Key result
The pre-ictal phase 5 minutes before seizure onset was associated with significant tachycardia compared to baseline 240 minutes prior (119.36 vs 66.52 bpm; p=0.0207).
Why the study?
Does heart rate variability analysis detect significant autonomic changes in the pre-ictal phase of epileptic seizures compared to baseline?
Observational (n=12)
Does heart rate variability analysis detect significant autonomic changes in the pre-ictal phase of epileptic seizures compared to baseline?
Absolute Event Rate: 119.36% vs 66.52%
p-value: p=0.0207
Significant changes in linear and non-linear HRV parameters occur 5 minutes before an epileptic seizure, suggesting potential for early seizure detection algorithms.
May support pre-seizure alert algorithms; hypothesis-generating pending prospective validation.
OBJECTIVE: The purpose of the present study was to analyze the effects of epilepsy on the autonomic control of the heart in pre-ictal phase in order to find an algorithm of early detection of seizure onset. METHODS: Overall 133 epileptic seizures were analyzed from 12 patients with epilepsy (seven males and five females; mean age 43.91 years, SD: 10.16) participated in this study. Single lead electrocardiogram recordings of epileptic patients were compiled. 240, 90-30, 30-10 and 5 minutes heart rate variability (HRV) signals of preseizure were chosen for analysis of heart rate. As HRV signals are non-stationary, a set of time and frequency domain features (Mean HR, Triangular Index, LF, HF, LF/HF) and nonlinear parameters (SD1, SD2 and SD2/SD1 indices derived from Poincare plots) extracted from HRV is analyzed. Statistical analysis was performed using paired sample t-test for comparisons of the segments and differences between pre-ictal segments were evaluated by Tukey tests. RESULTS: There was slight tachycardia in segments near the seizure (30 minutes before: 85.3517 bpm, 5 minutes before: 119.3630.82 bpm, p=0.0207) which significantly differ from baseline in segments far from seizure (240 minutes before: 66.5211.7 bpm). Also there was significant increase in LF/HF ratio (30 minutes before: 1.10.22, 5 minutes before: 2.120.5, p=0.0332) and SD2/SD1 ratio (30 minutes before: 1.20.15, 5 minutes before: 2.030.55, p=0.0431) when compared to segments far from the seizure (240 minutes before: 0.780.24 and 0.780.14) respectively. Although there was about decrease of triangular index in segments near the seizure the percentage of decrease was not comparable to segments far from the seizure. CONCLUSION: Significant changes of HRV parameters in pre-ictal (5 minutes before the seizure) are obviously higher in comparison to interictal baseline. Pre-ictal significant changes of HRV suggesting that this time can be considered as prediction time for designing an algorithm of early detection of seizure onset based on HRV.
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Behbahani et al. (2013) conducted an observational in Epilepsy (n=12). Pre-ictal phase (5 minutes before seizure) vs. Interictal baseline (240 minutes before seizure) was evaluated on Mean heart rate (p=0.0207). The pre-ictal phase 5 minutes before seizure onset was associated with significant tachycardia compared to baseline 240 minutes prior (119.36 vs 66.52 bpm; p=0.0207).
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