Heart rate variability in infants with West syndrome

Møller, M.; Høgenhaven, Hans; Uldall, Peter; Ballegaard, Martin

doi:10.1016/j.seizure.2015.02.003

Cited by 9 publications

(10 citation statements)

References 21 publications

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“…There are also treatment implications if HRV proves a reliable SUDEP biomarker, as certain therapies may have a beneficial effect on HRV. Children with infantile spasms have low HRV at the time of diagnosis, but this improves following treatment . As well, therapeutic application of vagal nerve stimulation (VNS) is associated with a reduction in T‐wave alternans, a measure of cardiac instability, making VNS an attractive candidate to reduce SUDEP risk; however, the effects of VNS on HRV have not yet been thoroughly studied, and a clear reduction in SUDEP incidence post‐VNS implantation has not been shown .…”

Section: Discussionmentioning

confidence: 99%

“…Children with infantile spasms have low HRV at the time of diagnosis, but this improves following treatment. 34,35 As well, therapeutic application of vagal nerve stimulation (VNS) is associated with a reduction in T-wave alternans, a measure of cardiac instability, making VNS an attractive candidate to reduce SUDEP risk; however, the effects of VNS on HRV have not yet been thoroughly studied, and a clear reduction in SUDEP incidence post-VNS implantation has not been shown. 36,37 In the future, clinicians may use sequential HRV measurements to assess whether a patient's SUDEP risk had changed on a given treatment.…”

Section: Future Directionsmentioning

confidence: 99%

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Heart rate variability in epilepsy: A potential biomarker of sudden unexpected death in epilepsy risk

et al. 2018

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These findings suggest that autonomic dysfunction is associated with SUDEP risk in patients with epilepsy due to sodium channel mutations. The relationship of HRV to SUDEP merits further study; HRV may eventually have potential as a biomarker of SUDEP risk, which would allow for more informed counseling of patients and families, and also serve as a useful outcome measure for research aimed at developing therapies and interventions to reduce SUDEP risk.

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Section: Discussionmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

Heart rate variability in epilepsy: A potential biomarker of sudden unexpected death in epilepsy risk

et al. 2018

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“…A number of studies have investigated the effects of drug treatment on abnormal HRV in epilepsy. In some cases, such as the already‐discussed West syndrome, there are multiple studies with data that generally agree that there is HRV improvement following treatment initiation . In epilepsy with older childhood onset, autonomic balance also appears to partially normalize following treatment initiation as well …”

Section: Effects Of Treatment On Interictal Hrvmentioning

confidence: 98%

“…A fourth study examined HRV in sleep only found an increased LF component . Following treatment, there is a shift toward recovery of parasympathetic function …”

Section: Interictal Hrv Patterns In Different Epilepsy Typesmentioning

confidence: 99%

“…HRV has been studied in patients with epileptic spasms in infancy, with 2 studies reporting findings indicating a shift toward sympathetic dominance, and one no significant differences other than lower heart rate in slow wave sleep . A fourth study examined HRV in sleep only found an increased LF component .…”

Section: Interictal Hrv Patterns In Different Epilepsy Typesmentioning

confidence: 99%

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Heart rate variability measurement in epilepsy: How can we move from research to clinical practice?

2018

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Our objective was to critically evaluate the literature surrounding heart rate variability (HRV) in people with epilepsy and to make recommendations as to how future research could be directed to facilitate and accelerate integration into clinical practice. We reviewed relevant HRV publications including those involving human subjects with seizures. HRV has been studied in patients with epilepsy for more than 30 years and, overall, patients with epilepsy display altered interictal HRV, suggesting a shift in autonomic balance toward sympathetic dominance. This derangement appears more severe in those with temporal lobe epilepsy and drug-resistant epilepsy. Normal diurnal variation in HRV is also disturbed in at least some people with epilepsy, but this aspect has received less study. Some therapeutic interventions, including vagus nerve stimulation and antiepileptic medications, may partially normalize altered HRV, but studies in this area are sometimes contradictory. During seizures, the changes in HRV may be complex, but the general trend is toward a further increase in sympathetic overactivity. Research in HRV in people with epilepsy has been limited by inconsistent experimental protocols and studies that are often underpowered. HRV measurement has the potential to aid clinical epilepsy management in several possible ways. HRV may be useful in predicting which patients are likely to benefit from surgical interventions such as vagus nerve stimulation and focal cerebral resection. As well, HRV could eventually have utility as a biomarker of risk for sudden unexpected death in epilepsy (SUDEP). However, at present, the inconsistent measurement protocols used in research are hindering translation into clinical practice. A minimum protocol for HRV evaluation, to be used in all studies involving epilepsy patients, is necessary to eventually allow HRV to become a useful tool for clinicians. We propose a straightforward protocol, involving 5-minute measurements of root mean square of successive differences in wakefulness and light sleep.

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Sleep-Related Epilepsy, Dysautonomia, and Sudden Nocturnal Death

Proserpio

Giacomini

Agostoni

et al. 2021

Autonomic Nervous System and Sleep

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Heart rate variability in infants with West syndrome

Abstract: Our data suggest that the initial reduction in HRV in patients at the time of onset of WS is transient and related to the presence of hypsarrhythmia.

Cited by 9 publications

References 21 publications

Heart rate variability in epilepsy: A potential biomarker of sudden unexpected death in epilepsy risk

Heart rate variability in epilepsy: A potential biomarker of sudden unexpected death in epilepsy risk

Heart rate variability measurement in epilepsy: How can we move from research to clinical practice?

Sleep-Related Epilepsy, Dysautonomia, and Sudden Nocturnal Death

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