Document Detail


Cardiac vagal activation by adrenocorticotropic hormone treatment in infants with West syndrome.
MedLine Citation:
PMID:  17287597     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
West syndrome (WS) is a generalized epileptic syndrome of infancy and early childhood with various etiologies, and consists of a triad of infantile spasm, arrest or regress of psychomotor development and specific electroencephalogram (EEG) pattern of hypsarrhythmia. WS had been believed to be refractory, but recent evidence supports effectiveness of adrenocorticotropic hormone (ACTH) treatment. The ACTH treatment, however, has a problem that it is often accompanied by adverse autonomic symptoms. We therefore examined heart rate variability (HRV) for assessing cardiac autonomic functions in WS and prospectively observed the changes during ACTH treatment. We studied 15 patients with WS and 9 age-matched controls during sleep (EEG stage 2). Compared with controls, the patients with WS were greater in the low-frequency component (LF) of HRV, an index reflecting sympatho-vagal interaction (p = 0.02), but were comparable for high-frequency component (HF) and LF-to-HF ratio (LF/HF), indices reflecting cardiac vagal activity and sympathetic predominance, respectively. During ACTH treatment, heart rate decreased (p < 0.01), LF and HF increased (p < 0.01), and LF/HF did not differ significantly. These results indicate that WS might be accompanied by autonomic changes and that ACTH treatment enhances parasympathetic function and causes bradycardia.
Authors:
Ayako Hattori; Junichiro Hayano; Shinji Fujimoto; Naoki Ando; Kumiko Mizuno; Michi Kamei; Satoru Kobayashi; Tatsuya Ishikawa; Hajime Togari
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  The Tohoku journal of experimental medicine     Volume:  211     ISSN:  0040-8727     ISO Abbreviation:  Tohoku J. Exp. Med.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-08     Completed Date:  2007-03-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417355     Medline TA:  Tohoku J Exp Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  133-9     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Neonatology and Congenital Disorders, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. aykhat@med.nagoya-cu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adrenocorticotropic Hormone / adverse effects*,  pharmacology,  therapeutic use*
Autonomic Nervous System / drug effects*
Bradycardia / chemically induced*
Electrocardiography
Electroencephalography
Heart Rate / drug effects
Humans
Infant
Spasms, Infantile / drug therapy*
Statistics, Nonparametric
Chemical
Reg. No./Substance:
9002-60-2/Adrenocorticotropic Hormone

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


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