Document Detail


Autonomic changes with seizures correlate with postictal EEG suppression.
MedLine Citation:
PMID:  22539579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Sudden unexpected death in epilepsy (SUDEP) poses a poorly understood but considerable risk to people with uncontrolled epilepsy. There is controversy regarding the significance of postictal generalized EEG suppression as a biomarker for SUDEP risk, and it remains unknown whether postictal EEG suppression has a neurologic correlate. Here, we examined the profile of autonomic alterations accompanying seizures with a wrist-worn biosensor and explored the relationship between autonomic dysregulation and postictal EEG suppression.
METHODS: We used custom-built wrist-worn sensors to continuously record the sympathetically mediated electrodermal activity (EDA) of patients with refractory epilepsy admitted to the long-term video-EEG monitoring unit. Parasympathetic-modulated high-frequency (HF) power of heart rate variability was measured from concurrent EKG recordings.
RESULTS: A total of 34 seizures comprising 22 complex partial and 12 tonic-clonic seizures from 11 patients were analyzed. The postictal period was characterized by a surge in EDA and heightened heart rate coinciding with persistent suppression of HF power. An increase in the EDA response amplitude correlated with an increase in the duration of EEG suppression (r = 0.81, p = 0.003). Decreased HF power correlated with an increase in the duration of EEG suppression (r = -0.87, p = 0.002).
CONCLUSION: The magnitude of both sympathetic activation and parasympathetic suppression increases with duration of EEG suppression after tonic-clonic seizures. These results provide autonomic correlates of postictal EEG suppression and highlight a critical window of postictal autonomic dysregulation that may be relevant in the pathogenesis of SUDEP.
Authors:
M-Z Poh; T Loddenkemper; C Reinsberger; N C Swenson; S Goyal; J R Madsen; R W Picard
Related Documents :
8319059 - Colour doppler and duplex ultrasound assessment of peyronie's disease in impotent men.
20630689 - Clinical course of asymptomatic patients with carotid duplex scan end diastolic velocit...
11851769 - New concept parameters of rigiscan in differentiation of vascular erectile dysfunction:...
17907509 - Prediction of premature atherosclerosis by endothelial dysfunction and increased intima...
10466989 - Cerebral ischemic disease and morphometric analyses of carotid plaques.
18418229 - Endothelial dysfunction and carotid lesions are strong predictors of clinical events in...
11759979 - Impact of liver cirrhosis on nutritional and immunological status.
18302559 - A preliminary study of simple voice assessment in a routine clinical setting to predict...
17992509 - Acute disseminated encephalomyelitisin the intensive care unit:clinical features and ou...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-04-25
Journal Detail:
Title:  Neurology     Volume:  78     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-05     Completed Date:  2012-08-09     Revised Date:  2013-06-25    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1868-76     Citation Subset:  AIM; IM    
Affiliation:
Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA. zher@mit.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Autonomic Nervous System / physiopathology*
Death, Sudden / etiology
Electrocardiography
Electroencephalography*
Epilepsy / complications*,  physiopathology*
Galvanic Skin Response / physiology*
Heart Rate / physiology
Humans
Seizures / physiopathology
Single-Blind Method
Comments/Corrections
Comment In:
Neurology. 2013 Apr 16;80(16):1538-9   [PMID:  23589642 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Genotype patterns at PICALM, CR1, BIN1, CLU, and APOE genes are associated with episodic memory.
Next Document:  Phenotype and genotype analysis in amyotrophic lateral sclerosis with TARDBP gene mutations.