Temporal lobe epilepsy surgery significantly reduced low frequency powers of heart rate and systolic blood pressure, as well as baroreflex sensitivity, compared to pre-surgical baseline (P < 0.05).
Observational (n=18)
Does TLE surgery reduce sympathetic cardiovascular modulation in patients with temporal lobe epilepsy?
TLE surgery reduces sympathetic cardiovascular modulation and baroreflex sensitivity, which may help stabilize cardiovascular control and reduce the risk of sudden unexpected death in epilepsy (SUDEP).
p-value: p=< 0.05
In temporal lobe epilepsy (TLE), there is evidence of ictal and interictal autonomic dysregulation, predominantly with sympathetic overactivity. The effects of TLE surgery on autonomic cardiovascular control and on baroreflex sensitivity (BRS) have not been studied. To evaluate such effects, we monitored heart rate (HR), systolic blood pressure (BP(sys)) and respiration in 18 TLE patients 3-4 months before and after TLE surgery. We used Blackman-Tukey spectral analysis to assess sympathetic and parasympathetic modulation as powers of HR and BP(sys) oscillations in the low frequency (LF, 0.04-0.15 Hz) and high frequency (HF, 0.15-0.5 Hz) bands. BRS was determined as the LF transfer function gain between BP and HR. After surgery, HR, BP(sys), respiration and HF powers remained unchanged, while LF powers of HR (1.57 +/- 1.54 bpm(2)) and BP(sys) (2.19 +/- 1.34 mmHg(2)) and BRS (0.68 +/- 0.31 bpm/mmHg) were smaller than pre-surgical LF powers of HR (3.87 +/- 3.26 bpm(2)) and BP(sys) (4.80 +/- 3.84 mmHg(2)) and BRS (1.12 +/- 0.39 bpm/mmHg; P < 0.05). After TLE surgery, there is a reduction of sympathetic cardiovascular modulation and BRS that might result from decreased influences of interictal epileptogenic discharges on brain areas involved in cardiovascular autonomic control. TLE surgery seems to stabilize the cardiovascular control in epilepsy patients by reducing the risk of sympathetically mediated tachyarrhythmias and excessive bradycardiac counter-regulation, both of which might be relevant for the pathophysiology of sudden unexpected death in epilepsy patients (SUDEP). Thus, TLE surgery might contribute to reducing the risk of SUDEP.
Hilz et al. (Wed,) conducted a observational in Temporal lobe epilepsy (TLE) (n=18). Temporal lobe epilepsy (TLE) surgery vs. Pre-surgical baseline was evaluated on Sympathetic and parasympathetic modulation (LF and HF powers of HR and BPsys) and baroreflex sensitivity (BRS) (p=< 0.05). Temporal lobe epilepsy surgery significantly reduced low frequency powers of heart rate and systolic blood pressure, as well as baroreflex sensitivity, compared to pre-surgical baseline (P < 0.05).