Heart rate variability in untreated newly diagnosed temporal lobe epilepsy: Evidence for ictal sympathetic dysregulation

Andrea Romigi, Maria Albanese, Fabio Placidi, Francesca Izzi, Nicola Biagio Mercuri, Angela Marchi, Claudio Liguori, Nicoletta Campagna, Andrea Duggento, Antonio Canichella, Giada Ricciardo Rizzo, M. Guerrisi, Maria Grazia Marciani, Nicola Toschi

Research output: Contribution to journalArticle

Abstract

Summary Objective To compare heart rate variability (HRV) parameters in newly diagnosed and untreated temporal lobe epilepsy (TLE) between the interictal, preictal, ictal, and postictal states. Methods HRV parameters were extracted from single-lead electrocardiography data collected during video-electroencephalography (EEG) recordings from 14 patients with newly diagnosed TLE in a resting, awake, and supine state. HRV parameters in the time and frequency domains included low frequency (LF), high frequency (HF), standard deviation of all consecutive R wave intervals (SDNN), and square root of the mean of the sum of the squares of differences between adjacent R wave intervals (RMSSD). Cardiovagal index (CVI), cardiosympathetic index (CSI), and approximate entropy (ApEn) were also studied. Results Frequency domain analysis showed significantly higher preictal, ictal, and postictal LF/HF ratio compared to the interictal state. Similarly, the LF component increased progressively and was significantly higher during the ictal state compared to interictal and preictal states. RR interval values were lower in the ictal state compared to basal and preictal states and in the postictal state compared to the preictal state. Interictal RMSSD was significantly higher compared to all other states, and ictal SDNN was significantly higher compared to all other states. Ictal CSI was significantly higher compared to preictal and interictal states, whereas preictal CVI was lower than in basal and ictal states. In addition, ictal ApEn was significantly lower than interictal and preictal ApEn. Interictal CVI was lower in left TLE compared to right TLE. In addition, in left TLE, ictal CVI was higher than interictal CVI, whereas in right TLE, CVI was lower in the preictal state compared to all other states. Significance Our data suggest an ictal sympathetic overdrive with partial recovery in the postictal state. Higher sympathetic tone and vagal tone imbalance may induce early autonomic dysfunction and increase cardiovascular risk in patients affected by TLE.

Original languageEnglish
Pages (from-to)418-426
Number of pages9
JournalEpilepsia
Volume57
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

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Temporal Lobe Epilepsy
Heart Rate
Stroke
Entropy
Video Recording
Electroencephalography
Electrocardiography

Keywords

  • Autonomic nervous system
  • Heart rate variability
  • Temporal lobe epilepsy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Heart rate variability in untreated newly diagnosed temporal lobe epilepsy : Evidence for ictal sympathetic dysregulation. / Romigi, Andrea; Albanese, Maria; Placidi, Fabio; Izzi, Francesca; Mercuri, Nicola Biagio; Marchi, Angela; Liguori, Claudio; Campagna, Nicoletta; Duggento, Andrea; Canichella, Antonio; Ricciardo Rizzo, Giada; Guerrisi, M.; Marciani, Maria Grazia; Toschi, Nicola.

In: Epilepsia, Vol. 57, No. 3, 01.03.2016, p. 418-426.

Research output: Contribution to journalArticle

Romigi, A, Albanese, M, Placidi, F, Izzi, F, Mercuri, NB, Marchi, A, Liguori, C, Campagna, N, Duggento, A, Canichella, A, Ricciardo Rizzo, G, Guerrisi, M, Marciani, MG & Toschi, N 2016, 'Heart rate variability in untreated newly diagnosed temporal lobe epilepsy: Evidence for ictal sympathetic dysregulation', Epilepsia, vol. 57, no. 3, pp. 418-426. https://doi.org/10.1111/epi.13309
Romigi, Andrea ; Albanese, Maria ; Placidi, Fabio ; Izzi, Francesca ; Mercuri, Nicola Biagio ; Marchi, Angela ; Liguori, Claudio ; Campagna, Nicoletta ; Duggento, Andrea ; Canichella, Antonio ; Ricciardo Rizzo, Giada ; Guerrisi, M. ; Marciani, Maria Grazia ; Toschi, Nicola. / Heart rate variability in untreated newly diagnosed temporal lobe epilepsy : Evidence for ictal sympathetic dysregulation. In: Epilepsia. 2016 ; Vol. 57, No. 3. pp. 418-426.
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abstract = "Summary Objective To compare heart rate variability (HRV) parameters in newly diagnosed and untreated temporal lobe epilepsy (TLE) between the interictal, preictal, ictal, and postictal states. Methods HRV parameters were extracted from single-lead electrocardiography data collected during video-electroencephalography (EEG) recordings from 14 patients with newly diagnosed TLE in a resting, awake, and supine state. HRV parameters in the time and frequency domains included low frequency (LF), high frequency (HF), standard deviation of all consecutive R wave intervals (SDNN), and square root of the mean of the sum of the squares of differences between adjacent R wave intervals (RMSSD). Cardiovagal index (CVI), cardiosympathetic index (CSI), and approximate entropy (ApEn) were also studied. Results Frequency domain analysis showed significantly higher preictal, ictal, and postictal LF/HF ratio compared to the interictal state. Similarly, the LF component increased progressively and was significantly higher during the ictal state compared to interictal and preictal states. RR interval values were lower in the ictal state compared to basal and preictal states and in the postictal state compared to the preictal state. Interictal RMSSD was significantly higher compared to all other states, and ictal SDNN was significantly higher compared to all other states. Ictal CSI was significantly higher compared to preictal and interictal states, whereas preictal CVI was lower than in basal and ictal states. In addition, ictal ApEn was significantly lower than interictal and preictal ApEn. Interictal CVI was lower in left TLE compared to right TLE. In addition, in left TLE, ictal CVI was higher than interictal CVI, whereas in right TLE, CVI was lower in the preictal state compared to all other states. Significance Our data suggest an ictal sympathetic overdrive with partial recovery in the postictal state. Higher sympathetic tone and vagal tone imbalance may induce early autonomic dysfunction and increase cardiovascular risk in patients affected by TLE.",
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AU - Romigi, Andrea

AU - Albanese, Maria

AU - Placidi, Fabio

AU - Izzi, Francesca

AU - Mercuri, Nicola Biagio

AU - Marchi, Angela

AU - Liguori, Claudio

AU - Campagna, Nicoletta

AU - Duggento, Andrea

AU - Canichella, Antonio

AU - Ricciardo Rizzo, Giada

AU - Guerrisi, M.

AU - Marciani, Maria Grazia

AU - Toschi, Nicola

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N2 - Summary Objective To compare heart rate variability (HRV) parameters in newly diagnosed and untreated temporal lobe epilepsy (TLE) between the interictal, preictal, ictal, and postictal states. Methods HRV parameters were extracted from single-lead electrocardiography data collected during video-electroencephalography (EEG) recordings from 14 patients with newly diagnosed TLE in a resting, awake, and supine state. HRV parameters in the time and frequency domains included low frequency (LF), high frequency (HF), standard deviation of all consecutive R wave intervals (SDNN), and square root of the mean of the sum of the squares of differences between adjacent R wave intervals (RMSSD). Cardiovagal index (CVI), cardiosympathetic index (CSI), and approximate entropy (ApEn) were also studied. Results Frequency domain analysis showed significantly higher preictal, ictal, and postictal LF/HF ratio compared to the interictal state. Similarly, the LF component increased progressively and was significantly higher during the ictal state compared to interictal and preictal states. RR interval values were lower in the ictal state compared to basal and preictal states and in the postictal state compared to the preictal state. Interictal RMSSD was significantly higher compared to all other states, and ictal SDNN was significantly higher compared to all other states. Ictal CSI was significantly higher compared to preictal and interictal states, whereas preictal CVI was lower than in basal and ictal states. In addition, ictal ApEn was significantly lower than interictal and preictal ApEn. Interictal CVI was lower in left TLE compared to right TLE. In addition, in left TLE, ictal CVI was higher than interictal CVI, whereas in right TLE, CVI was lower in the preictal state compared to all other states. Significance Our data suggest an ictal sympathetic overdrive with partial recovery in the postictal state. Higher sympathetic tone and vagal tone imbalance may induce early autonomic dysfunction and increase cardiovascular risk in patients affected by TLE.

AB - Summary Objective To compare heart rate variability (HRV) parameters in newly diagnosed and untreated temporal lobe epilepsy (TLE) between the interictal, preictal, ictal, and postictal states. Methods HRV parameters were extracted from single-lead electrocardiography data collected during video-electroencephalography (EEG) recordings from 14 patients with newly diagnosed TLE in a resting, awake, and supine state. HRV parameters in the time and frequency domains included low frequency (LF), high frequency (HF), standard deviation of all consecutive R wave intervals (SDNN), and square root of the mean of the sum of the squares of differences between adjacent R wave intervals (RMSSD). Cardiovagal index (CVI), cardiosympathetic index (CSI), and approximate entropy (ApEn) were also studied. Results Frequency domain analysis showed significantly higher preictal, ictal, and postictal LF/HF ratio compared to the interictal state. Similarly, the LF component increased progressively and was significantly higher during the ictal state compared to interictal and preictal states. RR interval values were lower in the ictal state compared to basal and preictal states and in the postictal state compared to the preictal state. Interictal RMSSD was significantly higher compared to all other states, and ictal SDNN was significantly higher compared to all other states. Ictal CSI was significantly higher compared to preictal and interictal states, whereas preictal CVI was lower than in basal and ictal states. In addition, ictal ApEn was significantly lower than interictal and preictal ApEn. Interictal CVI was lower in left TLE compared to right TLE. In addition, in left TLE, ictal CVI was higher than interictal CVI, whereas in right TLE, CVI was lower in the preictal state compared to all other states. Significance Our data suggest an ictal sympathetic overdrive with partial recovery in the postictal state. Higher sympathetic tone and vagal tone imbalance may induce early autonomic dysfunction and increase cardiovascular risk in patients affected by TLE.

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