McNicholas Olivia C, Jiménez-Jiménez Diego, Oliveira Joana F A, Ferguson Lauren, Bellampalli Ravishankara, McLaughlin Charlotte, Chowdhury Fahmida Amin, Martins Custodio Helena, Moloney Patrick, Mavrogianni Anna, Diehl Beate, Sisodiya Sanjay M
Sir Jules Thorn Telemetry Unit, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK.
Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.
Brain Commun. 2024 Sep 10;6(5):fcae269. doi: 10.1093/braincomms/fcae269. eCollection 2024.
Heatwaves have serious impacts on human health and constitute a key health concern from anthropogenic climate change. People have different individual tolerance for heatwaves or unaccustomed temperatures. Those with epilepsy may be particularly affected by temperature as the electroclinical hallmarks of brain excitability in epilepsy (inter-ictal epileptiform discharges and seizures) are influenced by a range of physiological and non-physiological conditions. Heatwaves are becoming more common and may affect brain excitability. Leveraging spontaneous heatwaves during periods of intracranial EEG recording in participants with epilepsy in a non-air-conditioned telemetry unit at the National Hospital for Neurology and Neurosurgery in London from May to August 2015-22, we examined the impact of heatwaves on brain excitability. In London, a heatwave is defined as three or more consecutive days with daily maximum temperatures ≥28°C. For each participant, we counted inter-ictal epileptiform discharges using four 10-min segments within, and outside of, heatwaves during periods of intracranial EEG recording. Additionally, we counted all clinical and subclinical seizures within, and outside of, heatwaves. We searched for causal rare genetic variants and calculated the epilepsy PRS. Nine participants were included in the study (six men, three women), median age 30 years (range 24-39). During heatwaves, there was a significant increase in the number of inter-ictal epileptiform discharges in three participants. Five participants had more seizures during the heatwave period, and as a group, there were significantly more seizures during the heatwaves. Genetic data, available for eight participants, showed none had known rare, genetically-determined epilepsies, whilst all had high polygenic risk scores for epilepsy. For some people with epilepsy, and not just those with known, rare, temperature-sensitive epilepsies, there is an association between heatwaves and increased brain excitability. These preliminary data require further validation and exploration, as they raise concerns about the impact of heatwaves directly on brain health.
热浪对人类健康有严重影响，是人为气候变化引发的关键健康问题。人们对热浪或不习惯的温度有不同的个体耐受性。癫痫患者可能特别容易受到温度影响，因为癫痫中大脑兴奋性的电临床特征（发作间期癫痫样放电和癫痫发作）会受到一系列生理和非生理条件的影响。热浪正变得越来越普遍，可能会影响大脑兴奋性。利用2015年5月至2022年8月在伦敦国立神经病学和神经外科医院的非空调遥测病房对癫痫患者进行颅内脑电图记录期间的自发热浪，我们研究了热浪对大脑兴奋性的影响。在伦敦，热浪被定义为连续三天或以上每日最高气温≥28°C。对于每位参与者，我们在颅内脑电图记录期间，对热浪期间及其之外的四个10分钟时间段内的发作间期癫痫样放电进行计数。此外，我们统计了热浪期间及其之外的所有临床和亚临床癫痫发作。我们搜索了因果罕见基因变异并计算了癫痫PRS。九名参与者纳入研究（六名男性，三名女性），中位年龄30岁（范围24 - 39岁）。在热浪期间，三名参与者的发作间期癫痫样放电数量显著增加。五名参与者在热浪期间癫痫发作更多，总体而言，热浪期间的癫痫发作明显更多。八名参与者的基因数据显示，没有人患有已知的罕见遗传性癫痫，而所有人的癫痫多基因风险评分都很高。对于一些癫痫患者，不仅仅是那些已知的、罕见的、温度敏感型癫痫患者，热浪与大脑兴奋性增加之间存在关联。这些初步数据需要进一步验证和探索，因为它们引发了对热浪直接影响大脑健康的担忧。
