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Circadian Factors in Stroke: A Clinician’s Perspective

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, th...

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Autores principales: Korostovtseva, Lyudmila S., Kolomeichuk, Sergey N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10209385/
https://www.ncbi.nlm.nih.gov/pubmed/37191897
http://dx.doi.org/10.1007/s40119-023-00313-w
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author Korostovtseva, Lyudmila S.
Kolomeichuk, Sergey N.
author_facet Korostovtseva, Lyudmila S.
Kolomeichuk, Sergey N.
author_sort Korostovtseva, Lyudmila S.
collection PubMed
description 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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spelling pubmed-102093852023-05-26 Circadian Factors in Stroke: A Clinician’s Perspective Korostovtseva, Lyudmila S. Kolomeichuk, Sergey N. Cardiol Ther Review 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. Springer Healthcare 2023-05-16 2023-06 /pmc/articles/PMC10209385/ /pubmed/37191897 http://dx.doi.org/10.1007/s40119-023-00313-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Review
Korostovtseva, Lyudmila S.
Kolomeichuk, Sergey N.
Circadian Factors in Stroke: A Clinician’s Perspective
title Circadian Factors in Stroke: A Clinician’s Perspective
title_full Circadian Factors in Stroke: A Clinician’s Perspective
title_fullStr Circadian Factors in Stroke: A Clinician’s Perspective
title_full_unstemmed Circadian Factors in Stroke: A Clinician’s Perspective
title_short Circadian Factors in Stroke: A Clinician’s Perspective
title_sort circadian factors in stroke: a clinician’s perspective
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10209385/
https://www.ncbi.nlm.nih.gov/pubmed/37191897
http://dx.doi.org/10.1007/s40119-023-00313-w
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