Evaluation of autonomic tone and cerebral hemodynamics in children with Dravet syndrome

IF 2.7 3区医学 Q2 CLINICAL NEUROLOGY

Seizure-European Journal of Epilepsy Pub Date : 2025-07-02 DOI:10.1016/j.seizure.2025.07.002

Pooja Dhir , Kiran Prakash , Sandeep Negi , Abhay Partap Maurya , Parteek Bhatia , Priyanka Madaan , Anupriya Kaur , Naveen Sankhyan , Parampreet Singh Kharbanda , Jitendra Kumar Sahu

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引用次数: 0

Abstract

Background

The mortality in Dravet syndrome (DS) due to sudden unexpected death in epilepsy patients (SUDEP) or status epilepticus (SE) is a major concern, and autonomic tone dysfunction is implicated as a potential contributing factor. This study evaluated autonomic dysfunction by measuring heart rate variability (HRV) and cerebral hemodynamic by assessing cerebral blood flow velocity (CBFV) using Transcranial Doppler in children with DS.

Methods

This prospective study enrolled children with DS and age-and sex-matched healthy control group (HCs). We measured HRV on short-term electrocardiograms (ECGs) recorded at PowerLab 15T instrument. HRV parameters were analysed in time domain, frequency domain, and by non-linear methods and compared with HCs. Furthermore, we assessed CBFV in DS (n = 33) and compared with normative data.

Results

HRV was significantly reduced in children with DS (n = 51) compared with HCs (n = 55) across multiple parameters, including SDRR (p < 0.0001), SDSD (p < 0.0001), RMSSD (p < 0.0001), pRR50 (p = 0.0023), total power (p < 0.0001), LF power (p < 0.0001), LF ( %) (p = 0.0485), HF power (p = 0.0002), SD1 (p < 0.0001), and SD2 (p < 0.0001). A significant negative correlation was observed in HRV [LF (nu)] and epilepsy severity score (p = 0.048). CBFV parameters were significantly reduced compared with normative data and significantly negatively correlated with epilepsy severity scores, peak systolic velocity (PSV) (p = 0.001), mean velocity (p = 0.006), and peak diastolic velocity (p = 0.021).

Conclusions

Our study provides proof-of-concept of depressed autonomic tone and altered cerebral hemodynamic in DS.

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Dravet综合征患儿自主神经张力和脑血流动力学的评价

背景：由于癫痫患者（SUDEP）或癫痫持续状态（SE）突然意外死亡而导致的Dravet综合征（DS）死亡率是一个主要关注的问题，自主神经张力功能障碍被认为是一个潜在的促进因素。本研究通过测量心率变异性（HRV）和经颅多普勒测量脑血流速度（CBFV）来评估DS患儿的自主神经功能障碍。方法本前瞻性研究纳入DS患儿和年龄、性别匹配的健康对照组（hc）。我们用PowerLab 15T仪器记录的短期心电图（ECGs）测量HRV。采用非线性方法对HRV参数进行时域、频域分析，并与HCs进行比较。此外，我们评估了33例DS患者的CBFV，并与规范数据进行了比较。结果包括SDRR （p < p）在内的多个参数，DS患儿（n = 51）的shrv明显低于hc患儿（n = 55）。0.0001), SDSD (p <；0.0001), RMSSD (p <；0.0001), pRR50 (p = 0.0023)，总功率(p <；0.0001)，低功率(p <；0.0001), LF (%) (p = 0.0485)， HF功率（p = 0.0002）， SD1 (p <；0.0001), SD2 (p <；0.0001)。HRV [LF (nu)]与癫痫严重程度评分呈显著负相关（p = 0.048）。与规范数据相比，CBFV参数显著降低，并与癫痫严重程度评分、峰值收缩速度（PSV）（p = 0.001）、平均速度（p = 0.006）和峰值舒张速度（p = 0.021）呈显著负相关。结论我们的研究为退行性椎体滑移患者自主神经张力下降和脑血流动力学改变提供了概念证明。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seizure-European Journal of Epilepsy 医学-临床神经学

CiteScore

5.60

自引率

6.70%

发文量

231

审稿时长

34 days

期刊介绍： Seizure - European Journal of Epilepsy is an international journal owned by Epilepsy Action (the largest member led epilepsy organisation in the UK). It provides a forum for papers on all topics related to epilepsy and seizure disorders.