This Heart Disease Risk Factor Doesn't Show Up On A Blood Test - air pollution - by mindbodygreen

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This Heart Disease Risk Factor Doesn't Show Up On A Blood Test

Down to the Core of the Paradox: Thrombectomy in Large Stroke and Favorable Outcome — Do Time and Mismatch Matter?

 I hope this doesn't mean you're giving up! Stroke survivors have no choice but to soldier thru regardless of the incompetence of the stroke medical world in not solving stroke to 100% recovery!

Down to the Core of the Paradox: Thrombectomy in Large Stroke and Favorable Outcome — Do Time and Mismatch Matter?

Chen J, Nie X, Wang M, Zhang D, Sun D, Pan Y, Huo X, Li Z, Miao Z, for the ANGEL-ASPECT Study Group. Time-Dependent Impact of Mismatch Profiles on Outcomes Following Endovascular Thrombectomy for Large Ischemic Stroke. Stroke. 2026;57:641–649.

Patients with large-core infarctions have long been considered poor candidates for reperfusion therapy.(Why?) Although six recent randomized controlled trials evaluating endovascular therapy (EVT) versus medical management have since largely challenged this view, only 20 to 30% of these patients achieve functional independence at 90 days. In small-core infarctions, perfusion mismatch between the irreversibly damaged tissue of the core and the salvageable penumbra has become the cornerstone of EVT decision-making, particularly in the late time window. However, whether the same principle applies to large-core infarctions is uncertain. Notably, previous subgroup analyses yielded conflicting results, and it remains unknown whether perfusion mismatch can reliably inform EVT decisions in large-core infarctions across different time windows.

The authors performed a secondary, post hoc analysis of the ANGEL-ASPECT trial, a multicenter randomized controlled trial comparing EVT with medical management in adults aged 18-80 years with acute ischemic stroke and large-core infarction of the anterior circulation defined as: ASPECTS 3-5 within 24 hours, or core volume 70-100mL and either ASPECTS 0-2 within 24 hours or ASPECTS > 5 at 6-24 hours. Perfusion mismatch was defined using two criteria: (1) mismatch ratio ≥ 1.8 and mismatch volume ≥ 15mL, or (2) mismatch radio ≥ 1.2 and mismatch volume ≥ 10mL. Unadjusted logistic regression assessed the association between treatment and 90-day functional independence (mRS 0–3), including treatment-by-mismatch interaction within each time stratum (≤6 versus >6 hours) and treatment-by-time interaction in the overall cohort. Secondary outcomes included recanalization, 90-day mRS distribution, mortality, and intracranial hemorrhage.

Using the most stringent definition, 346 of the 426 participants (81%) displayed a perfusion mismatch. In the early time window (≤ 6 hours), EVT was associated with higher odds of functional independence at 90 days among patients with a perfusion mismatch compared with medical management alone (49 vs 28%; OR 2.41 [95% CI 1.28–4.55]), whereas no benefit was observed in those without a mismatch. In the late window, EVT conferred no significant advantage, aside from a non-significant trend toward benefit in the no-mismatch group. Treatment-by-mismatch and treatment-by-time interaction tests were not statistically significant for primary and secondary outcomes. Sensitivity analyses excluding wake-up stroke yielded consisted results. Any ICH occurred more frequently in the EVT group, while rates of symptomatic ICH were comparable across treatment arms.

Overall, this post hoc analysis suggests that among patients with large-core infarctions, those imaged within the early time window and exhibiting a perfusion mismatch may, as predicted by the core/penumbra model, derive the greatest benefit from EVT, whereas benefit in the late-time window appeared less dependent on mismatch status. These results contrast with subgroup analyses from SELECT-2,1 which reported EVT benefit irrespective of mismatch status, but partially align with those of TESLA,2 which did not meet its primary endpoint yet, somewhat unexpectedly, suggested a trend toward EVT benefit primarily in patients without a mismatch. Notably, some patients with no apparent mismatch still experienced favorable outcomes with EVT in extended time windows, further challenging the large-core paradox. Such findings may reflect favorable baseline characteristics; however, alternative explanations, including imaging limitations, overestimation of the core, residual tissue viability (so-called heterogeneity within the core), and reduction of vasogenic edema, cannot be excluded.3

Considering the limited subgroup sizes, potential selection bias with high prevalence of perfusion mismatch, and the unadjusted nature of the statistical analyses, these findings should be interpreted with caution. Current guidelines do not support selecting or excluding patients from EVT solely based on perfusion imaging,4 and further studies are needed to clarify how perfusion mismatch profiles and imaging timing should inform EVT decisions in large stroke.

We asked 4 dietitians the one supplement they actually take—they all said the same thing - magnesium

 

Do you really think your competent? doctor will instruct the dietician to get this correctly in your diet protocol? Sorry, you DON'T HAVE A DIET PROTOCOL, DO YOU?

We asked 4 dietitians the one supplement they actually take—they all said the same thing

Dietitians agree on this go-to supplement for better rest, recovery and daily nutrient support when diet alone falls short

Reviewed by Dietitian Katey Davidson, M.Sc.FN, RD, CPT

Key Points

• Dietitians recommend magnesium supplements when food alone doesn’t meet daily needs.
• Magnesium supports sleep, muscle and nerve function, making it important to prioritize.
• Individual needs vary, so work with a healthcare provider for personalized advice.

Getting your nutrition from food first is an important goal, but even nutrition experts can have occasional nutrient gaps. Registered dietitians spend their careers helping others eat well, so it may be surprising that many turn to supplements to fill in where food falls short.

Although individual needs vary, some supplements are more widely beneficial than others, since certain nutrients can be difficult to get through diet alone. We asked four dietitians which supplement they take every day, and they all gave the same answer: magnesium. Keep reading to learn why magnesium is often recommended as a go-to supplement and what you should know before considering it yourself.

Why Dietitians Take Magnesium

Magnesium is an essential mineral that plays a role in hundreds of processes throughout the body—from supporting muscle function and nerve signaling to helping regulate blood sugar levels. It’s naturally found in foods like nuts, seeds, leafy greens, legumes and whole grains. However, many people don’t consume enough of these foods on a regular basis.

Related video: Doctors urge caution over rising magnesium supplement trend (Welltica+)

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Doctors urge caution over rising magnesium supplement trend

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As a result, nearly half of Americans fall short of the recommended daily intake, which is 400–420 milligrams (mg) per day for men and 310–320 mg for women, says Elizabeth Ward, M.S., RDN.

For Ward, this gap was the reason she began supplementing. "I started taking [magnesium] because I realized I wasn't getting enough magnesium every day from food."

Beyond filling nutrient gaps, dietitians shared several other reasons they take magnesium daily. One of the most common? Better sleep. Magnesium helps regulate gamma-aminobutyric acid (GABA), a brain chemical that calms the central nervous system. This can make it easier to unwind at the end of the day and improve overall sleep quality. As dietitian Lisa Moskovitz, RD, CDN explains, "When I do take it at night I will feel more rested and I have better quality sleep."

Magnesium’s benefits extend beyond sleep. It also supports muscle and nerve function. Megan Huff, RDN, says it has made a noticeable difference: "I started taking magnesium glycinate for restless legs and leg cramps, and since taking it, I haven't experienced either for two years!"

For Ashley Kitchens, M.P.H., RD, the draw was athletic recovery. "As a CrossFit athlete, I train hard five days a week. Because magnesium plays a key role in muscle function, I added it in to supplement my workouts and recovery."

Who Is Most Likely to Benefit

While magnesium can be helpful for many people, dietitians say certain groups may be more likely to benefit from supplementation:

• Athletes and Very Active Individuals. People who exercise frequently or sweat heavily may have increased magnesium needs. "You lose magnesium through sweat, plus it's critical for muscle contraction and recovery," says Kitchens.
• Older Adults. As we age, the body becomes less efficient at absorbing magnesium from food, making supplementation potentially beneficial for this group, explains Kitchens.
• People with Sleep Difficulties. “People who wake up in the middle of the night, don't wake up feeling well-rested are most likely to benefit from magnesium,” says Huff. However, it’s important to consider that underlying health issues may also be contributing and should be discussed with a healthcare provider.
• People with Low Magnesium Intake. Individuals who don’t regularly consume magnesium-rich foods due to dietary limitations or picky eating patterns may also fall short. Working with a registered dietitian can help improve food choices and determine whether supplementation is needed.

Who Should Use Caution

Although magnesium supplements are generally safe for most people, certain groups should speak with their healthcare provider before starting one.

People with chronic kidney disease, in particular, need to be cautious. Healthy kidneys help remove excess magnesium from the body, but when kidney function is impaired, magnesium can build up to unsafe levels, warn Kitchens and Huff.

Huff also notes that individuals with myasthenia gravis—an autoimmune condition that causes muscle weakness—should consult a healthcare professional before supplementing. Since magnesium has a muscle-relaxing effect, it may worsen symptoms in some cases.

Potential Side Effects

Magnesium supplements are generally well tolerated, but the most common side effects are digestive. "High doses of magnesium from supplements or medications such as laxatives and antacids that contain magnesium can result in diarrhea, nausea and cramping," says Ward. She adds that magnesium oxide, in particular, is more likely to cause stomach upset.

To minimize these effects, Kitchens recommends starting with a lower dose and increasing gradually. She learned this firsthand after taking too high of a dose before bed and experiencing noticeable digestive discomfort the next morning.

At very high doses, more serious effects—such as low blood pressure or an irregular heartbeat—can occur, Kitchens notes.

Ward also cautions that magnesium supplements can interact with certain medications, including antibiotics and osteoporosis treatments, potentially reducing their effectiveness. For this reason, always let your healthcare provider and pharmacist know about any supplements you're taking.

What to Look for When Buying Magnesium

Not all magnesium supplements are created equal. Dietitians recommend keeping a few key factors in mind when choosing one:

• Choose a Well-Absorbed Form. Forms like magnesium glycinate (or bisglycinate) and magnesium malate are typically well absorbed and gentle on the stomach. In contrast, magnesium oxide tends to be less bioavailable and more likely to cause digestive discomfort.
• Match the Form to Your Goal. "Know what your goal and objective is with taking magnesium so you can find the best form for your goals and needs," says Moskovitz. For example, magnesium citrate is often used for its mild laxative effect, while magnesium glycinate is commonly chosen for sleep and muscle support.
• Follow Dosing Instructions. The recommended upper limit for supplemental magnesium is 350 mg per day for adults. Exceeding this amount isn’t necessary unless advised by a healthcare provider, says Ward.
• Look for Independent Testing. To ensure quality and accuracy, Huff suggests choosing supplements verified by an independent organization such as NSF International, USP or Informed Choice.
• Watch for Misleading Claims. "Common red flags when it comes to searching for a magnesium supplement is vague labeling and companies that make wild health claims without any evidence to back them up," says Kitchens.
• Be Cautious with Added Ingredients. Huff advises against products that contain proprietary herbal blends or extra nutrients that may interact with medications or lead to excessive intake when combined with other supplements. In many cases, taking just a magnesium supplement on its own is the simplest and safest choice.

Our Expert Take

Dietitians generally recommend a food-first approach to nutrition, but in some cases, supplements can help fill nutritional gaps. With nearly half of adults falling short of the daily recommendations for magnesium from food alone, it’s easy to see why dietitians choose to supplement and often recommend magnesium.

That said, not everyone needs a magnesium supplement, and more isn’t always better. Individual needs can vary based on diet, health status and lifestyle. For that reason, it’s important to work with a healthcare provider to determine what’s right for you.

Read the original article on EatingWell

The magnesium-rich seed that can also help with inflammation

Do you really think your competent? doctor will instruct the dietician to get this correctly in your diet protocol? Sorry, you DON'T HAVE A DIET PROTOCOL, DO YOU?

The magnesium-rich seed that can also help with inflammation

1) Brazil nuts

There are a whopping 18.8 mg of magnesium in a single Brazil nut, meaning that an ounce (about 6 nuts) will net you nearly 113 mg of magnesium — more than a third of the daily recommendation. While Brazil nuts are a great source of magnesium, it’s important to not go overboard. They're extremely high in selenium, which can be toxic in large amounts. Research shows that just two Brazil nuts a day are all you need to reap their nutritional benefits.

2) Cashews

Cashews contain 82.8 mg of magnesium per 1-ounce serving. Try adding them to a stir-fry or curry, or roasting them on their own as a snack. Beyond their high magnesium content, cashews are rich in amino acids and minerals that help the body regulate hormone levels, heart function, and nerve function.

3) Almonds

With 76.5 mg of magnesium in a 1-ounce serving, eating a handful of almonds is one of the fastest ways to boost your magnesium intake. What’s more, research shows that almonds are also powerhouses for gut health, weight management, and reducing your risk for cardiovascular disease.

4) Pine nuts

Pine nuts have 71.2 mg of magnesium in a 1-ounce serving. You’ll find them most often in pesto and salads, which is great news because pairing pine nuts with leafy greens (which are also high in magnesium) is a great way to reach your daily magnesium goal.

5) Peanuts

Though they’re technically legumes, with 47.6 mg of magnesium per ounce, peanuts are one of the “nuts” with the highest concentration of magnesium. Consuming both tree nuts and peanuts on a daily basis comes with several benefits, as they are packed with nutrients like protein, iron, magnesium, phosphorus, zinc, copper, thiamin and vitamin E.

6) Hazelnuts

In every 1-ounce serving of hazelnuts, there are 46.2 mg of magnesium. Consuming hazelnuts regularly has been linked to lower risk for heart disease, type 2 diabetes and high blood pressure. There is even some evidence to suggest that hazelnuts can help reduce your likelihood of developing certain cancers.

7) Walnuts

With 44.8 mg of magnesium in every ounce, walnuts are rich in vital nutrients and antioxidants. They are great sources of omega 3s – fatty acids that support the brain, heart, immune system and more – as well as vitamin E, which protects the body from damage by free radicals that weaken cells over time.

8) Macadamia nuts

Macadamia nuts clock in at 36.9 mg of magnesium per ounce. Aside from their high magnesium content, they’ve been shown to reduce high cholesterol, inflammation and oxidative stress, which can support overall health.

9) Pistachios

There are 34.3 mg of magnesium in every ounce of pistachios. It’s safe to say pistachios are having a moment right now, and for good reason. This nut found in viral sensations like Dubai chocolate packs several nutritional benefits, from high levels of anti-inflammatory properties to their relatively low fat content compared to other nuts.

10) Pecans

Tied with pistachios, pecans also contain 34.3 mg per 1-ounce serving. They’re a remarkable source of healthy fats, and may help protect against heart disease, gallstones, type 2 diabetes and high blood pressure.

Transcutaneous spinal stimulation with upper extremity robotic training in chronic stroke and spinal cord injury: individual neurophysiological and clinical responses

 How close is your competent? doctor to using this? What is your doctor doing to prevent spasticity from interfering with this intervention?

Transcutaneous spinal cord stimulation (tSCS) is a non-invasive neuromodulation technique that delivers mild electrical currents through the skin to the spinal cord. It stimulates dormant nerve pathways to help restore voluntary movement, balance, and sensation, typically when paired with physical or occupational therapy.

Transcutaneous spinal stimulation with upper extremity robotic training in chronic stroke and spinal cord injury: individual neurophysiological and clinical responses

• Jeonghoon Oh,
• Michelle S. Scheffler,
• Shane T. King,
• Erin E. Mahan,
• Melissa Lee,
• Catherine Martin,
• Alexander G. Steele,
• Jony Sheynin,
• Jenny Dinh,
• Argyrios Stampas,
• Teresa Kaldis,
• Timea M. Hodics,
• Marcia K. O’Malley &
• Dimitry G. Sayenko 

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Background

Damage to the corticospinal tract after stroke and spinal cord injury (SCI) often results in persistent upper extremity (UE) impairment. Transcutaneous spinal stimulation (TSS) and robotic technologies have been explored as approaches to facilitate motor training; however, their combined effects on UE sensorimotor recovery remain poorly understood. The purpose of this study was to examine the effects of TSS combined with UE robotic training in individuals with chronic stroke or SCI.

Methods

Five participants with stroke and six with SCI completed a 14-week, sham controlled, single blind crossover study consisting of four total weeks of assessments (one week each pre and post for both training phases), four weeks of UE training with sham TSS, a two-week washout period, and four weeks of UE training with active TSS. Each one-hour session (three days/week) included robotic exoskeleton-assisted UE movements and hand grip training, performed concurrently with sham or active TSS. Assessments included electrophysiological measurements and standardized rehabilitation outcomes.

Results

Descriptive analysis revealed meaningful individual improvements masked by group-level heterogeneity. In the stroke group, three participants showed grip strength improvement (assessed without stimulation) after the active phase (+ 9.4 Newtons [N] to + 23.9 N), with two-to-four-fold increases in forearm muscle activation. Mean Fugl-Meyer overall UE scores improved from 89 to 94.2. In the SCI group, two participants showed grip strength gains. One participant exhibited a six-fold immediate force increase (1.0 N to 6.2 N) during stimulation. Another participant achieved improved grip strength without stimulation (23.9 N to 36.8 N) and a three-fold increase in electromyography (EMG) activity from the flexor carpi radialis and first dorsal interosseous muscles, alongside partial pin-prick sensory recovery and self-reported restoration of previously affected perspiration during the active TSS phase.

Conclusions

Varied outcomes in participants confirm that therapeutic effects of combined TSS and robotic UE training are highly individualized. Three critical elements must be blended for the best outcomes of this combinatorial approach: residual UE function, a curated stimulation paradigm, and tailored UE training that provides appropriate challenge, intensity, and salience. The results suggest TSS with UE robotic training hold key potential when considered in the context of the physiological and functional profile of each participant.

Highlights

• Cervical TSS was applied during robotic upper extremity training in individuals with neurological impairment.

• A within-subject sham-controlled crossover design compared active and sham stimulation conditions.

• Neurophysiological responses and sensorimotor performance varied across individuals during stimulation.

• Improvements were most frequently observed during near motor-threshold stimulation combined with active task engagement.

Barriers, facilitators and promising interventions for reducing sedentary behaviour during and after stroke rehabilitation – A scoping review

Reducing sedentary time IS EXCEEDINGLY SIMPLE! And you're too fucking stupid to see it!

With 100% recovery protocols your survivor will be spending all her time doing exercises and looking forward to recovery. No time for resting!  

 Barriers, facilitators and promising interventionsfor reducing sedentary behaviour during andafter stroke rehabilitation – A scoping review

Lisenka te Lindert, Winke van Meijeren-Pont, Jorit Meesters, Jan Schoones, Florian Allonsius, Åsa Mennema, Rienk Dekker & Aleid de Rooij To cite this article: Lisenka te Lindert, Winke van Meijeren-Pont, Jorit Meesters, Jan Schoones, Florian Allonsius, Åsa Mennema, Rienk Dekker & Aleid de Rooij (22 Jun 2026): Barriers, facilitators and promising interventions for reducing sedentary behaviour during and after stroke rehabilitation – A scoping review, Disability and Rehabilitation, DOI: 10.1080/09638288.2026.2686317 To link to this article: https://doi.org/10.1080/09638288.2026.2686317

ABSTRACT Purpose: Reducing sedentary behaviour (SB) in stroke rehabilitation is essential, yet effects of most interventions remain limited. this review used the Behaviour change wheel to identify: (1) barriers and facilitators for reducing SB of stroke survivors and (2) Behaviour change techniques (Bcts) incorporated in “promising” interventions. Materials and methods: Seven databases were searched from inception to January 2025. Data were systematically extracted and coded using the capacity Opportunity Motivation – Behaviour model (cOM-B) and the theoretical Domains Framework (tDF). Results: thirty-nine studies on barriers and facilitators were included, identifying 32 different barriers and 30 facilitators in inpatient settings and 109 barriers and 73 facilitators in outpatient/community settings, spanning all cOM-B domains. Four of seven interventions were rated as “promising” (predefined criterion: statistically significant changes within or between group(s)). these interventions applied 11–34 Bcts, including goal setting, action planning, reviewing goals, feedback, social support, instruction, and demonstration. Conclusions: Given the variety of barriers and facilitators experienced, personalised approaches are essential. Promising interventions share components that can inform SB-focused intervention design, but further research is needed to determine how these components can be combined and tailored to support sustained SB reduction. hIMPLICATION FOR REHABILITATION • An analysis of each stroke survivor’s individual behaviour and context should guide the application of promising Behaviour change techniques (Bcts), to ensure interventions address the barriers and strengthen the facilitators, identified for that individual. • the broad heterogeneity of barriers and facilitators across cOM-B domains highlights the importance of a person-centred approach, as individual physical, cognitive, emotional, and contextual profiles strongly influence the potential to reduce sedentary behaviour. • clinicians may use the recurring Behaviour change techniques observed in promising interventions—such as goal setting, action planning, reviewing behaviour goals, feedback, instruction, demonstration, and social support—to structure behaviour-change interventions.

Flavanols Might Be the Missing Piece in Your Heart-Healthy Diet by Super Age

 Do you really think your competent? doctor will instruct the dietician to get this correctly in your diet protocol? Sorry, you DON'T HAVE A DIET PROTOCOL, DO YOU?

Flavanols Might Be the Missing Piece in Your Heart-Healthy Diet

Two At-Home Strength Tests That Predict Longevity by Super Age

Grip strength: (My right hand has gotten even stronger, left hand, complete failure of my doctor and therapists to get any recovery there.)

2.Sit-to-stand test

In the past 20 years my score would always be 1.5 and it will never get better during my next 30+ years. It has absolutely nothing to do with my longevity or cardiovascular risk!

Neither of these has anything to do with my longevity!

Two At-Home Strength Tests That Predict Longevity

Scientists Discover Surprising Way To Help the Brain Recover After Stroke

 Will your competent? doctor get this written up in a protocol? NO? So completely fucking incompetent then! And your board of directors is so incompetent they don't recognize incompetence in their staff! Will your doctor at least get human testing going?

Scientists Discover Surprising Way To Help the Brain Recover After Stroke

A new study suggests that strengthening the body’s natural circadian rhythms may help the brain recover after stroke, even when treatment begins days after the injury.

Every year, millions of people survive a stroke, but recovery often continues long after the immediate medical emergency has passed. Scientists are increasingly discovering that factors beyond the initial brain injury—including sleep, the body’s internal clock, and the brain’s own cleaning system—may play important roles in determining how well the brain heals.

Now, researchers at the University of Rochester Medicine report that strengthening the body’s natural daily rhythms may help boost recovery after stroke. The study suggests that reinforcing circadian rhythms, the 24-hour biological cycles that regulate sleep and many other bodily functions, could enhance the brain’s ability to clear waste and reduce lingering inflammation.

Published in the Journal of Clinical Investigation, the research found that treatments designed to reinforce circadian rhythms improved recovery in mouse models of stroke. The benefits were associated with enhanced function of the glymphatic system, a recently discovered network that helps flush waste products from the brain, as well as lower levels of inflammatory molecules that can persist long after the initial injury.

The research builds on more than a decade of work led by URochester Medicine neuroscientist Maiken Nedergaard, MD, DMSc, whose team discovered the glymphatic system in 2012. This network circulates cerebrospinal fluid throughout the brain, helping remove waste and debris. Later studies showed that glymphatic activity is strongest during sleep and is important for maintaining brain health.

Expanding on those findings, neuroscientist Lauren Hablitz, PhD, helped show that glymphatic function is regulated not only by sleep but also by circadian rhythms, the body’s internal 24-hour clock. In a landmark 2020 study, Hablitz, Nedergaard, and colleagues demonstrated that glymphatic activity follows daily patterns even when sleep is not a factor, establishing a direct link between circadian biology and the brain’s waste-clearing system.

Stroke as a Disorder of Timing

“The discussion of stroke recovery really starts with the idea that stroke is not just a vascular event, but also a disorder of timing,” said Hablitz, lead author of the new study.

Scientists have long observed that strokes follow predictable daily patterns. They occur more frequently in the morning and are often most severe near the end of the sleep cycle. Many stroke survivors also experience disruptions to their sleep-wake schedules, which have been associated with poorer recovery, depression, and reduced quality of life.

“That led us to ask a simple question,” said Hablitz. “If timing is broken after a stroke, can we improve recovery by reinforcing the biological clock?”

Glymphatic Dysfunction and Brain Inflammation

In a healthy brain, the glymphatic system moves cerebrospinal fluid along blood vessels and through brain tissue, delivering nutrients while removing waste products and inflammatory signals. Previous research has shown that this system becomes less effective after a stroke, potentially reducing the brain’s ability to clear harmful molecules during recovery.

Traditionally, stroke research has focused on identifying harmful forms of inflammation and finding ways to suppress them. Hablitz and her colleagues suggest that impaired waste clearance may also play an important role.

“We think part of the problem may be a failure of cleaning,” she said. “If the system responsible for clearing signaling molecules isn’t working properly, everything builds up.”

According to this model, a stroke damages not only brain tissue but also the pathways responsible for removing inflammatory signals. As those molecules accumulate, they may contribute to ongoing damage and slower recovery.

Testing Circadian-Based Stroke Treatments

To determine whether restoring circadian rhythms could improve recovery, the researchers tested several approaches known to affect the body’s internal clock, including controlled light exposure, melatonin, a clock-targeting drug called KL001, and time-restricted feeding.

The team first showed that each method enhanced glymphatic function in healthy animals. They then evaluated the two most promising interventions, KL001 and time-restricted feeding, in mouse models of stroke.

Treatment began three days after the stroke, well beyond the limited window when clot-busting drugs and other emergency treatments are effective. Even with that delay, mice receiving either intervention experienced better motor recovery, smaller brain lesions, improved glymphatic flow, and lower levels of inflammatory cytokines.

“All of the cytokines moved in the same direction,” Hablitz said. “That suggests we may not be targeting one specific inflammatory pathway. Instead, we may be helping the brain clear inflammatory signals more effectively.”

Time-Restricted Feeding Shows Promise

Because time-restricted feeding produced some of the strongest results, the findings may have practical relevance for stroke rehabilitation. The approach is already being studied for conditions including obesity, diabetes, and cardiovascular disease.

“One of the exciting aspects of this work is that we’re studying interventions that could potentially be implemented not only in hospitals but also at home,” Hablitz said.

Future Directions for Circadian Stroke Therapy

The researchers emphasize that the results are currently limited to animal studies. More research is needed to better understand how circadian rhythms, glymphatic function, and inflammation interact following a stroke.

Future work will examine whether improved glymphatic flow directly contributes to recovery and whether circadian-based therapies can be advanced into clinical trials.

More broadly, the findings reflect a growing view in neuroscience that sleep, circadian rhythms, and fluid movement through the brain are central to overall brain health. By better understanding how the body’s internal clock regulates the glymphatic system, researchers hope to develop new treatments not only for stroke recovery but also for other neurological conditions involving inflammation and impaired waste removal.

“Understanding how circadian regulation shapes glymphatic clearance will help us develop more targeted therapies,” said Hablitz. “Ultimately, our goal is to find ways to improve the brain’s ability to clear waste, reduce inflammation, and recover after injury.”

Reference: “Chronotherapy to reinforce circadian rhythms improves poststroke outcomes and glymphatic function in mice” by Emma Waight, Yuxi Zhu, Ashley Caudell, Velia S. Vizcarra, Evan Newbold, Michael J. Giannetto, Evalien Duyvestyn, Estephanie Balbuena, Wei Song, Tanzil M. Arefin, Yuki Mori, Maiken Nedergaard and Lauren M. Hablitz, 15 June 2026, The Journal of Clinical Investigation.
DOI: 10.1172/JCI201800