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Vol 54, No 4 (2020)
Research Paper
Submitted: 2019-09-25
Accepted: 2020-04-24
Published online: 2020-06-17
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Cardiac autonomic modulation in drug-resistant epilepsy patients after vagus nerve stimulation therapy

Victor Constantinescu1, Daniela Matei1, Irina Constantinescu2, Dan Iulian Cuciureanu1
DOI: 10.5603/PJNNS.a2020.0044
·
Pubmed: 32557527
·
Neurol Neurochir Pol 2020;54(4):329-336.
Affiliations
  1. University of Medicine and Pharmacy, Universitatii street No 16, 700115 Iasi, Romania
  2. Department of Neurology, Regional Hospital of Orléans, 14 Avenue de l'Hôpital, 45100 Orléans, France

open access

Vol 54, No 4 (2020)
Research papers
Submitted: 2019-09-25
Accepted: 2020-04-24
Published online: 2020-06-17

Abstract

The positive effect of vagus nerve stimulation (VNS) in patients with drug-resistant epilepsy is considered to be mediated by the afferent pathways of the vagus nerve, but the efferent pathways may influence the cardiac autonomic activity.

Aim of the study. To assess the effects of VNS on cardiac autonomic modulation in epilepsy patients, over three months of neurostimulation.

Clinical rationale for the study. Linear and non-linear heart rate variability (HRV) analysis can provide information on the sympathovagal balance and reveal particularities of the central control of the autonomic cardiovascular function.

Materials and Methods. Using Biopac Acquisition System, we analysed HRV parameters in resting condition and during sympathetic and parasympathetic activation tests in five patients with drug-resistant epilepsy, who underwent VNS procedure.

Results. During the sympathetic and vagal activation tests, all five patients presented normal responses of cardiac autonomic activity, reflected in RMSSD, HFnu and LF/HF dynamics in both HRV evaluations. No bradycardia, cardiac arrhythmia or orthostatic hypotension was registered during the two evaluations.

Conclusions. Our results indicate that VNS appears not to alter the cardiac autonomic function after three months of neurostimulation. HRV analysis is a useful tool for evaluating cardiac autonomic modulation in epilepsy patients during VNS therapy.

Clinical Implications. Patients with decreased HRV should be periodically monitored. Cardiac changes in patients with epilepsy are important because of the additional risk of arrhythmias mediated through the autonomic dysfunction.

Abstract

The positive effect of vagus nerve stimulation (VNS) in patients with drug-resistant epilepsy is considered to be mediated by the afferent pathways of the vagus nerve, but the efferent pathways may influence the cardiac autonomic activity.

Aim of the study. To assess the effects of VNS on cardiac autonomic modulation in epilepsy patients, over three months of neurostimulation.

Clinical rationale for the study. Linear and non-linear heart rate variability (HRV) analysis can provide information on the sympathovagal balance and reveal particularities of the central control of the autonomic cardiovascular function.

Materials and Methods. Using Biopac Acquisition System, we analysed HRV parameters in resting condition and during sympathetic and parasympathetic activation tests in five patients with drug-resistant epilepsy, who underwent VNS procedure.

Results. During the sympathetic and vagal activation tests, all five patients presented normal responses of cardiac autonomic activity, reflected in RMSSD, HFnu and LF/HF dynamics in both HRV evaluations. No bradycardia, cardiac arrhythmia or orthostatic hypotension was registered during the two evaluations.

Conclusions. Our results indicate that VNS appears not to alter the cardiac autonomic function after three months of neurostimulation. HRV analysis is a useful tool for evaluating cardiac autonomic modulation in epilepsy patients during VNS therapy.

Clinical Implications. Patients with decreased HRV should be periodically monitored. Cardiac changes in patients with epilepsy are important because of the additional risk of arrhythmias mediated through the autonomic dysfunction.

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Keywords

drug-resistant epilepsy, vagus nerve stimulation, cardiac autonomic modulation, heart rate variability, linear and non-linear analysis

About this article
Title

Cardiac autonomic modulation in drug-resistant epilepsy patients after vagus nerve stimulation therapy

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 54, No 4 (2020)

Article type

Research Paper

Pages

329-336

Published online

2020-06-17

Page views

1432

Article views/downloads

666

DOI

10.5603/PJNNS.a2020.0044

Pubmed

32557527

Bibliographic record

Neurol Neurochir Pol 2020;54(4):329-336.

Keywords

drug-resistant epilepsy
vagus nerve stimulation
cardiac autonomic modulation
heart rate variability
linear and non-linear analysis

Authors

Victor Constantinescu
Daniela Matei
Irina Constantinescu
Dan Iulian Cuciureanu

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