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迷走神经刺激对癫痫患者心血管调节的影响。

Effects of vagus nerve stimulation on cardiovascular regulation in patients with epilepsy.

作者信息

Stemper B, Devinsky O, Haendl T, Welsch G, Hilz M J

机构信息

Department of Neurology, University of Erlangen-Nurnberg, Erlangen, Germany.

出版信息

Acta Neurol Scand. 2008 Apr;117(4):231-6. doi: 10.1111/j.1600-0404.2007.00944.x. Epub 2007 Nov 13.

Abstract

OBJECTIVE

To evaluate the impact of vagus nerve stimulation (VNS) on heart rate and blood pressure (BP) modulation in epilepsy patients.

MATERIAL AND METHODS

Twenty-one epilepsy patients with VNS were tested during on (60 s) and off (5 min) phases. We monitored BP, RR intervals (RRI) and respiration. Spectral analysis was performed in low- (LF: 0.04-0.15 Hz) and high-frequency bands (HF: 0.15-0.5 Hz). For coherences above 0.5, we calculated the LF transfer function between systolic BP and RRI, and the HF transfer function gain and phase between RRI and respiration. Differences between the on and off phases were evaluated using Wilcoxon test.

RESULTS

VNS did not change RRI and BP values. The LF power of BP and the LF and HF power of RRI increased significantly. There was a slight change in the RRI/BP LF gain and the RRI/respiration HF gain (ns). The HF phase between RRI and respiration decreased significantly.

CONCLUSIONS

Our findings show that VNS influences both sympathetic and parasympathetic cardiovascular modulation. However, our results also show that VNS does not negatively influence autonomic cardiovascular regulation.

摘要

目的

评估迷走神经刺激(VNS)对癫痫患者心率和血压(BP)调节的影响。

材料与方法

对21例接受VNS治疗的癫痫患者在开启(60秒)和关闭(5分钟)阶段进行测试。我们监测了血压、RR间期(RRI)和呼吸。在低频(LF:0.04 - 0.15赫兹)和高频波段(HF:0.15 - 0.5赫兹)进行频谱分析。对于相干性高于0.5的情况,我们计算了收缩压与RRI之间的LF传递函数,以及RRI与呼吸之间的HF传递函数增益和相位。使用Wilcoxon检验评估开启和关闭阶段之间的差异。

结果

VNS未改变RRI和BP值。血压的LF功率以及RRI的LF和HF功率显著增加。RRI/BP的LF增益和RRI/呼吸的HF增益有轻微变化(无统计学意义)。RRI与呼吸之间的HF相位显著降低。

结论

我们的研究结果表明,VNS影响交感神经和副交感神经对心血管的调节。然而,我们的结果也表明,VNS不会对自主心血管调节产生负面影响。

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