The potential of cortical electrical stimulation for the study of autonomic dysfunction in patients with epilepsy

Autonomic disorders, including changes in heart rate, blood pressure, and respiration parameters, are some of the clinical manifestations of epileptic seizures, and their nature and severity may provide information about the localization of the epileptic focus. The origin of seizures from specific cortical structures of the brain, which belong to the central autonomic network and are involved in the autonomic regulation of vital functions, is often accompanied by typical changes in systemic hemodynamics and respiration; however, the pathogenesis of these processes is poorly understood. Modern approaches to examining patients with epilepsy, particularly the implantation of depth electrodes and direct cortical electrical stimulation of brain regions involved in autonomic regulation, enable the study of autonomic changes during an epileptic seizure with a direct connection to the studied cortical structure. The study of the relationship between the cortical centers of autonomic regulation and the function of the cardiovascular system, as part of the brain-heart axis concept, is a key area of neurocardiology and is important for understanding the pathogenesis and potential prevention of life-threatening conditions in patients with epilepsy.