Power spectrum analysis of heart rate variability in children with epilepsy

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Yang TF, Wong TT, Chang KP, Kwan SY, Kuo WY, Lee YC, and Kuo TB (2001) Power spectrum analysis of heart rate variability in children with epilepsy. Childs Nerv Syst 17:10 602–6.

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Abstract: OBJECT: Children with epilepsy have been found to be at increased risk of death during childhood. Sudden unexpected death (SUDEP) has accounted for at least 12% of deaths of children with epilepsy. The exact mechanisms of SUDEP are unknown; however, theories suggested have, to date, focused on autonomic instability. The purpose of this study was to investigate autonomic function in children with chronic epilepsy by means of power spectrum analysis of heart rate variability. METHODS: Thirty patients with epilepsy and 30 control subjects, all between the ages of 4 and 10 years, were enrolled in this study. Power spectrum analysis of heart rate variability (HRV) was performed under standardized conditions after the patients had rested for 15 min. Each patient was tested in a supine position first and then again in a head-up tilted position, with 15 min between the two tests. RESULTS: There was no significant difference between the low-frequency component (LF) and the high-frequency component (HF) of heart rate variability, or the LF/HF ratio, between the study and control groups, whether the test subjects were in the supine or the head-up tilt position. In the control group, however, the subjects showed a significantly greater LF component and a smaller HF component of heart rate variability, and a greater LF/HF ratio in the head-up position than in the supine position. This implies a normal sympathovagal balance. This phenomenon was not observed in the study group. This implies that the modulating effects on autonomic function deriving from the hemisphere were probably disturbed, owing to the brain lesions that each of the study group patients had already sustained. CONCLUSIONS: A disturbed balance of activity between the sympathetic and parasympathetic nervous system might result from the loss of hemispheric influence in patients with epilepsy. Nevertheless, further investigation is clearly necessary to ascertain the possible association of this disturbed balance with SUDEP. Further investigation is also needed to establish the exact location of the region in the brain that gives rise to this modulating influence.

Keywords: Power spectrum analysis · Heart rate variability · Epilepsy · Sudden unexpected death · Autonomic function

Context

  • Comparison of children with and without epilepsy, with 30 children in each group. Subjects rested supineon a tilt table for 15 min and were then made head-up at a 15 degree angle. In children with epilepsy, in contrast to controls, low-frequency variation in heart rate did not change significantly after this change in position. This may suggest impaired autonomic control.

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