Key result
Vagus nerve stimulation for 3 months in 5 patients with drug-resistant epilepsy did not disrupt cardiac autonomic function, maintaining appropriate responses to autonomic activation tests.
Why the study?
The influence of VNS on cardiovascular autonomic function in drug-resistant epilepsy patients remains debated.
Does vagus nerve stimulation affect cardiovascular autonomic function measured by heart rate variability in drug-resistant epilepsy patients?
Observational (n=5)
Does vagus nerve stimulation affect cardiovascular autonomic function measured by heart rate variability in drug-resistant epilepsy patients?
Vagus nerve stimulation for three months in epilepsy patients does not appear to disrupt cardiac autonomic function as measured by heart rate variability.
May support cardiac safety of vagus nerve stimulation in epilepsy; leaves open validation in larger trials.
BACKGROUND: Vagus nerve stimulation (VNS) exerts a cortical modulating effect through its diffuse projections, especially involving cerebral structures related to autonomic regulation. The influence of VNS on cardiovascular autonomic function in drug-resistant epilepsy patients is still debated. We aimed to evaluate the impact of VNS on cardiovascular autonomic function in drug-resistant epilepsy patients, after three months of neurostimulation, using the heart rate variability (HRV) analysis. METHODOLOGY: Multiple Trigonometric Regressive Spectral analysis enables a precise assessment of the autonomic control on the heart rate. We evaluated time and frequency-domain HRV parameters in resting condition and during sympathetic and parasympathetic activation tests in five epilepsy patients who underwent VNS procedure. RESULTS: We found appropriate cardiac autonomic responses to sympathetic and parasympathetic activation tests, described by RMSSD, pNN50, HF and LF/HF dynamics after three months of VNS. ON period of the neurostimulation may generate a transient vagal activation reflected on heart rate and RMSSD values, as observed in one of our cases. CONCLUSION: VNS therapy in epilepsy patients seems not to disrupt the cardiac autonomic function. HRV represents a useful tool in evaluating autonomic activity. More extensive studies are needed to further explore cardiac autonomic response after neurostimulation.
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Constantinescu et al. (2019) conducted an observational in drug-resistant epilepsy (n=5). Vagus nerve stimulation was evaluated on cardiovascular autonomic function (time and frequency-domain HRV parameters). Vagus nerve stimulation for 3 months in 5 patients with drug-resistant epilepsy did not disrupt cardiac autonomic function, maintaining appropriate responses to autonomic activation tests.
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