Characteristics of Heart Rate Variability During the Peri-ictal Period in Focal Epilepsy
SUN Jiankui
WANG Qun
Abstract：Objective To explore the characterization of heart rate variability during the peri-ictal period in focal epilepsy.Methods A total of 102 patients with focal epilepsy who underwent preoperative evaluation and completed surgery at the Epilepsy Center of Beijing Tiantan Hospital,Capital Medical University from September 2014 to September 2019 were collected.A total of 198 focal seizures were selected.RR intervals of two adjacent electrocardiograph activities were measured manually,and the square root of the mean squared differences of successive NN intervals(RMSSD)was calculated.RMSSD differences were compared 60 seconds before onset,during ictal period and 60 seconds after termination.The difference of RMSSD among different types of heart rate change,different seizure types,different pre-ictal states,and different sites and sides of epileptic focus were compared.Results There were significant differences in RMSSD among the ictal period and 60 seconds before the onset and 60 seconds after the termination(P＜0.001),suggesting decrease in RMSSD during the ictal period.The RMSSD was decreased during the ictal period of seizures with increased heart rate(P＜0.001).RMSSD decreased in complex partial seizures(P＜0.001).RMSSD decreased in medial temporal lobe epilepsy(the right medial temporal lobe epilepsy P＜0.001,the left medial temporal lobe epilepsy P＜0.001).There was no significant decrease in RMSSD in seizures with no change in heart rate(P=0.556)or in seizures with decreased heart rate(P=0.983),simple partial seizures(P=0.869),lateral temporal lobe epilepsy(the right lateral temporal lobe epilepsy P=0.204,the left lateral temporal lobe epilepsy P=0.849)and extratemporal lobe epilepsy(the right extratemporal lobe epilepsy P=0.188,the left extratemporal lobe epilepsy P=0.068).The RMSSD difference between ictal period and 60 seconds before onset was more in sleep phase(P=0.039).Conclusion The decrease of heart rate variability was easy to occur in the ictal period of seizures with increased heart rate,complex partial seizures and medial temporal lobe epilepsy,suggesting that parasympathetic activity decreased during the ictal period.The decrease of heart rate variability during the sleep phase was more significant than that during the awake phase,suggesting that parasympathetic activity decreased more significantly during the sleep phase.
Keywords：focal epilepsyheart rate variabilitythe square root of the mean squared differences of successive NN intervalsmedial temporal lobe epilepsylateral temporal lobe epilepsyextratemporal lobe epilepsy
Publication Date：2024-04-15
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 1189-1193 )