Heart Rate Variability Analysis Shows an Enhanced Cardiovagal Tone in Patients with Late-Onset Temporal Lobe Epilepsy (LOTLE)
Abstract number :
1.231
Submission category :
4. Clinical Epilepsy / 4D. Prognosis
Year :
2021
Submission ID :
1826606
Source :
www.aesnet.org
Presentation date :
12/4/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:55 AM
Authors :
Giacomo Evangelista, MD - "G. D'Annunzio" University of Chieti-Pescara; Fedele Dono - Department of Neuroscience, Imaging and Clinical Science - "G. D'Annunzio" University of Chieti-Pescara; Stefano Consoli - Department of Neuroscience, Imaging and Clinical Science - "G. D'Annunzio" University of Chieti-Pescara; Romina Venditti - Department of Neuroscience, Imaging and Clinical Science - "G. D'Annunzio" University of Chieti-Pescara; Maria Vittoria De Angelis - Department of Neurology - "SS Annunziata" Hospital, Chieti; Massimiliano Faustino - Department of Cardiology - "SS Annunziata" Hospital, Chieti; Laura Bonanni - Department of Neuroscience, Imaging and Clinical Science - "G. D'Annunzio" University of Chieti-Pescara; Francesca Anzellotti - Department of Neurology - "SS Annunziata" Hospital, Chieti; Marco Onofrj - Department of Neuroscience, Imaging and Clinical Science - Department of Neurology; Stefano Sensi - Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST-, - University G. d'Annunzio of Chieti-Pescara, Italy; Catello Vollono - Department of Geriatrics, Neurosciences & Orthopedics Unit of Neurophysiopathology and Sleep Medicine - IRCCS Policlinico Universitario Agostino Gemelli Catholic University, Rome
Rationale: Temporal lobe epilepsy (TLE) is one of the most frequent forms of focal epilepsy. According to the age of onset, two main TLE subgroups can be distinguished: 1) early onset TLE (EOTLE, i.e. patients who develop epilepsy in the first two decades of life) and 2) late onset TLE (LOTLE, i.e. patients who develop epilepsy after 50 years old). Temporal lobe plays a central role in the regulation of the "Central Autonomic Network" and cardiovascular functions. Lesions in this area are usually associated with abnormalities in the regulation of heart rate (HR) and development of cardiac arrhythmia. This study aims at comparing HRV changes in two groups of patients suffering from Temporal Lobe Epilepsy (TLE). To that aim, we evaluated patients differentiated by early and late onset of TLE.
Methods: We enrolled twenty-five adults with LOTLE (LOTLE group) and 18 EOTLE age, sex, and seizure-frequency matched controls (EOTLE group). Each patient underwent a 20-minute EEG + EKG recording in resting state before and during 3-minutes hyperpnea. Heart rate variability (HRV) analysis was performed on EKG records. Time-domain and frequency domain analysis parameters were compared between groups. An index reflecting the change in heart rate (HR) upon hyperventilation (HFn/hp) was also calculated.
Results: Compared to EOTLE group, the LOTLE group showed a statistically significant increased HF values (p=0.04) which is indicative of increased vagal tone. In addition, a decrease in low frequency (LF) (p=0.03) and in the low frequency/high frequency ratio (LF/HF) (p=0.03) was observed, indicative of lower risk of cardiovascular mortality. Finally, LOTLE showed a significant HR changes upon hyperventilation according to HFn/hp value (p=0.02).
Conclusions: The main finding of the study is that LOTLE is associated with a increase in the vagal tone compared to EOTLE. These results indicate that patients with LOTLE may have lower risk to develop cardiac dysfunctions or cardiac arrhythmia.
Funding: Please list any funding that was received in support of this abstract.: No funding was received for this study.
Clinical Epilepsy