Abstracts

Interictal and Postictal Respiratory Variability Is a Strong Predictor of Severe Hypoxemia After Generalized Convulsive Seizures

Abstract number : 3.223
Submission category : 2. Translational Research / 2C. Biomarkers
Year : 2024
Submission ID : 481
Source : www.aesnet.org
Presentation date : 12/9/2024 12:00:00 AM
Published date :

Authors :
Presenting Author: Jack Caplan, BS – University of Iowa Carver College of Medicine

Laura Vilella, MD – University of Texas Health Science Center at Houston
Paula Lee, MD – University of Iowa
Deidre Dragon, BS – University of Iowa
Linder Wendt, MS – University of Iowa
Patrick Ten Eyck, PhD – University of Iowa
Shiqiang Tao, PHD – University of Texas Health Science Center at Houston
Guo-Qiang Zhang, MS, PhD – University of Texas Health Science Center at Houston
Johnson Hampson, MSBME – University of Texas, UT Health Houston
Sandhya Rani, PhD – University of Texas Health Science Center at Houston
Jennifer Ogren, MD – Center for SUDEP Research
Nuria Lacuey-Lecumberri, MD, PhD – University of Texas Health Science Center at Houston
Beate Diehl, MD – University College London
Daniel Friedman, MD – New York University Grossman School of Medicine, NYU Langone Health
Lisa Bateman, MD, FRCPC – Cedars-Sinai Medical Center
Ronald Harper, PhD – University of California, Los Angeles
Maromi Nei, MD – Thomas Jefferson University
Stephan Schuele, MD – Northwestern University Feinberg School of Medicine
Orrin Devinsky, MD – NYU Grossman School of Medicine
Samden Lhatoo, MD, FRCP – University of Texas Health Science Center at Houston
George Richerson, MD, PhD – University of Iowa
Brian Gehlbach, MD – University of Iowa
Rup Sainju, MBBS – University of Iowa

Rationale: Severe periictal hypoxemia is considered a potential biomarker for SUDEP. Data in mouse models suggest increased interictal respiratory rate variability predisposes them to SUDEP. A recent study showed epilepsy patients with increased interictal breathing variability have more severe postictal hypoxemia after a generalized convulsive seizure (GCS). This study aimed to define the relationship between inter-breath interval (IBI) variability and hypoxemia after GCS in a larger cohort.


Methods: We retrospectively analyzed continuous video-EEG, pulse oximetry (SpO2), respiratory data (respiratory inductance plethysmography and nasal pressure or thermistry, when available) and demographic data of patients with epilepsy aged >18 years collected from epilepsy monitoring units at multiple centers that are members of the Center for SUDEP Research.

Interictal (~5 minutes each of awake and NREM) and postictal (the first 3 minutes after GCS) respiratory data were used to assess variability of IBI. Mean, standard deviation, coefficient of variation (CV), and root mean square of successive differences (RMSSD) of IBI were calculated. Poincaré plots of IBI were created with calculation of short-term (SD-1) and long-term (SD-2) variability. The primary outcome was severity of periictal oxygen desaturation expressed as SpO2 nadir and duration of SpO2 < 90% in the periictal period.


Measures of respiratory variability and other relevant parameters were utilized to create univariate and multivariate models using generalized linear models with appropriate link function. Best multivariate models were chosen based on Akaike information criterion values, with the lowest value suggesting the best fit. p < 0.05 was considered statistically significant.

Translational Research