiology, Necmettin Erbakan University, 42060, Konya, Turkey
| | - Seyma Turkseven
- Regenerative and Restorative Medical Research Center, Istanbul Medipol University, Ekinciler Cad. 19, TR-34810, Istanbul, Turkey
| | - Busra Gurel
- Regenerative and Restorative Medical Research Center, Istanbul Medipol University, Ekinciler Cad. 19, TR-34810, Istanbul, Turkey
- School of Medicine, Department of Medical Biochemistry, Acibadem University, 34752, Istanbul, Turkey
| | - Taha Kelestemur
- Regenerative and Restorative Medical Research Center, Istanbul Medipol University, Ekinciler Cad. 19, TR-34810, Istanbul, Turkey
- Department of Physiology, Istanbul Medipol University, 34810, Istanbul, Turkey
- Department of Physiology, Necmettin Erbakan University, 42060, Konya, Turkey
| | - Elif Sertel
- Regenerative and Restorative Medical Research Center, Istanbul Medipol University, Ekinciler Cad. 19, TR-34810, Istanbul, Turkey
- Department of Physiology, Istanbul Medipol University, 34810, Istanbul, Turkey
| | - Zafer Sahin
- Department of Physiotherapy and Rehabilitation, Necmettin Erbakan University, 42060, Konya, Turkey
| | - Selim Kutlu
- Department of Physiology, Necmettin Erbakan University, 42060, Konya, Turkey
| | - Ulkan Kilic
- Regenerative and Restorative Medical Research Center, Istanbul Medipol University, Ekinciler Cad. 19, TR-34810, Istanbul, Turkey
| | - Ahmet Tarik Baykal
- School of Medicine, Department of Medical Biochemistry, Acibadem University, 34752, Istanbul, Turkey
| | - Ertugrul Kilic
- Regenerative and Restorative Medical Research Center, Istanbul Medipol University, Ekinciler Cad. 19, TR-34810, Istanbul, Turkey.
- Department of Physiology, Istanbul Medipol University, 34810, Istanbul, Turkey.
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Ku Mohd Noor KM, Wyse C, Roy LA, Biello SM, McCabe C, Dewar D. Chronic photoperiod disruption does not increase vulnerability to focal cerebral ischemia in young normotensive rats. J Cereb Blood Flow Metab 2017; 37:3580-3588. [PMID: 27789784 PMCID: PMC5669340 DOI: 10.1177/0271678x16671316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Photoperiod disruption, which occurs during shift work, is associated with changes in metabolism or physiology (e.g. hypertension and hyperglycaemia) that have the potential to adversely affect stroke outcome. We sought to investigate if photoperiod disruption affects vulnerability to stroke by determining the impact of photoperiod disruption on infarct size following permanent middle cerebral artery occlusion. Adult male Wistar rats (210-290 g) were housed singly under two different light/dark cycle conditions ( n = 12 each). Controls were maintained on a standard 12:12 light/dark cycle for nine weeks. For rats exposed to photoperiod disruption, every three days for nine weeks, the lights were switched on 6 h earlier than in the previous photoperiod. T2-weighted magnetic resonance imaging was performed at 48 h after middle cerebral artery occlusion. Disruption of photoperiod in young healthy rats for nine weeks did not alter key physiological variables that can impact on ischaemic damage, e.g. blood pressure and blood glucose immediately prior to middle cerebral artery occlusion. There was no effect of photoperiod disruption on infarct size after middle cerebral artery occlusion. We conclude that any potentially adverse effect of photoperiod disruption on stroke outcome may require additional factors such as high fat/high sugar diet or pre-existing co-morbidities.
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Affiliation(s)
- Ku Mastura Ku Mohd Noor
- 1 Institute of Neuroscience and Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Cathy Wyse
- 2 Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Lisa A Roy
- 1 Institute of Neuroscience and Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Stephany M Biello
- 1 Institute of Neuroscience and Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Christopher McCabe
- 1 Institute of Neuroscience and Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Deborah Dewar
- 1 Institute of Neuroscience and Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Zheng D, Sato S, Cao YJ, Arima H, Carcel C, Chalmers J, Anderson CS. Circadian variation in clinical features and outcome of intracerebral hemorrhage: The INTERACT studies. Chronobiol Int 2016; 33:1182-1187. [PMID: 27485147 DOI: 10.1080/07420528.2016.1210158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Previous studies consistently reported a diurnal variation in the occurrence of intracerebral hemorrhage (ICH), with a morning peak. However, limited knowledge exists on the circadian pattern of ICH severity and outcome. This study aimed to determine possible associations between ICH onset time and admission severity and 90-day outcomes using the combined data set of the pilot and main-phase Intensive blood pressure (BP) reduction in an acute cerebral hemorrhage trial (INTERACT). The ICH onset time was categorized into three groups (1: 00:00-07:59; 2: 08:00-15:59; and 3: 16:00-23:59). We found an association between onset time and low Glasgow Coma Scale score: aOR (time 1: 1.72, 95% CI 1.12-2.66; time 3: 1.95, 95% CI 1.31-2.89, p = 0.003; in comparison to time 2). There was no association between onset time and volume of ICH (adjusted p = 0.354) or 90-day outcomes of death or major disability, and death and major disability separately (all adjusted p > 0.4). The results showed that more severe cases of ICH patients, defined by a reduced level of consciousness, had late afternoon to early morning stroke onset, but this was unrelated to baseline hematoma volume or location. There was no circadian influence on ICH clinical outcome.
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Affiliation(s)
- Danni Zheng
- a Neurological and Mental Health Division, The George Institute for Global Health , Sydney , Australia.,b Sydney Medical School, The University of Sydney , Sydney , Australia
| | - Shoichiro Sato
- a Neurological and Mental Health Division, The George Institute for Global Health , Sydney , Australia.,c Department of Cerebrovascular Medicine , National Cerebral and Cardiovascular Center , Osaka , Japan
| | - Yong-Jun Cao
- a Neurological and Mental Health Division, The George Institute for Global Health , Sydney , Australia.,d Department of Neurology , The Second Affiliated Hospital of Soochow University , Suzhou , China
| | - Hisatomi Arima
- a Neurological and Mental Health Division, The George Institute for Global Health , Sydney , Australia.,e Department of Preventive Medicine and Public Health , Faculty of Medicine, Fukuoka University , Fukuoka , Japan
| | - Cheryl Carcel
- a Neurological and Mental Health Division, The George Institute for Global Health , Sydney , Australia.,f Department of Neurology , Royal Prince Alfred Hospital , Sydney , Australia
| | - John Chalmers
- a Neurological and Mental Health Division, The George Institute for Global Health , Sydney , Australia.,b Sydney Medical School, The University of Sydney , Sydney , Australia
| | - Craig S Anderson
- a Neurological and Mental Health Division, The George Institute for Global Health , Sydney , Australia.,b Sydney Medical School, The University of Sydney , Sydney , Australia.,f Department of Neurology , Royal Prince Alfred Hospital , Sydney , Australia
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Earnest DJ, Neuendorff N, Coffman J, Selvamani A, Sohrabji F. Sex Differences in the Impact of Shift Work Schedules on Pathological Outcomes in an Animal Model of Ischemic Stroke. Endocrinology 2016; 157:2836-43. [PMID: 27254002 PMCID: PMC4929545 DOI: 10.1210/en.2016-1130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Circadian clock desynchronization has been implicated in the pathophysiology of cardiovascular disease and related risk factors (eg, obesity, diabetes). Thus, we examined the extent to which circadian desynchronization exacerbates ischemic stroke outcomes and whether its detrimental effects on stroke severity and functional impairments are further modified by biological sex. Circadian entrainment of activity rhythms in all male and female rats was observed during exposure to a fixed light-dark (LD) 12:12 cycle but was severely disrupted when this LD cycle was routinely shifted (12 h advance/5 d) for approximately 7 weeks. In contrast to the regular estrous cycles in fixed LD animals, cyclicity was abolished and persistent estrus was evident in all shifted LD females. The disruption of estrous cyclicity in shifted LD females was associated with a significant increase in serum estradiol levels relative to that observed in fixed LD controls. Circadian rhythm disruption exacerbated stroke outcomes in both shifted LD male and female rats and further amplified sex differences in stroke impairments. In males, but not females, circadian disruption after exposure to the shifted LD cycle was marked by high rates of mortality. In surviving females, circadian desynchronization after exposure to shifted LD cycles produced significant increases in stroke-induced infarct volume and sensorimotor deficits with corresponding decreases in serum IGF-1 levels. These results suggest that circadian rhythm disruption associated with shift work schedules or the irregular nature of our everyday work and/or social environments may interact with other nonmodifiable risk factors such as biological sex to modulate the pathological effects of stroke.
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Affiliation(s)
- David J Earnest
- Department of Neuroscience and Experimental Therapeutics (D.J.E., N.N., J.C., A.S., F.S.) and Women's Health in Neuroscience Program (A.S., F.S.), Texas A&M Health Science Center, College of Medicine, Bryan, Texas 77807-3260; and Department of Biology (D.J.E.) and Center for Biological Clocks Research (D.J.E.), Texas A&M University, College Station, Texas 77843-3258
| | - Nichole Neuendorff
- Department of Neuroscience and Experimental Therapeutics (D.J.E., N.N., J.C., A.S., F.S.) and Women's Health in Neuroscience Program (A.S., F.S.), Texas A&M Health Science Center, College of Medicine, Bryan, Texas 77807-3260; and Department of Biology (D.J.E.) and Center for Biological Clocks Research (D.J.E.), Texas A&M University, College Station, Texas 77843-3258
| | - Jason Coffman
- Department of Neuroscience and Experimental Therapeutics (D.J.E., N.N., J.C., A.S., F.S.) and Women's Health in Neuroscience Program (A.S., F.S.), Texas A&M Health Science Center, College of Medicine, Bryan, Texas 77807-3260; and Department of Biology (D.J.E.) and Center for Biological Clocks Research (D.J.E.), Texas A&M University, College Station, Texas 77843-3258
| | - Amutha Selvamani
- Department of Neuroscience and Experimental Therapeutics (D.J.E., N.N., J.C., A.S., F.S.) and Women's Health in Neuroscience Program (A.S., F.S.), Texas A&M Health Science Center, College of Medicine, Bryan, Texas 77807-3260; and Department of Biology (D.J.E.) and Center for Biological Clocks Research (D.J.E.), Texas A&M University, College Station, Texas 77843-3258
| | - Farida Sohrabji
- Department of Neuroscience and Experimental Therapeutics (D.J.E., N.N., J.C., A.S., F.S.) and Women's Health in Neuroscience Program (A.S., F.S.), Texas A&M Health Science Center, College of Medicine, Bryan, Texas 77807-3260; and Department of Biology (D.J.E.) and Center for Biological Clocks Research (D.J.E.), Texas A&M University, College Station, Texas 77843-3258
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Fodor DM, Babiciu I, Perju-Dumbrava L. Circadian Variation of Stroke Onset: A Hospital-Based Study. ACTA ACUST UNITED AC 2014; 87:242-9. [PMID: 26528031 PMCID: PMC4620674 DOI: 10.15386/cjmed-328] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 10/24/2014] [Accepted: 10/28/2014] [Indexed: 11/24/2022]
Abstract
Aims and background. The circadian pattern of stroke occurrence variation has been recognized with certain differences between authors and stroke types. The underlying reason may be related to exogenous factors (cyclic physical activity, including sleep–awake cycles and assuming the up-right posture) and endogenous factors, with their diurnal variation (blood pressure, hemostatic balance, autonomic system activity). The aims of the present study are to investigate the existence of a circadian variation of stroke and the possible differences between stroke subtypes in the Cluj Napoca area. Materials and method. The stroke event data were acquired from the Patient Records of a consecutive series of 1083 patients admitted through the Emergency Room at Neurology Departments I and II of the District Hospital of Cluj Napoca, between 1 January 2012 and 31 December 2012. The classifiable onset time was assigned to one of four six-hour intervals: 00.01–06.00 (night), 06.01–12.00 (morning), 12.01–18.00 (afternoon) and 18.01–24.00 (evening). Demographic data and vascular risk factors were recorded. Results. All three stroke types (ischemic stroke, hemorrhagic stroke and subarachnoid hemorrhage) have shown a circadian variation regarding their occurrence, with the peak of incidence in the morning and the nadir during nighttime. This circadian pattern is independent by demographic factors and vascular risk factors. Conclusion. Our study confirmed the circadian variation of onset occurrence for all stroke subtypes. Some triggering factors promote ischemic stroke and prevent hemorrhagic stroke. The diurnal pattern of variation with the higher incidence in the morning and the lower in the night may lead to chrono-therapeutic and preventive approach (chrono-therapy of the risk factors), which targets the period of the highest vulnerability after awaking.
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Affiliation(s)
- Dana Marieta Fodor
- Neurology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Ioana Babiciu
- Neurology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
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Raj K, Bhatia R, Prasad K, Srivastava MVP, Vishnubhatla S, Singh MB. Seasonal differences and circadian variation in stroke occurrence and stroke subtypes. J Stroke Cerebrovasc Dis 2014; 24:10-6. [PMID: 25284717 DOI: 10.1016/j.jstrokecerebrovasdis.2014.07.051] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 07/16/2014] [Accepted: 07/23/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND India is a subtropical country with clear seasonal variations in weather conditions. Seasonal and circadian variation in occurrence of subtypes of cerebrovascular disease has been of interest in several studies from different countries and climate zones, but discrepant results have made the conclusions unclear. The aim of the present study was to observe the seasonal and circadian variation in the occurrence of stroke and its subtypes among our population. METHODS This was a cross-sectional observational study based on new cases and past cases of stroke on follow-up, conducted between January 2011 and December 2012 in the Department of Neurology, at the All India Institute of Medical Sciences, New Delhi, India. The date and time of onset of the stroke was recorded. The categorization of months into season was in accordance with the Indian Meteorological Department guidelines. The time of onset was distributed into 6 hourly intervals. Statistical calculations were performed using Stata version 12.1 and SPSS version 20. RESULTS A total of 583 patients were included for the study. The rate of occurrence of stroke was highest in the late morning 0600-1159 hours (P value <.001) compared with other times of the day, regardless of gender or age for both ischemic and hemorrhagic strokes. It was lowest in late evening (1800-2359 hours) quadrant compared with other quadrants. Although there was no significant difference found by dichotomizing the groups into two 6-month periods, there was an increasing trend in number of patients with stroke during the months November-February. There was no difference in stroke occurrence between the types of stroke or within each type among different seasons with different temperatures. Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification of ischemic strokes also did not show any association with season or circadian rhythm. CONCLUSIONS There is a significant increase in occurrence of strokes between 0600 and 1159 hours and lowest between 1800-2359 hours. No significant variation in stroke occurrence or subtype for any of the seasons was observed.
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Affiliation(s)
- Kishan Raj
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
| | - Kameshwar Prasad
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | | | - Mamta Bhushan Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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Morning Blood Pressure Surge and Nighttime Blood Pressure in Relation to Nocturnal Sleep Pattern and Arterial Stiffness. J Cardiovasc Nurs 2014; 29:E10-7. [DOI: 10.1097/jcn.0b013e318291ee43] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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15
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Kõrv J, Vibo R, Kadlecová P, Kobayashi A, Czlonkowska A, Brozman M, Švigelj V, Csiba L, Fekete K, Demarin V, Vilionskis A, Jatuzis D, Krespi Y, Ahmed N, Mikulík R. Benefit of thrombolysis for stroke is maintained around the clock: results from the SITS-EAST Registry. Eur J Neurol 2013; 21:112-7. [DOI: 10.1111/ene.12257] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 07/26/2013] [Indexed: 11/28/2022]
Affiliation(s)
- J. Kõrv
- Department of Neurology and Neurosurgery; University of Tartu; Tartu Estonia
| | - R. Vibo
- Department of Neurology and Neurosurgery; University of Tartu; Tartu Estonia
| | - P. Kadlecová
- International Clinical Research Center; St Anne's Hospital; Brno Czech Republic
| | - A. Kobayashi
- Second Department of Neurology; Institute of Psychiatry and Neurology; Warsaw Poland
- Interventional Stroke Treatment Centre; Institute of Psychiatry and Neurology; Warsaw Poland
| | - A. Czlonkowska
- Second Department of Neurology; Institute of Psychiatry and Neurology; Warsaw Poland
- Department of Experimental and Clinical Pharmacology; Medical University of Warsaw; Warsaw Poland
| | - M. Brozman
- Neurology Department; University Hospital Nitra; Nitra Slovakia
| | - V. Švigelj
- Department of Vascular Neurology and Neurological Intensive Care; University Medical Centre Ljubljana and Zdravstveni Nasveti; Ljubljana Slovenia
| | - L. Csiba
- Department of Neurology; Medical and Health Science Center; University of Debrecen; Debrecen Hungary
| | - K. Fekete
- Department of Neurology; Medical and Health Science Center; University of Debrecen; Debrecen Hungary
| | | | - A. Vilionskis
- Department of Neurology and Neurosurgery; Vilnius University and Republican Vilnius University Hospital; Vilnius Lithuania
| | - D. Jatuzis
- Department of Neurology and Neurosurgery; Vilnius University and Vilnius University Hospital Santariskiu Clinics; Vilnius Lithuania Lithuania
| | - Y. Krespi
- Stroke Rehabilitation and Research Center; Memorial Sisli Hospital; Memorial Health Group Stroke Center; Istanbul Turkey
| | - N. Ahmed
- Department of Neurology; Karolinska University Hospital; Solna, and Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
| | - R. Mikulík
- Neurology Department; International Clinical Research Center; St Anne's Hospital; Brno Czech Republic
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