Dono Fedele, Evangelista Giacomo, Frazzini Valerio, Vollono Catello, Carrarini Claudia, Russo Mirella, Ferrante Camilla, Di Stefano Vincenzo, Marchionno Luciano P, De Angelis Maria V, Faustino Massimiliano, Bonanni Laura, Onofrj Marco, Sensi Stefano L, Anzellotti Francesca
Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.
AP-HP, Epilepsy Unit, Pitié-Salpêtrière Hospital, and Sorbonne University, Paris, France.
Front Neurol. 2020 Aug 14;11:842. doi: 10.3389/fneur.2020.00842. eCollection 2020.
The temporal lobe, a critical hub for cognition, also plays a central role in the regulation of autonomic cardiovascular functions. Lesions in this area are usually associated with abnormalities in the regulation of heart rate (HR) and blood pressure (BP). The analysis of the heart rate variability (HRV) is useful to evaluate the cardiac parasympathetic nervous system activity. This study aims at comparing HRV changes occurring in two groups of patients suffering from Temporal Lobe Epilepsy (TLE). To that aim, we evaluated patients differentiated by the right or left location of the epileptic foci. Fifty-two adult patients with a diagnosis of TLE were enrolled. Each patient underwent a 20-min EEG + EKG recording in resting state. According to the localization of epileptic focus, patients were divided into two subgroups: right TLE (R-TLE) and left TLE (L-TLE). HRV parameters were calculated with a short-lasting analysis of EKG recordings. Time-domain and frequency domain-related, as well as non-linear analysis, parameters, were compared between the two groups. Compared to the R-TLE group, L-TLE subjects showed a significant decrease in low frequency (LF) ( < 0.01) and low frequency/high-frequency ratio (LF/HF) ( < 0.001) as well as increased HF values ( < 0.01), a parameter indicative of the presence of an increased cardiac vagal tone. These results were also confirmed in the subgroup analysis that took into account the seizure types, responses to antiepileptic drugs, seizure frequencies, and etiology. The main finding of the study is that, compared to R-TLE, L-TLE is associated with increased cardiac vagal tone. These results indicate that patients with TLE exhibit a lateralized cardiac autonomic control. L-TLE patients may have a lower risk of developing cardiac dysfunctions and less susceptible to develop Sudden Death for Epilepsy (SUDEP).
颞叶是认知的关键枢纽，在自主心血管功能调节中也起着核心作用。该区域的病变通常与心率（HR）和血压（BP）调节异常有关。心率变异性（HRV）分析有助于评估心脏副交感神经系统活动。本研究旨在比较两组颞叶癫痫（TLE）患者的HRV变化。为此，我们评估了根据癫痫病灶右侧或左侧位置区分的患者。招募了52例诊断为TLE的成年患者。每位患者在静息状态下进行了20分钟的脑电图+心电图记录。根据癫痫病灶的定位，患者分为两个亚组：右侧TLE（R-TLE）和左侧TLE（L-TLE）。通过对心电图记录进行短期分析来计算HRV参数。比较了两组之间与时域和频域相关以及非线性分析的参数。与R-TLE组相比，L-TLE受试者的低频（LF）（<0.01）和低频/高频比值（LF/HF）（<0.001）显著降低，而高频值（HF）升高（<0.01），HF是提示心脏迷走神经张力增加的参数。在考虑癫痫发作类型、对抗癫痫药物的反应、癫痫发作频率和病因的亚组分析中也证实了这些结果。该研究的主要发现是，与R-TLE相比，L-TLE与心脏迷走神经张力增加有关。这些结果表明，TLE患者表现出心脏自主控制的偏侧化。L-TLE患者发生心脏功能障碍的风险可能较低，且较不易发生癫痫性猝死（SUDEP）。
