EEG Section, NINDS, National Institutes of Health, Bethesda, MD 20814, United States of America.
Department of Physiology & Pharmacology, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, United States of America.
Auton Neurosci. 2022 Jul;240:102971. doi: 10.1016/j.autneu.2022.102971. Epub 2022 Mar 16.
Activity in both divisions of the autonomic nervous system (ANS) can increase during seizures and result in tachy- or bradyarrhythmias. We sought to determine the patterns of ANS activity that led to heart rate (HR) changes and whether the character of ANS and HR changes can impact the seizures themselves. Simultaneous recordings of vagus nerve and cervical sympathetic ganglionic or nerve activity, EEG, ECG, and blood pressure were acquired from 16 urethane-anesthetized rats that received systemic kainic acid to induce seizures. After initial continuous seizure activity, discrete seizures were observed in 11/16 rats. Individual seizures were classified based on HR changes as tachycardic (n = 3), bradycardic (n = 17), or one of two more severe categories in which (a) the seizure appeared to be terminated by severe bradyarrhythmia (n = 5) or (b) the animal died (n = 6). Interestingly, even simple bradycardic seizures had episodes of dramatically increased respiratory effort, which we interpret as evidence of airway occlusion based on muscle artifacts in the recordings with transient blood pressure decreases. In the severe outcomes, ANS activity increased during seizures until it caused a drastic HR reduction (>50%), in which case seizure and ANS activity decreased dramatically. Sympathetic activity during this late vulnerable period was important for survival. We conclude that individual seizures produce (a) stereotypical changes in autonomic activity and HR, (b) persistence of sympathetic tone helps to protect against death, and (c) bradycardic seizures may indicate increased risk for seizure-associated obstructive apnea.
自主神经系统(ANS)的两个分支的活动在癫痫发作期间会增加,并导致心动过速或心动过缓。我们试图确定导致心率(HR)变化的 ANS 活动模式,以及 ANS 和 HR 变化的特征是否会影响癫痫发作本身。我们从 16 只接受全身海人酸以诱导癫痫发作的氨基甲酸乙酯麻醉大鼠中同时记录迷走神经和颈交感神经节或神经活动、脑电图、心电图和血压。在最初的连续癫痫发作活动后,观察到 11/16 只大鼠出现离散癫痫发作。根据 HR 变化,将单个癫痫发作分类为心动过速(n = 3)、心动过缓(n = 17)或两种更严重类别的一种,其中 (a) 癫痫发作似乎因严重心动过缓而终止(n = 5)或 (b) 动物死亡(n = 6)。有趣的是,即使是简单的心动过缓性癫痫发作也会出现呼吸努力显著增加的情况,我们根据记录中的肌肉伪影和短暂的血压下降将其解释为气道阻塞的证据。在严重结局中,癫痫发作期间 ANS 活动增加,直到导致 HR 急剧下降(>50%),在这种情况下,癫痫发作和 ANS 活动急剧下降。在此晚期脆弱期期间,交感神经活动对生存很重要。我们得出结论,单个癫痫发作产生 (a) 自主活动和 HR 的典型变化,(b) 交感神经张力的持续存在有助于防止死亡,以及 (c) 心动过缓性癫痫发作可能表明与癫痫发作相关的阻塞性呼吸暂停风险增加。
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