Article
Interictal heart rate variability changes of patients undergoing anterior thalamic nuclei deep brain stimulation for the treatment of epilepsy
Veränderungen der Herzfrequenzvariabilität nach Tiefen Hirnstimulation des vorderen Thalamuskerns bei Epilepsiepatienten
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Published: | June 4, 2021 |
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Objective: Reduced heart rate variability (HRV) is associated with maladaptive response to mental and physical stress, shortened life expectancy and increased risk of death in epilepsy, acute myocardial infarct and diabetic neuropathy. HRV changes after resective epilepsy surgery / vagus nerve stimulation were reported. We aimed to examine the effects of anterior thalamic nuclei (ANT) deep brain stimulation (DBS) on HRV parameters in 30 patients underwent DBS implantation at 2 Hungarian epilepsy centers between 2011 and 2019.
Methods: We retrospectively analyzed data of 30 drug resistant patient’s charts and collected ECG epochs recorded during video-EEG monitoring both in awake and N1 or N2 stage sleep at 3 timepoints: T1) before DBS implantation, T2) after surgery without stimulation and T3) after stimulation was started. ECG epochs were analyzed using HRV Kubios Premium Software. Statistical analysis was carried out by factorial one-way repeated measures Anova.
Results: Among time domain parameters mean RMSSD (square root of the mean squared differences between successive RR intervals) and SDNN (standard deviation of RR intervals) values significantly (p <0.05) differed between timepoints, showing an increase in HRV after surgery. Frequency domain parameters LF (low frequency: 0.04 - 0.15 Hz), HF (high frequency 0.15-0.4Hz) in sleep, LF/HF ratio in awake and VLF (very low frequency: < 0.04Hz) also significantly (p <0.05) changed suggesting improved autonomic regulation after surgery.
Conclusion: ANT DBS implantation might positively influence autonomic regulation reflected by increased HRV in drug resistant epilepsy patients undergoing DBS implantation. Prospective studies are needed for further evidence.