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Autonomic Dysfunction Contributes to Impairment of Cerebral Autoregulation in Patients with Epilepsy

Patients with epilepsy frequently experience autonomic dysfunction and impaired cerebral autoregulation. The present study investigates autonomic function and cerebral autoregulation in patients with epilepsy to determine whether these factors contribute to impaired autoregulation. A total of 81 pat...

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Autores principales: Chen, Shu-Fang, Pan, Hsiu-Yung, Huang, Chi-Ren, Huang, Jyun-Bin, Tan, Teng-Yeow, Chen, Nai-Ching, Hsu, Chung-Yao, Chuang, Yao-Chung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073240/
https://www.ncbi.nlm.nih.gov/pubmed/33920691
http://dx.doi.org/10.3390/jpm11040313
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author Chen, Shu-Fang
Pan, Hsiu-Yung
Huang, Chi-Ren
Huang, Jyun-Bin
Tan, Teng-Yeow
Chen, Nai-Ching
Hsu, Chung-Yao
Chuang, Yao-Chung
author_facet Chen, Shu-Fang
Pan, Hsiu-Yung
Huang, Chi-Ren
Huang, Jyun-Bin
Tan, Teng-Yeow
Chen, Nai-Ching
Hsu, Chung-Yao
Chuang, Yao-Chung
author_sort Chen, Shu-Fang
collection PubMed
description Patients with epilepsy frequently experience autonomic dysfunction and impaired cerebral autoregulation. The present study investigates autonomic function and cerebral autoregulation in patients with epilepsy to determine whether these factors contribute to impaired autoregulation. A total of 81 patients with epilepsy and 45 healthy controls were evaluated, assessing their sudomotor, cardiovagal, and adrenergic functions using a battery of autonomic nervous system (ANS) function tests, including the deep breathing, Valsalva maneuver, head-up tilting, and Q-sweat tests. Cerebral autoregulation was measured by transcranial Doppler examination during the breath-holding test, the Valsalva maneuver, and the head-up tilting test. Autonomic functions were impaired during the interictal period in patients with epilepsy compared to healthy controls. The three indices of cerebral autoregulation—the breath-holding index (BHI), an autoregulation index calculated in phase II of the Valsalva maneuver (ASI), and cerebrovascular resistance measured in the second minute during the head-up tilting test (CVR(2-min))—all decreased in patients with epilepsy. ANS dysfunction correlated significantly with impairment of cerebral autoregulation (measured by BHI, ASI, and CVR(2-min)), suggesting that the increased autonomic dysfunction in patients with epilepsy may augment the dysregulation of cerebral blood flow. Long-term epilepsy, a high frequency of seizures, and refractory epilepsy, particularly temporal lobe epilepsy, may contribute to advanced autonomic dysfunction and impaired cerebral autoregulation. These results have implications for therapeutic interventions that aim to correct central autonomic dysfunction and impairment of cerebral autoregulation, particularly in patients at high risk for sudden, unexplained death in epilepsy.
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spelling pubmed-80732402021-04-27 Autonomic Dysfunction Contributes to Impairment of Cerebral Autoregulation in Patients with Epilepsy Chen, Shu-Fang Pan, Hsiu-Yung Huang, Chi-Ren Huang, Jyun-Bin Tan, Teng-Yeow Chen, Nai-Ching Hsu, Chung-Yao Chuang, Yao-Chung J Pers Med Article Patients with epilepsy frequently experience autonomic dysfunction and impaired cerebral autoregulation. The present study investigates autonomic function and cerebral autoregulation in patients with epilepsy to determine whether these factors contribute to impaired autoregulation. A total of 81 patients with epilepsy and 45 healthy controls were evaluated, assessing their sudomotor, cardiovagal, and adrenergic functions using a battery of autonomic nervous system (ANS) function tests, including the deep breathing, Valsalva maneuver, head-up tilting, and Q-sweat tests. Cerebral autoregulation was measured by transcranial Doppler examination during the breath-holding test, the Valsalva maneuver, and the head-up tilting test. Autonomic functions were impaired during the interictal period in patients with epilepsy compared to healthy controls. The three indices of cerebral autoregulation—the breath-holding index (BHI), an autoregulation index calculated in phase II of the Valsalva maneuver (ASI), and cerebrovascular resistance measured in the second minute during the head-up tilting test (CVR(2-min))—all decreased in patients with epilepsy. ANS dysfunction correlated significantly with impairment of cerebral autoregulation (measured by BHI, ASI, and CVR(2-min)), suggesting that the increased autonomic dysfunction in patients with epilepsy may augment the dysregulation of cerebral blood flow. Long-term epilepsy, a high frequency of seizures, and refractory epilepsy, particularly temporal lobe epilepsy, may contribute to advanced autonomic dysfunction and impaired cerebral autoregulation. These results have implications for therapeutic interventions that aim to correct central autonomic dysfunction and impairment of cerebral autoregulation, particularly in patients at high risk for sudden, unexplained death in epilepsy. MDPI 2021-04-17 /pmc/articles/PMC8073240/ /pubmed/33920691 http://dx.doi.org/10.3390/jpm11040313 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chen, Shu-Fang
Pan, Hsiu-Yung
Huang, Chi-Ren
Huang, Jyun-Bin
Tan, Teng-Yeow
Chen, Nai-Ching
Hsu, Chung-Yao
Chuang, Yao-Chung
Autonomic Dysfunction Contributes to Impairment of Cerebral Autoregulation in Patients with Epilepsy
title Autonomic Dysfunction Contributes to Impairment of Cerebral Autoregulation in Patients with Epilepsy
title_full Autonomic Dysfunction Contributes to Impairment of Cerebral Autoregulation in Patients with Epilepsy
title_fullStr Autonomic Dysfunction Contributes to Impairment of Cerebral Autoregulation in Patients with Epilepsy
title_full_unstemmed Autonomic Dysfunction Contributes to Impairment of Cerebral Autoregulation in Patients with Epilepsy
title_short Autonomic Dysfunction Contributes to Impairment of Cerebral Autoregulation in Patients with Epilepsy
title_sort autonomic dysfunction contributes to impairment of cerebral autoregulation in patients with epilepsy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073240/
https://www.ncbi.nlm.nih.gov/pubmed/33920691
http://dx.doi.org/10.3390/jpm11040313
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