Authors :
Presenting Author: Edeline Jean Baptiste, BS – Boston Children's Assistant
Solveig Vieluf, phd – Research Fellow, Neurology, Boston Children's Hospital; Sarah Cantley, BA – Clinical Research Assistant II, Neurology, Boston Children's Hospital; Michele Jackson, BA – Research Manager, Neurology, Boston Children's Hospital; Bo Zhang, PhD – Associate Professor of Neurology, Neurology and ICCTR Biostatistics and Research Design Center, Boston Children's Hospital; Tobias Loddenkemper, MD – Attending Physician, Neurology, Boston Children's Hospital
Rationale:
Twenty-four-hour patterns of heart rate (HR) might be altered by seizure occurrence. In our previous study, HR amplitude and mean 24-hour patterns did not differ between patients with and without seizures. 1 However, cardiac activity changes throughout development and differs between females and males. We evaluated the relationship between age, sex, and 24-hour HR modulation levels and amplitudes in patients with and without seizures.
Methods:
We enrolled children (three to twelve years) and adolescents (12-21 years) with either no seizure or with one or more seizures (focal impaired awareness or tonic-clonic seizure) during continuous video-EEG monitoring at a tertiary care center. Participants wore a biosensor (E4, Empatica, Milan, Italy), which recorded HR on left and/or right wrists and/or ankles. We modeled the 24-hour pattern of HR recordings with nonlinear mixed-effects harmonic models and calculated HR mean and amplitude of the modulation curve from the resulting curve per patient (Figure 1 A, B). By multivariate analysis of variance, we evaluated the relationship between age group (children, adolescents), sex (female, male), and seizure occurrence (yes, no) for HR mean and amplitude of the modulated 24-hour curves (Figure 1 C, D).
Results:
We analyzed 100 patients including 54 children (mean age: 8.13 years, IQR: 3.86, range: 8.62 years, 24 female, 30 male; 20 with seizure, 34 without seizure) and 46 adolescents (mean age: 15.87 years, IQR: 4.07, range: 8.95 years, 24 female, 22 male; 24 with seizure, 22 without seizure). While the main effect of seizure occurrence was not significantly different for HR mean and amplitude, the main effect of age group was significant for HR mean (F(1, 92) = 5.68, p = 0.02,
η² = 0.06). Furthermore, for HR mean the interaction effect of seizure occurrence by age group (F(1, 92) = 9.37, p < 0.01,