Heart-rate variability indices as predictors of the response to vagus nerve stimulation in patients with drug-resistant epilepsy.
Kristen Sparrow • August 05, 2019
I came across this article while reading a recent review of the engineering behind auricular vagal nerve stimulation. This was at the tail end of the paper, and I have to admit, I feel validated. The first poster and publication I did was on the correlation between clinical responders and their change in HRV for the better. That was a very long time ago. It looks like this phenonomenon may hold up for implanted vagal nerve stimulation in addition to acupuncture. Amazing.
Heart-rate variability indices as predictors of the response to vagus nerve stimulation in patients with drug-resistant epilepsy.
Abstract
OBJECTIVE:
To assess heart-rate variability (HRV) measures of interictal electrocardiography (ECG) for drug-resistant epilepsy and to relate the findings to the outcome of vagus nerve stimulation (VNS) treatment.
METHODS:
Time-domain, frequency-domain, and nonlinear analyses were used to analyze preoperative HRV measures in 32 patients with drug-resistant epilepsy who had received VNS implants at the same hospital and 32 healthy age- and sex-matched control subjects. HRV measurements based on ambulatory 24 h ECG recordings were analyzed to identify seizure reduction 1 year after VNS treatment. Responders were defined as having at least 50% seizure reduction 1 year after treatment.
RESULTS:
Patients with drug-resistant epilepsy had significantly lower time domain (SDNN, RMSSD, pNN50), frequency domain (VLF, LF, HF, TP), and nonlinear (SD1, SD2) HRV measurements than matched healthy controls. None of the analyzed HRV measures of the responders differed significantly from their controls, whereas those of the nonresponders had significantly lower RMSSD, pNN50, HF, and SD1 than the responders.
SIGNIFICANCE:
The preoperative HRV indices demonstrate that nonresponders have more pronounced impairment of their cardiac autonomic function than the responders. Presurgical HRV measurements representing parasympathetic cardiac control or vagal tone were significantly associated with the responsiveness to VNS. Thus the measurements show promise for predicting the reduction of seizure frequency after VNS treatment.
