Graeme Clark Institute for Biomedical Engineering, The University of Melbourne, Australia; Seer Medical, Australia.
Department of Biomedical Engineering, The University of Melbourne, Australia.
EBioMedicine. 2021 Oct;72:103619. doi: 10.1016/j.ebiom.2021.103619. Epub 2021 Oct 11.
Circadian and multiday rhythms are found across many biological systems, including cardiology, endocrinology, neurology, and immunology. In people with epilepsy, epileptic brain activity and seizure occurrence have been found to follow circadian, weekly, and monthly rhythms. Understanding the relationship between these cycles of brain excitability and other physiological systems can provide new insight into the causes of multiday cycles. The brain-heart link has previously been considered in epilepsy research, with potential implications for seizure forecasting, therapy, and mortality (i.e., sudden unexpected death in epilepsy).
We report the results from a non-interventional, observational cohort study, Tracking Seizure Cycles. This study sought to examine multiday cycles of heart rate and seizures in adults with diagnosed uncontrolled epilepsy (N=31) and healthy adult controls (N=15) using wearable smartwatches and mobile seizure diaries over at least four months (M=12.0, SD=5.9; control M=10.6, SD=6.4). Cycles in heart rate were detected using a continuous wavelet transform. Relationships between heart rate cycles and seizure occurrence were measured from the distributions of seizure likelihood with respect to underlying cycle phase.
Heart rate cycles were found in all 46 participants (people with epilepsy and healthy controls), with circadian (N=46), about-weekly (N=25) and about-monthly (N=13) rhythms being the most prevalent. Of the participants with epilepsy, 19 people had at least 20 reported seizures, and 10 of these had seizures significantly phase locked to their multiday heart rate cycles.
Heart rate cycles showed similarities to multiday epileptic rhythms and may be comodulated with seizure likelihood. The relationship between heart rate and seizures is relevant for epilepsy therapy, including seizure forecasting, and may also have implications for cardiovascular disease. More broadly, understanding the link between multiday cycles in the heart and brain can shed new light on endogenous physiological rhythms in humans.
This research received funding from the Australian Government National Health and Medical Research Council (investigator grant 1178220), the Australian Government BioMedTech Horizons program, and the Epilepsy Foundation of America's 'My Seizure Gauge' grant.
昼夜节律和多日节律存在于许多生物系统中，包括心脏病学、内分泌学、神经病学和免疫学。在癫痫患者中，已经发现癫痫脑活动和发作的发生遵循昼夜、每周和每月的节律。了解这些大脑兴奋性周期与其他生理系统之间的关系，可以为多日周期的原因提供新的见解。大脑-心脏的联系在癫痫研究中已经被考虑在内，这可能对癫痫发作预测、治疗和死亡率（即癫痫猝死）有影响。
我们报告了一项非干预性、观察性队列研究“追踪癫痫发作周期”的结果。这项研究旨在使用可穿戴智能手表和移动癫痫日记，在至少四个月的时间里（参与者平均 12.0 个月，标准差 5.9；对照组平均 10.6 个月，标准差 6.4），检查诊断为未控制的癫痫成人（n=31）和健康成人对照者（n=15）的心率和癫痫发作的多日周期。使用连续小波变换检测心率周期。通过从潜在周期相位的角度测量与癫痫发作发生的关系来测量心率周期与癫痫发作发生之间的关系。
所有 46 名参与者（癫痫患者和健康对照组）都发现了心率周期，其中昼夜节律（n=46）、大约每周（n=25）和大约每月（n=13）节律最为常见。在癫痫患者中，有 19 人至少报告了 20 次癫痫发作，其中 10 人癫痫发作与他们的多日心率周期明显锁相。
心率周期与多日癫痫节律相似，可能与癫痫发作的可能性相关。心率与癫痫发作之间的关系与癫痫治疗有关，包括癫痫发作预测，也可能对心血管疾病有影响。更广泛地说，了解心脏和大脑中的多日周期之间的联系，可以为人类的内源性生理节律提供新的认识。
这项研究得到了澳大利亚政府国家卫生和医学研究委员会（研究员资助 1178220）、澳大利亚政府生物医学技术视野计划和美国癫痫基金会“我的癫痫计”资助的支持。
