Heart rate variability modifications in adult patients with early versus late-onset temporal lobe epilepsy: A comparative observational study

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology Pub Date : 2023-04-01 DOI:10.1016/j.neucli.2023.102852

Fedele Dono , Giacomo Evangelista , Stefano Consoli , Romina Venditti , Mirella Russo , Maria Vittoria De Angelis , Massimiliano Faustino , Angelo Di Iorio , Catello Vollono , Francesca Anzellotti , Marco Onofrj , Stefano L. Sensi

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引用次数: 2

Abstract

Objectives

Temporal lobe epilepsy (TLE) is the most frequent form of focal epilepsy. TLE is associated with cardio-autonomic dysfunction and increased cardiovascular (CV) risk in patients over the fifth decade of age. In these subjects, TLE can be classified as early-onset (EOTLE; i.e., patients who had developed epilepsy in their youth) and late-onset (LOTLE; i.e., patients who developed epilepsy in adulthood). Heart rate variability (HRV) analysis is useful for assessing cardio-autonomic function and identifying patients with increased CV risk. This study compared changes in HRV occurring in patients over the age of 50, with EOTLE or LOTLE.

Methods

We enrolled twenty-seven adults with LOTLE and 23 with EOTLE. Each patient underwent a EEG and EKG recording during 20-minutes of resting state and a 5-minutes hyperventilation (HV). Short-term HRV analysis was performed both in time and frequency domains. Linear Mixed Models (LMM) were used to analyze HRV parameters according to the condition (baseline and HV) and group (LOTLE and EOTLE groups).

Results

Compared to the LOTLE group, the EOTLE group showed significantly decreased LnRMSSD (natural logarithm of the root mean square of the difference between contiguous RR intervals) (p-value=0.05), LnHF ms² (natural logarithm of high frequency absolute power) (p-value=0.05), HF n.u. (high frequency power expressed in normalized units) (p-value=0.008) and HF% (high frequency power expressed in percentage) (p-value=0.01). In addition, EOTLE patients exhibited increased LF n.u. (low frequency power expressed in normalized units) (p-value=0.008) and LF/HF (low frequency/high frequency) ratio (p-value=0.007). During HV, the LOTLE group exhibited a multiplicative effect for the interaction between group and condition with increased LF n.u. (p = 0.003) and LF% (low frequency expressed in percentage) (p = 0.05) values.

Conclusions

EOTLE is associated with reduced vagal tone compared to LOTLE. Patients with EOTLE may have a higher risk of developing cardiac dysfunction or cardiac arrhythmia than LOTLE patients.

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成年早发与晚发颞叶癫痫患者心率变异性的改变：一项比较观察性研究

目的颞叶癫痫（TLE）是最常见的局灶性癫痫。TLE与第五个十岁以上患者的心自主功能障碍和心血管（CV）风险增加有关。在这些受试者中，TLE可分为早发性（EOTLE；即年轻时患癫痫的患者）和晚发性（LOTLE；即成年后患癫痫的病人）。心率变异性（HRV）分析有助于评估心脏自主功能和识别心血管风险增加的患者。本研究比较了50岁以上患有EOTLE或LOTLE的患者的HRV变化。方法我们招募了27名患有LOTLE的成年人和23名患有EOTLE。每位患者在20分钟的休息状态和5分钟的过度换气（HV）期间都接受了脑电图和心电图记录。在时域和频域中进行短期HRV分析。使用线性混合模型（LMM）根据条件（基线和HV）和组（LOTLE和EOTLE组）分析HRV参数，LnHF ms2（高频绝对功率的自然对数）（p值=0.05）、HF n.u.（以归一化单位表示的高频功率）（p价值=0.008）和HF%（以百分比表示的高频电力）（p数值=0.01），EOTLE患者表现出LF n.u.（以标准化单位表示的低频功率）（p值=0.008）和LF/HF（低频/高频）比（p值=0.007）增加。在HV期间，LOTLE组表现出对组和条件之间的相互作用的倍增效应，LF n.u.（p=0.003）和LF%（以百分比表示的低频）（p=0.05）值增加。结论与LOTLE相比，OTLE与迷走神经张力降低有关。EOTLE患者可能比LOTLE患者有更高的心功能障碍或心律失常风险。

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

Neurophysiologie Clinique/Clinical Neurophysiology 医学-临床神经学

CiteScore

5.20

自引率

3.30%

发文量

审稿时长

60 days

期刊介绍： Neurophysiologie Clinique / Clinical Neurophysiology (NCCN) is the official organ of the French Society of Clinical Neurophysiology (SNCLF). This journal is published 6 times a year, and is aimed at an international readership, with articles written in English. These can take the form of original research papers, comprehensive review articles, viewpoints, short communications, technical notes, editorials or letters to the Editor. The theme is the neurophysiological investigation of central or peripheral nervous system or muscle in healthy humans or patients. The journal focuses on key areas of clinical neurophysiology: electro- or magneto-encephalography, evoked potentials of all modalities, electroneuromyography, sleep, pain, posture, balance, motor control, autonomic nervous system, cognition, invasive and non-invasive neuromodulation, signal processing, bio-engineering, functional imaging.