■癫痫患者经常经历自主神经功能障碍,与癫痫猝死密切相关(SUDEP)。SUDEP最常见于夜间或睡眠期间,和频繁的夜间癫痫发作是一个既定的危险因素。这项研究调查了夜间癫痫发作对癫痫自主神经功能障碍的影响。
■这项回顾性研究纳入了进行24小时脑电图监测的额叶癫痫(FLE)患者。所有参与者均分为夜间FLE(NFLE,>90%的癫痫发作发生在睡眠期间)或昼夜FLE(DFLE)组。在清醒和睡眠阶段同时获得EEG和ECG信号。进行了脑电图电流密度源和自主网络的连通性分析。心电图分析采用时域和频域心率变异性(HRV)分析方法。在NFLE和DFLE组之间比较获得的参数。
■15例NFLE和16例DFLE患者的年龄差异无统计学意义,性别,疾病持续时间,癫痫发作频率,或两组之间抗癫痫药物的数量。在睡眠中,在HRV参数的减少和β-1(13-22Hz)电流源密度功率的增加在双侧中央小叶(BA4,5,6),precuneus(BA7),与DFLE组相比,NFLE组观察到扣带回(BA31)。NFLE组还显示了中央自主神经的超连通性(分布在10个节点上的12条边),交感神经(2条边分布在3个节点上),和睡眠期间的副交感神经(分布在6个节点上的4个边缘)β-1频段网络。在清醒的时候,NFLE组和DFLE组的中枢和心脏自主神经变量无显著差异.
■发作间心脏和中枢自主神经功能障碍同时发生,可归因于脑-心脏自主神经轴。我们的发现表明,夜间癫痫发作可能导致癫痫患者睡眠期间的发作间自主神经功能障碍。
UNASSIGNED: Patients with epilepsy frequently experience autonomic dysfunction, closely related to sudden unexplained death in epilepsy (SUDEP). SUDEP occurs most often at night or during sleep, and frequent nocturnal seizures are an established risk factor. This study investigated the influence of nocturnal seizures on autonomic dysfunction in epilepsy.
UNASSIGNED: This retrospective study enrolled frontal lobe epilepsy (FLE) patients who performed 24-hour EEG monitoring. All participants were divided into nocturnal FLE (NFLE, > 90% of seizures occurring during sleep) or diurnal FLE (DFLE) groups. EEG and ECG signals were simultaneously obtained during waking and sleep stages. EEG current density source and connectivity analysis of the autonomic network were performed. ECG was analyzed across time and frequency domains heart rate variability (HRV) analysis method was used. The obtained parameters were compared between the NFLE and DFLE groups.
UNASSIGNED: Fifteen NFLE and 16 DFLE patients were enrolled with no significant difference in age, sex, disease duration, seizure frequency, or the number of anti-seizure medications between the two groups. During sleep, a decrease in HRV parameters and an increase of the beta-1 (13-22 Hz) current source density power in the bilateral paracentral lobule (BA4,5,6), precuneus (BA7), and cingulate (BA31) were observed in the NFLE group compared to DFLE group. The NFLE group also showed hyperconnectivity in the central autonomic (12 edges distributed over 10 nodes), sympathetic (2 edges distributed over 3 nodes), and parasympathetic (4 edges distributed over 6 nodes) beta-1 frequency band networks during sleep. During wakefulness, central and cardiac autonomic variables were not significantly different between the NFLE and DFLE groups.
UNASSIGNED: Interictal cardiac and central autonomic dysfunction occurred simultaneously and can be attributed to the brain-heart autonomic axis. Our findings suggest that nocturnal seizures may contribute to interictal autonomic dysfunction during sleep in people with epilepsy.