Heart rate variability is reduced during the menstrual phase in women with catamenial C1-type temporal lobe epilepsy.

Abstract

INTRODUCTION:

Temporal lobe epilepsy (TLE) is the most frequent focal epilepsy in adulthood. Catamenial C1-type TLE, is characterized by a cyclic seizure exacerbation during the menstrual phase. The heart rate variability (HRV) analysis assesses cardiac autonomic control and may represent a biomarker for Sudden Unexpected Death in Epilepsy (SUDEP). It is plausible that female sex hormones can influence HRV. These changes might be more pronounced in patients suffering from catamenial C1-type TLE where hormonal changes also increase seizure susceptibility. To that aim, we evaluated HRV changes during the menstrual phase of women suffering from catamenial C1-type TLE.

METHODS:

We enrolled 12 adults with a diagnosis of catamenial C1-type TLE (Catamenial Group) and 12 age-, and seizure-frequency-matched controls with TLE (Non-Catamenial Group). Each patient underwent a 20-minute EEG + EKG recording in resting state during the menstrual phase. HRV parameters were calculated with a short-lasting analysis of EKG records. Time domain-related, frequency domain-related, as well as non-linear analysis parameters, were compared between the two groups.

RESULT:

Compared to the Non-Catamenial Group, the Catamenial Group showed significant reductions in SDNN (p-value = 0.01), RMSSD (p-value = 0.04), pNN50 (p-value = 0.001), LnLF ms2 (p-value = 0.05), LnHF ms2 (p-value = 0.007), SD1 (p-value = 0.02), and SD2 (p-value = 0.01). These results were independent from age, disease duration, numbers of ASM, and seizure etiology.

CONCLUSION:

Our data provide experimental evidence that vagal output is reduced during the menstrual phase in patients with catamenial C1-type TLE. These results indicate that, during the menstrual phase, patients with catamenial C1-type TLE may be at a higher risk of developing cardiac dysfunctions and SUDEP.

• Authors: Fedele Dono, Giacomo Evangelista, Stefano Consoli, Giovanna Scorrano, Martina Di Pietro, Maria Vittoria De Angelis, Massimiliano Faustino, Raffaella Franciotti, Francesca Anzellotti, Marco Onofrj, Valerio Frazzini, Catello Vollono, Stefano L Sensi
• Journal: Epilepsy & behavior : E&B (Epilepsy Behav) Vol. 127 Pg. 108508 (02 2022) ISSN: 1525-5069 [Electronic] United States
• PMID: 34974372 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 Elsevier Inc. All rights reserved.

Topics

• Adult
• Autonomic Nervous System
• Epilepsy, Temporal Lobe
• Female
• Heart Rate (physiology)
• Humans
• Seizures
• Sudden Unexpected Death in Epilepsy