Cardiovascular autonomic function and baroreflex sensitivity in drug-resistant temporal lobe epilepsy

•Autonomic dysfunction in epilepsy is proposed as one possible mechanism behind SUDEP.•Parasympathetic dysfunction observed in people with drug-resistant temporal lobe epilepsy may increase the risk of SUDEP.•Heart rate variability, baroreflex sensitivity, and a battery of cardiac autonomic function...

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Published in:Epilepsy & behavior 2023-01, Vol.138, p.109013-109013, Article 109013
Main Authors: Athira, S.B., Pal, Pravati, Nair, Pradeep P., Nanda, Nivedita, Aghoram, Rajeswari
Format: Article
Language:English
Subjects:
Autonomic dysfunction
Autonomic Nervous System
Baroreflex - physiology
Baroreflex sensitivity
Blood Pressure - physiology
Drug Resistant Epilepsy
Epilepsy, Temporal Lobe - complications
Hand Strength
Heart Rate - physiology
Heart rate variability
Humans
Sudden Unexpected Death in Epilepsy
SUDEP
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Summary:•Autonomic dysfunction in epilepsy is proposed as one possible mechanism behind SUDEP.•Parasympathetic dysfunction observed in people with drug-resistant temporal lobe epilepsy may increase the risk of SUDEP.•Heart rate variability, baroreflex sensitivity, and a battery of cardiac autonomic function tests are established tools to assess autonomic dysfunction in persons with epilepsy. Temporal lobe epilepsy (TLE) is often associated with autonomic manifestations. Sudden unexpected death in epilepsy (SUDEP) is a leading cause of mortality in epilepsy. Cardiac disturbances and autonomic dysfunction are the potential mechanisms behind SUDEP. Though heart rate variability (HRV) and autonomic function tests are well studied in drug-resistant temporal lobe epilepsy, there is a paucity of data on baroreflex sensitivity (BRS), a better marker of cardiac mortality in this population. We aimed to study the interictal cardiac autonomic function and BRS in people living with drug-resistant temporal lobe epilepsy compared to healthy controls. Thirty drug-resistant temporal lobe epilepsy (TLE) individuals and thirty healthy volunteers were recruited. Heart rate variability at rest, heart rate and blood pressure (BP) at rest, during deep breathing, postural change, BP response to isometric handgrip exercise, and baroreflex sensitivity were recorded in all study participants. The results were analyzed and compared between the two groups. Compared to controls, the resting heart rate, HRV, parasympathetic reactivity test, and BRS significantly differed in people living with drug-resistant TLE. Time-domain indices including SDNN (p 
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2022.109013