Vagus nerve stimulation induces changes in respiratory sinus arrhythmia of epileptic children during sleep
Autor: | Fabrice Wallois, Boubker Zaaimi, Patrick Berquin, Reinhard Grebe |
---|---|
Rok vydání: | 2009 |
Předmět: |
Male
Adolescent Vagus Nerve Stimulation Respiratory rate Polysomnography medicine.medical_treatment Autonomic Nervous System Electrocardiography Heart Rate Heart rate medicine Humans Arrhythmia Sinus Respiratory system Vagal tone Child Epilepsy medicine.diagnostic_test business.industry Electroencephalography Heart Respiration Disorders Vagus nerve Autonomic nervous system Autonomic Nervous System Diseases Neurology Anesthesia Female Neurology (clinical) Sleep business Vagus nerve stimulation |
Zdroj: | Epilepsia. 50:2473-2480 |
ISSN: | 1528-1167 0013-9580 |
Popis: | Summary Purpose: This study analyzed the direct short-term effect of vagus nerve stimulation (VNS) on respiratory sinus arrhythmia (RSA) in children with pharmacoresistant epilepsy. Methods: RSA magnitude is calculated as the ratio between maximum and minimum heart rate for each respiratory cycle—before, during, and after the actual VNS period. In 10 children, changes in RSA magnitude were evaluated on polysomnographic recordings, including electrocardiography (ECG), electroencephalography (EEG), thoracoabdominal distension, nasal airflow, and VNS artifacts. Measurements during stimulation were compared with those at baseline, immediately preceding the VNS periods and individually for each patient. Result: During VNS, respiratory frequency increased and respiratory amplitude decreased with a variable effect on cardiac activity. The coupling between heart rate and respiratory rate was disturbed and RSA magnitude decreased significantly in 6 of 10 children during VNS. These changes in RSA magnitude varied from one child to another. The observed changes for respiratory and cardiac activity were concomitant with changes in RSA but were not correlated. Conclusion: Together with disorders of respiration, cardiac activity, and oxygen saturation (SaO2) described previously. VNS also modifies synchronization between cardiac and respiratory activity, resulting in poor optimization of oxygen delivery to tissues that can be regarded as an additive side effect, which should be considered in patients with already altered brain function. This interaction between the effects of VNS and potential autonomic nervous system (ANS) dysfunction already reported in epileptic patients should be considered to be potentially life-threatening. In addition, evaluation of changes in respiratory parameters can also provide reliable markers for further evaluation of the effectiveness of VNS. |
Databáze: | OpenAIRE |
Externí odkaz: |