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Chronic vagus nerve stimulation reverses heart rhythm complexity in patients with drug-resistant epilepsy: An assessment with multiscale entropy analysis.

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机构： [a]National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing 100084, China [b]Department of Biomedical Engineering, Chinese PLA General Hospital, Beijing 100853, China [c]Beijing Neurosurgical Institute, 100050 Beijing, China [d]Neurosurgery, Beijing Tian Tan Hospital Capital Medical University, 100050 Beijing, China [e]Man-Machine-Environment Engineering Institute, School of Aerospace Engineering, Tsinghua University, 100084 Beijing, China [f]Precision Medicine & Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute, 518055 Shenzhen, China [g]Center of Epilepsy, Beijing Institute for Brain Disorders, 100069 Beijing, China

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关键词： Drug-resistant epilepsy Vagus nerve stimulation Heart rate variability Complexity Multiscale entropy

摘要：

Vagus nerve stimulation (VNS) is an adjunctive treatment in drug-resistant epilepsy. The alterations in heart rate dynamics through VNS are not well understood. This study aimed to determine changes in heart rhythm complexity in association with VNS and to relate the findings to the outcome of VNS treatment in patients with drug-resistant epilepsy. We prospectively analyzed 32 patients with drug-resistant epilepsy, who underwent VNS implantation, and 32 age- and sex-matched healthy control subjects. The interictal heartbeat intervals were analyzed using the heart rhythm complexity with multiscale entropy (MSE) and traditional heart rate variability (HRV) analyses based on ambulatory 24-hour electrocardiograms (ECGs). Patients had significantly decreased complexity indices (Slope 5, Area 1-5, Area 6-15, Area 6-20) on MSE analysis and decreased HRV measurements (standard deviation of the heartbeat interval (SDNN), square root of the mean of sum of squares of the differences between adjacent RR intervals (RMSSD), pNN50, very low frequency (VLF), low frequency (LF), high frequency (HF), total power (TP)) in time and frequency domain analyses. After one year of VNS treatment in patients with drug-resistant epilepsy, there was a trend in an elevated MSE profile with significant higher values between the scales 1 and 9. Vagus nerve stimulation induces a more significant increase of MSE in VNS responders than those in the nonresponders. The conventional HRV measurements did not change. Our results suggest that heart rhythm complexity is impaired in patients with drug-resistant epilepsy, and this is at least partially reversed by VNS treatment. Furthermore, VNS-induced effects on heart rate complexity may be associated with the therapeutic response to VNS in patients with drug-resistant epilepsy. Copyright © 2018 Elsevier Inc. All rights reserved.

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出版当年[2017]版：

大类 | 3 区医学

小类 | 3 区行为科学 3 区临床神经病学 4 区精神病学

最新[2023]版：

大类 | 3 区医学

小类 | 3 区行为科学 3 区精神病学 4 区临床神经病学

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出版当年[2016]版：

Q2 PSYCHIATRY Q2 BEHAVIORAL SCIENCES Q2 CLINICAL NEUROLOGY

最新[2023]版：

Q2 PSYCHIATRY Q2 BEHAVIORAL SCIENCES Q3 CLINICAL NEUROLOGY

影响因子： 2.3 最新[2023版] 2.5 最新五年平均 2.631 出版当年[2016版] 2.522 出版当年五年平均 2.332 出版前一年[2015版] 2.6 出版后一年[2017版]

第一作者：

第一作者机构： [a]National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing 100084, China [b]Department of Biomedical Engineering, Chinese PLA General Hospital, Beijing 100853, China

通讯作者：

通讯机构： [a]National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing 100084, China [e]Man-Machine-Environment Engineering Institute, School of Aerospace Engineering, Tsinghua University, 100084 Beijing, China [f]Precision Medicine & Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute, 518055 Shenzhen, China [g]Center of Epilepsy, Beijing Institute for Brain Disorders, 100069 Beijing, China [*1]School of Aerospace Engineering, Tsinghua University, Room_204, North Part, Mengminwei Technology Building, Beijing 100084, China.

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Chronic vagus nerve stimulation reverses heart rhythm complexity in patients with drug-resistant epilepsy: An assessment with multiscale entropy analysis.

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