Impairment of Cardiac Autonomic Nerve Function in Pre-school Children With Intractable Epilepsy
Autor: | Zhao Yang, Tung-Yang Cheng, Jin Deng, Zhiyan Wang, Xiaoya Qin, Xi Fang, Yuan Yuan, Hongwei Hao, Yuwu Jiang, Jianxiang Liao, Fei Yin, Yanhui Chen, Liping Zou, Baomin Li, Yuxing Gao, Xiaomei Shu, Shaoping Huang, Feng Gao, Jianmin Liang, Luming Li |
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Rok vydání: | 2020 |
Předmět: |
0301 basic medicine
Cardiac function curve medicine.medical_specialty Intractable epilepsy 03 medical and health sciences Epilepsy 0302 clinical medicine Internal medicine Heart rate Medicine Heart rate variability Entropy (energy dispersal) RC346-429 Original Research Autonomic nerve Receiver operating characteristic business.industry pre-school children intractable epilepsy heart rate variability multiscale entropy medicine.disease symbolization entropy 030104 developmental biology Neurology Cardiology Neurology. Diseases of the nervous system Neurology (clinical) business 030217 neurology & neurosurgery |
Zdroj: | Frontiers in Neurology Frontiers in Neurology, Vol 12 (2021) |
ISSN: | 1664-2295 |
Popis: | Objective: Intractable epilepsy and uncontrolled seizures could affect cardiac function and the autonomic nerve system with a negative impact on children's growth. The aim of this study was to investigate the variability and complexity of cardiac autonomic function in pre-school children with pediatric intractable epilepsy (PIE).Methods: Twenty four-hour Holter electrocardiograms (ECGs) from 93 patients and 46 healthy control subjects aged 3–6 years were analyzed by the methods of traditional heart rate variability (HRV), multiscale entropy (MSE), and Kurths–Wessel symbolization entropy (KWSE). Receiver operating characteristic (ROC) curve analysis was used to estimate the overall discrimination ability. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) models were also analyzed.Results: Pre-school children with PIE had significantly lower HRV measurements than healthy controls in time (Mean_RR, SDRR, RMSSD, pNN50) and frequency (VLF, LF, HF, LF/HF, TP) domains. For the MSE analysis, area 1_5 in awake state was lower, and areas 6_15 and 6_20 in sleep state were higher in PIE with a significant statistical difference. KWSE in the PIE group was also inferior to that in healthy controls. In ROC curve analysis, pNN50 had the greatest discriminatory power for PIE. Based on both NRI and IDI models, the combination of MSE indices (wake: area1_5 and sleep: area6_20) and KWSE (m = 2, τ = 1, α = 0.16) with traditional HRV measures had greater discriminatory power than any of the single HRV measures.Significance: Impaired HRV and complexity were found in pre-school children with PIE. HRV, MSE, and KWSE could discriminate patients with PIE from subjects with normal cardiac complexity. These findings suggested that the MSE and KWSE methods may be helpful for assessing and understanding heart rate dynamics in younger children with epilepsy. |
Databáze: | OpenAIRE |
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