Author: Constantinescu V1, Matei D2, Constantinescu I3, Cuciureanu DI1
Affiliation: <sup>1</sup>Neurology Department, Faculty of Medicine, University of Medicine and Pharmacy Iasi, Iasi Romania.
<sup>2</sup>Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy Iasi, Iasi Romania.
<sup>3</sup>Neurology Department, Regional Hospital of Orléans, Orléans France.
Conference/Journal: Transl Neurosci.
Date published: 2019 Aug 24
Other:
Volume ID: 10 , Pages: 223-232 , Special Notes: doi: 10.1515/tnsci-2019-0036. eCollection 2019. , Word Count: 226
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.
KEYWORDS: cardiac autonomic modulation; drug-resistant epilepsy; heart rate variability; multiple trigonometric regressive spectral analysis; sympathetic and parasympathetic activation tests; sympathovagal balance; vagus nerve stimulation
PMID: 31497318 PMCID: PMC6708288 DOI: 10.1515/tnsci-2019-0036