Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies, and Technology - CAST-, University G. d'Annunzio of Chieti-Pescara, Italy.
Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Italy.
Neurophysiol Clin. 2023 Apr;53(2):102852. doi: 10.1016/j.neucli.2023.102852. Epub 2023 Mar 24.
Temporal lobe epilepsy (TLE) is the most frequent form of focal epilepsy. TLE is associated with cardio-autonomic dysfunction and increased cardiovascular (CV) risk in patients over the fifth decade of age. In these subjects, TLE can be classified as early-onset (EOTLE; i.e., patients who had developed epilepsy in their youth) and late-onset (LOTLE; i.e., patients who developed epilepsy in adulthood). Heart rate variability (HRV) analysis is useful for assessing cardio-autonomic function and identifying patients with increased CV risk. This study compared changes in HRV occurring in patients over the age of 50, with EOTLE or LOTLE.
We enrolled twenty-seven adults with LOTLE and 23 with EOTLE. Each patient underwent a EEG and EKG recording during 20-minutes of resting state and a 5-minutes hyperventilation (HV). Short-term HRV analysis was performed both in time and frequency domains. Linear Mixed Models (LMM) were used to analyze HRV parameters according to the condition (baseline and HV) and group (LOTLE and EOTLE groups).
Compared to the LOTLE group, the EOTLE group showed significantly decreased LnRMSSD (natural logarithm of the root mean square of the difference between contiguous RR intervals) (p-value=0.05), LnHF ms (natural logarithm of high frequency absolute power) (p-value=0.05), HF n.u. (high frequency power expressed in normalized units) (p-value=0.008) and HF% (high frequency power expressed in percentage) (p-value=0.01). In addition, EOTLE patients exhibited increased LF n.u. (low frequency power expressed in normalized units) (p-value=0.008) and LF/HF (low frequency/high frequency) ratio (p-value=0.007). During HV, the LOTLE group exhibited a multiplicative effect for the interaction between group and condition with increased LF n.u. (p = 0.003) and LF% (low frequency expressed in percentage) (p = 0.05) values.
EOTLE is associated with reduced vagal tone compared to LOTLE. Patients with EOTLE may have a higher risk of developing cardiac dysfunction or cardiac arrhythmia than LOTLE patients.
颞叶癫痫（TLE）是最常见的局灶性癫痫。TLE 与心脏自主神经功能障碍有关，并增加 50 岁以上患者的心血管（CV）风险。在这些患者中，TLE 可分为早发性（EOTLE；即，在年轻时发生癫痫的患者）和晚发性（LOTLE；即，在成年后发生癫痫的患者）。心率变异性（HRV）分析有助于评估心脏自主神经功能并识别具有增加 CV 风险的患者。本研究比较了年龄在 50 岁以上的患者中，EOTLE 或 LOTLE 患者的 HRV 变化。
我们招募了 27 名 LOTLE 患者和 23 名 EOTLE 患者。每位患者在 20 分钟的静息状态和 5 分钟的过度通气（HV）期间进行脑电图和心电图记录。在时间和频率域进行短期 HRV 分析。线性混合模型（LMM）用于根据条件（基线和 HV）和组（LOTLE 和 EOTLE 组）分析 HRV 参数。
与 LOTLE 组相比，EOTLE 组的 LnRMSSD（连续 RR 间期之间的均方根差的自然对数）显著降低（p 值=0.05），LnHF ms（高频绝对功率的自然对数）（p 值=0.05），HF n.u.（高频功率以归一化单位表示）（p 值=0.008）和 HF%（高频功率以百分比表示）（p 值=0.01）。此外，EOTLE 患者的 LF n.u.（以归一化单位表示的低频功率）（p 值=0.008）和 LF/HF（低频/高频）比值增加（p 值=0.007）。在 HV 期间，LOTLE 组表现出组和条件之间的交互作用的乘法效应，LF n.u.（p=0.003）和 LF%（低频以百分比表示）（p=0.05）值增加。
与 LOTLE 相比，EOTLE 与迷走神经张力降低有关。与 LOTLE 患者相比，EOTLE 患者可能具有更高的发展心脏功能障碍或心律失常的风险。
