The influence of circadian variation in ischemic stroke onset on the evolution of the severity of the clinical picture and disability

• Main Authors: Dana Marieta Fodor, Marius Marian Fodor, Ioana Cristina Stănescu, Gabriela Dogaru, Lăcrămioara Perju-Dumbravă
• Format: Article
• Language: English
• Published: Romanian Association of Balneology, Editura Balneara 2019-02-01
• Series: Balneo Research Journal
• Subjects: ischemic stroke occurrence; circadian variation; NIHSS; mRS
• Online Access: http://bioclima.ro/Balneo234.pdf
• ISSN: 2069-7597; 2069-7619

Introduction. The chronobiology of ischemic stroke describes an occurrence pattern with the highest incidence in the morning according to most literature reports, but its influence on the evolution of the severity of the neurological picture and functional status is little studied. Materials and method. This cohort study included 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 followed up for 2 years by 5 successive evaluations. The onset time of ischemic stroke was assigned to one of the six hours intervals: 00.01- 06.00 (night), 06.01-12.00 (morning), 12.01-18.00 (afternoon) and 18.01-24.00 (evening). For each patient, the National Institute of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) scores were recorded on the occasion of each evaluation. Statistical analysis was performed using Excel Microsoft, descriptive and ANOVA test. Results and conclusions. Our study confirms the incidence pattern of ischemic stroke with a morning peak, which is more obvious in the case of patients aged less than 65 years. Patients with stroke onset in the nocturnal interval have a less favorable neurological and functional evolution during the second year after ischemic stroke.