Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.
Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.
Epilepsy Behav. 2022 Feb;127:108508. doi: 10.1016/j.yebeh.2021.108508. Epub 2021 Dec 30.
Temporal lobe epilepsy (TLE) is the most frequent focal epilepsy in adulthood. Catamenial C1-type TLE, is characterized by a cyclic seizure exacerbation during the menstrual phase. The heart rate variability (HRV) analysis assesses cardiac autonomic control and may represent a biomarker for Sudden Unexpected Death in Epilepsy (SUDEP). It is plausible that female sex hormones can influence HRV. These changes might be more pronounced in patients suffering from catamenial C1-type TLE where hormonal changes also increase seizure susceptibility. To that aim, we evaluated HRV changes during the menstrual phase of women suffering from catamenial C1-type TLE.
We enrolled 12 adults with a diagnosis of catamenial C1-type TLE (Catamenial Group) and 12 age-, and seizure-frequency-matched controls with TLE (Non-Catamenial Group). Each patient underwent a 20-minute EEG + EKG recording in resting state during the menstrual phase. HRV parameters were calculated with a short-lasting analysis of EKG records. Time domain-related, frequency domain-related, as well as non-linear analysis parameters, were compared between the two groups.
Compared to the Non-Catamenial Group, the Catamenial Group showed significant reductions in SDNN (p-value = 0.01), RMSSD (p-value = 0.04), pNN50 (p-value = 0.001), LnLF ms (p-value = 0.05), LnHF ms (p-value = 0.007), SD1 (p-value = 0.02), and SD2 (p-value = 0.01). These results were independent from age, disease duration, numbers of ASM, and seizure etiology.
Our data provide experimental evidence that vagal output is reduced during the menstrual phase in patients with catamenial C1-type TLE. These results indicate that, during the menstrual phase, patients with catamenial C1-type TLE may be at a higher risk of developing cardiac dysfunctions and SUDEP.
颞叶癫痫（TLE）是成人中最常见的局灶性癫痫。月经周期型 C1 型 TLE 的特征是在月经期间癫痫发作加剧。心率变异性（HRV）分析评估心脏自主控制，可能是癫痫猝死（SUDEP）的生物标志物。女性性激素可能会影响 HRV，这是合理的。在患有月经周期型 C1 型 TLE 的患者中，这些变化可能更为明显，因为激素变化也会增加癫痫发作的易感性。为此，我们评估了患有月经周期型 C1 型 TLE 的女性在月经期间的 HRV 变化。
我们招募了 12 名诊断为月经周期型 C1 型 TLE 的成年患者（月经周期组）和 12 名年龄和发作频率匹配的 TLE 患者（非月经周期组）。每位患者在月经期间进行 20 分钟的脑电图+心电图记录。使用心电图记录的短暂分析计算 HRV 参数。比较两组之间的时域相关、频域相关和非线性分析参数。
与非月经周期组相比，月经周期组的 SDNN（p 值=0.01）、RMSSD（p 值=0.04）、pNN50（p 值=0.001）、LnLF ms（p 值=0.05）、LnHF ms（p 值=0.007）、SD1（p 值=0.02）和 SD2（p 值=0.01）均显著降低。这些结果与年龄、疾病持续时间、ASM 数量和癫痫病因无关。
我们的数据提供了实验证据，表明月经周期型 C1 型 TLE 患者的迷走神经输出在月经期间减少。这些结果表明，在月经期间，月经周期型 C1 型 TLE 患者可能面临更高的心脏功能障碍和 SUDEP 风险。
