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Cardiac autonomic control in patients with refractory epilepsy before and during vagus nerve stimulation treatment: a one-year follow-up study.
Epilepsia. 2006 Mar; 47(3):556-62.E

Abstract

PURPOSE

To elucidate possible effect of vagus nerve stimulation (VNS) therapy on interictal heart rate (HR) variability in patients with refractory epilepsy before and after 1-year VNS treatment.

METHODS

A 24-hour electrocardiogram (ECG) was recorded at the baseline and after 12 months of VNS treatment in 14 patients with refractory epilepsy, and once in 28 healthy age- and sex-matched control subjects. Time and frequency domain measures, along with fractal and complexity measures of HR variability, were analyzed from the ECG recordings.

RESULTS

The mean value of the RR interval (p=0.008), standard deviation of N-N intervals (SDNN) (p<0.001), very-low frequency (VLF) (p<0.001), low-frequency (LF) (p=0.001), and high-frequency (HF) (p=0.002) spectral components of HR variability, and the Poincaré components SD(1) (p=0.005) and SD(2) (p<0.001) of the patients with refractory epilepsy were significantly lower than those of the control subjects before VNS implantation. The nocturnal increase in HR variability usually seen in the normal population was absent in patients with refractory epilepsy. VNS had no significant effects on any of the HR-variability indexes despite a significant reduction in the frequency of seizures.

CONCLUSIONS

HR variability was reduced, and the nocturnal increase in HR variability was not present in patients with refractory epilepsy. One-year treatment with VNS did not have a marked effect on HR variability, suggesting that impaired cardiovascular autonomic regulation is associated with the epileptic process itself rather than with recurrent seizures.

Authors+Show Affiliations

Department of Neurology, University of Oulu, Oulu, Finland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16529621

Citation

Ronkainen, Eija, et al. "Cardiac Autonomic Control in Patients With Refractory Epilepsy Before and During Vagus Nerve Stimulation Treatment: a One-year Follow-up Study." Epilepsia, vol. 47, no. 3, 2006, pp. 556-62.
Ronkainen E, Korpelainen JT, Heikkinen E, et al. Cardiac autonomic control in patients with refractory epilepsy before and during vagus nerve stimulation treatment: a one-year follow-up study. Epilepsia. 2006;47(3):556-62.
Ronkainen, E., Korpelainen, J. T., Heikkinen, E., Myllylä, V. V., Huikuri, H. V., & Isojärvi, J. I. (2006). Cardiac autonomic control in patients with refractory epilepsy before and during vagus nerve stimulation treatment: a one-year follow-up study. Epilepsia, 47(3), 556-62.
Ronkainen E, et al. Cardiac Autonomic Control in Patients With Refractory Epilepsy Before and During Vagus Nerve Stimulation Treatment: a One-year Follow-up Study. Epilepsia. 2006;47(3):556-62. PubMed PMID: 16529621.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiac autonomic control in patients with refractory epilepsy before and during vagus nerve stimulation treatment: a one-year follow-up study. AU - Ronkainen,Eija, AU - Korpelainen,Juha T, AU - Heikkinen,Esa, AU - Myllylä,Vilho V, AU - Huikuri,Heikki V, AU - Isojärvi,Jouko I T, PY - 2006/3/15/pubmed PY - 2006/5/11/medline PY - 2006/3/15/entrez SP - 556 EP - 62 JF - Epilepsia JO - Epilepsia VL - 47 IS - 3 N2 - PURPOSE: To elucidate possible effect of vagus nerve stimulation (VNS) therapy on interictal heart rate (HR) variability in patients with refractory epilepsy before and after 1-year VNS treatment. METHODS: A 24-hour electrocardiogram (ECG) was recorded at the baseline and after 12 months of VNS treatment in 14 patients with refractory epilepsy, and once in 28 healthy age- and sex-matched control subjects. Time and frequency domain measures, along with fractal and complexity measures of HR variability, were analyzed from the ECG recordings. RESULTS: The mean value of the RR interval (p=0.008), standard deviation of N-N intervals (SDNN) (p<0.001), very-low frequency (VLF) (p<0.001), low-frequency (LF) (p=0.001), and high-frequency (HF) (p=0.002) spectral components of HR variability, and the Poincaré components SD(1) (p=0.005) and SD(2) (p<0.001) of the patients with refractory epilepsy were significantly lower than those of the control subjects before VNS implantation. The nocturnal increase in HR variability usually seen in the normal population was absent in patients with refractory epilepsy. VNS had no significant effects on any of the HR-variability indexes despite a significant reduction in the frequency of seizures. CONCLUSIONS: HR variability was reduced, and the nocturnal increase in HR variability was not present in patients with refractory epilepsy. One-year treatment with VNS did not have a marked effect on HR variability, suggesting that impaired cardiovascular autonomic regulation is associated with the epileptic process itself rather than with recurrent seizures. SN - 0013-9580 UR - https://www.unboundmedicine.com/medline/citation/16529621/Cardiac_autonomic_control_in_patients_with_refractory_epilepsy_before_and_during_vagus_nerve_stimulation_treatment:_a_one_year_follow_up_study_ L2 - https://doi.org/10.1111/j.1528-1167.2006.00467.x DB - PRIME DP - Unbound Medicine ER -