Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-University (LMU), Munich, Germany.
Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-University (LMU), Munich, Germany.
Epilepsy Behav. 2019 Mar;92:36-44. doi: 10.1016/j.yebeh.2018.11.034. Epub 2019 Jan 3.
Although an impact of epilepsy on circadian rhythmicity is well-recognized, there are profound gaps in our understanding of the influence of seizures on diurnal rhythms. The effect on activity levels and heart rate is of particular interest as it might contribute to the disease burden. The kindling model with telemetric transmitter implants provides excellent opportunities to study the consequences of focal and generalized seizures under standardized conditions. Data from kindled rats with generalized seizures revealed an increase in activity and heart rate during the resting phase. Total and short-term heart rate variabilities were not affected by electrode implantation or seizure induction. Ictal alterations in heart rate associated with generalized seizures were characterized by a biphasic bradycardia with an immediate drop of heart rate followed by a transient normalization and a second more steady decrease. In conclusion, the findings demonstrate that once daily generalized seizures can exert significant effects on heart rate rhythms. Respective alterations in patients would be of relevance for patient counselling and therapeutic management. Occurrence of biphasic bradycardia associated with seizure induction suggests that the kindling model is suitable to study the consequences and the prevention of ictal bradycardia, which may pose patients at risk for sudden unexpected death.
尽管癫痫对昼夜节律的影响已得到广泛认可,但我们对癫痫发作对昼夜节律的影响仍存在深刻的认识差距。活动水平和心率的影响尤其值得关注,因为它可能会增加疾病负担。带有遥测发射器植入物的点燃模型为在标准化条件下研究局灶性和全身性癫痫发作的后果提供了极好的机会。来自全身性癫痫发作的点燃大鼠的数据显示,在休息期间活动和心率增加。电极植入或癫痫诱导对总心率变异性和短期心率变异性没有影响。与全身性癫痫发作相关的心率的发作性改变的特征是双相性心动过缓,心率立即下降,随后短暂正常化,然后第二次更稳定地下降。总之,这些发现表明,每日一次的全身性癫痫发作可对心率节律产生重大影响。患者中相应的改变对于患者咨询和治疗管理具有重要意义。与癫痫诱导相关的双相性心动过缓的发生表明,点燃模型适合研究发作性心动过缓的后果和预防,这可能使患者面临突发意外死亡的风险。