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. 2019 Aug 24:10:223-232.
doi: 10.1515/tnsci-2019-0036. eCollection 2019.

Heart Rate Variability and Vagus Nerve Stimulation in Epilepsy Patients

Victor Constantinescu  1 , Daniela Matei  2 , Irina Constantinescu  3 , Dan Iulian Cuciureanu  1
Affiliations

Heart Rate Variability and Vagus Nerve Stimulation in Epilepsy Patients

Victor Constantinescu et al. Transl Neurosci. .

Abstract

Background: Vagus nerve stimulation (VNS) exerts a cortical modulating effect through its diffuse projections, especially involving cerebral structures related to autonomic regulation. The influence of VNS on cardiovascular autonomic function in drug-resistant epilepsy patients is still debated. We aimed to evaluate the impact of VNS on cardiovascular autonomic function in drug-resistant epilepsy patients, after three months of neurostimulation, using the heart rate variability (HRV) analysis.

Methodology: Multiple Trigonometric Regressive Spectral analysis enables a precise assessment of the autonomic control on the heart rate. We evaluated time and frequency-domain HRV parameters in resting condition and during sympathetic and parasympathetic activation tests in five epilepsy patients who underwent VNS procedure.

Results: We found appropriate cardiac autonomic responses to sympathetic and parasympathetic activation tests, described by RMSSD, pNN50, HF and LF/HF dynamics after three months of VNS. ON period of the neurostimulation may generate a transient vagal activation reflected on heart rate and RMSSD values, as observed in one of our cases.

Conclusion: VNS therapy in epilepsy patients seems not to disrupt the cardiac autonomic function. HRV represents a useful tool in evaluating autonomic activity. More extensive studies are needed to further explore cardiac autonomic response after neurostimulation.

Keywords: cardiac autonomic modulation; drug-resistant epilepsy; heart rate variability; multiple trigonometric regressive spectral analysis; sympathetic and parasympathetic activation tests; sympathovagal balance; vagus nerve stimulation.

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Figures

Figure 1
Figure 1
HRV parameters of the five patients. RS=resting state, DB=deep breathing test, HG=hand-grip test, ST=standing test, VA=Valsalva maneuver, formula imageTest 1, formula imageTest 2
Figure 2
Figure 2
HRV parameters of the third patient in resting state during test 2
Figure 3
Figure 3
RMSSD values of the third patient in resting state during test 2
See this image and copyright information in PMC

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