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Multiday cycles of heart rate are associated with seizure likelihood: An observational cohort study

BACKGROUND: Circadian and multiday rhythms are found across many biological systems, including cardiology, endocrinology, neurology, and immunology. In people with epilepsy, epileptic brain activity and seizure occurrence have been found to follow circadian, weekly, and monthly rhythms. Understandin...

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Autores principales: Karoly, Philippa J., Stirling, Rachel E., Freestone, Dean R., Nurse, Ewan S., Maturana, Matias I., Halliday, Amy J., Neal, Andrew, Gregg, Nicholas M., Brinkmann, Benjamin H., Richardson, Mark P., La Gerche, Andre, Grayden, David B., D'Souza, Wendyl, Cook, Mark J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517288/
https://www.ncbi.nlm.nih.gov/pubmed/34649079
http://dx.doi.org/10.1016/j.ebiom.2021.103619
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author Karoly, Philippa J.
Stirling, Rachel E.
Freestone, Dean R.
Nurse, Ewan S.
Maturana, Matias I.
Halliday, Amy J.
Neal, Andrew
Gregg, Nicholas M.
Brinkmann, Benjamin H.
Richardson, Mark P.
La Gerche, Andre
Grayden, David B.
D'Souza, Wendyl
Cook, Mark J.
author_facet Karoly, Philippa J.
Stirling, Rachel E.
Freestone, Dean R.
Nurse, Ewan S.
Maturana, Matias I.
Halliday, Amy J.
Neal, Andrew
Gregg, Nicholas M.
Brinkmann, Benjamin H.
Richardson, Mark P.
La Gerche, Andre
Grayden, David B.
D'Souza, Wendyl
Cook, Mark J.
author_sort Karoly, Philippa J.
collection PubMed
description BACKGROUND: Circadian and multiday rhythms are found across many biological systems, including cardiology, endocrinology, neurology, and immunology. In people with epilepsy, epileptic brain activity and seizure occurrence have been found to follow circadian, weekly, and monthly rhythms. Understanding the relationship between these cycles of brain excitability and other physiological systems can provide new insight into the causes of multiday cycles. The brain-heart link has previously been considered in epilepsy research, with potential implications for seizure forecasting, therapy, and mortality (i.e., sudden unexpected death in epilepsy). METHODS: We report the results from a non-interventional, observational cohort study, Tracking Seizure Cycles. This study sought to examine multiday cycles of heart rate and seizures in adults with diagnosed uncontrolled epilepsy (N=31) and healthy adult controls (N=15) using wearable smartwatches and mobile seizure diaries over at least four months (M=12.0, SD=5.9; control M=10.6, SD=6.4). Cycles in heart rate were detected using a continuous wavelet transform. Relationships between heart rate cycles and seizure occurrence were measured from the distributions of seizure likelihood with respect to underlying cycle phase. FINDINGS: Heart rate cycles were found in all 46 participants (people with epilepsy and healthy controls), with circadian (N=46), about-weekly (N=25) and about-monthly (N=13) rhythms being the most prevalent. Of the participants with epilepsy, 19 people had at least 20 reported seizures, and 10 of these had seizures significantly phase locked to their multiday heart rate cycles. INTERPRETATION: Heart rate cycles showed similarities to multiday epileptic rhythms and may be comodulated with seizure likelihood. The relationship between heart rate and seizures is relevant for epilepsy therapy, including seizure forecasting, and may also have implications for cardiovascular disease. More broadly, understanding the link between multiday cycles in the heart and brain can shed new light on endogenous physiological rhythms in humans. FUNDING: This research received funding from the Australian Government National Health and Medical Research Council (investigator grant 1178220), the Australian Government BioMedTech Horizons program, and the Epilepsy Foundation of America's ‘My Seizure Gauge’ grant.
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spelling pubmed-85172882021-10-21 Multiday cycles of heart rate are associated with seizure likelihood: An observational cohort study Karoly, Philippa J. Stirling, Rachel E. Freestone, Dean R. Nurse, Ewan S. Maturana, Matias I. Halliday, Amy J. Neal, Andrew Gregg, Nicholas M. Brinkmann, Benjamin H. Richardson, Mark P. La Gerche, Andre Grayden, David B. D'Souza, Wendyl Cook, Mark J. EBioMedicine Research paper BACKGROUND: Circadian and multiday rhythms are found across many biological systems, including cardiology, endocrinology, neurology, and immunology. In people with epilepsy, epileptic brain activity and seizure occurrence have been found to follow circadian, weekly, and monthly rhythms. Understanding the relationship between these cycles of brain excitability and other physiological systems can provide new insight into the causes of multiday cycles. The brain-heart link has previously been considered in epilepsy research, with potential implications for seizure forecasting, therapy, and mortality (i.e., sudden unexpected death in epilepsy). METHODS: We report the results from a non-interventional, observational cohort study, Tracking Seizure Cycles. This study sought to examine multiday cycles of heart rate and seizures in adults with diagnosed uncontrolled epilepsy (N=31) and healthy adult controls (N=15) using wearable smartwatches and mobile seizure diaries over at least four months (M=12.0, SD=5.9; control M=10.6, SD=6.4). Cycles in heart rate were detected using a continuous wavelet transform. Relationships between heart rate cycles and seizure occurrence were measured from the distributions of seizure likelihood with respect to underlying cycle phase. FINDINGS: Heart rate cycles were found in all 46 participants (people with epilepsy and healthy controls), with circadian (N=46), about-weekly (N=25) and about-monthly (N=13) rhythms being the most prevalent. Of the participants with epilepsy, 19 people had at least 20 reported seizures, and 10 of these had seizures significantly phase locked to their multiday heart rate cycles. INTERPRETATION: Heart rate cycles showed similarities to multiday epileptic rhythms and may be comodulated with seizure likelihood. The relationship between heart rate and seizures is relevant for epilepsy therapy, including seizure forecasting, and may also have implications for cardiovascular disease. More broadly, understanding the link between multiday cycles in the heart and brain can shed new light on endogenous physiological rhythms in humans. FUNDING: This research received funding from the Australian Government National Health and Medical Research Council (investigator grant 1178220), the Australian Government BioMedTech Horizons program, and the Epilepsy Foundation of America's ‘My Seizure Gauge’ grant. Elsevier 2021-10-11 /pmc/articles/PMC8517288/ /pubmed/34649079 http://dx.doi.org/10.1016/j.ebiom.2021.103619 Text en © 2021 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Research paper
Karoly, Philippa J.
Stirling, Rachel E.
Freestone, Dean R.
Nurse, Ewan S.
Maturana, Matias I.
Halliday, Amy J.
Neal, Andrew
Gregg, Nicholas M.
Brinkmann, Benjamin H.
Richardson, Mark P.
La Gerche, Andre
Grayden, David B.
D'Souza, Wendyl
Cook, Mark J.
Multiday cycles of heart rate are associated with seizure likelihood: An observational cohort study
title Multiday cycles of heart rate are associated with seizure likelihood: An observational cohort study
title_full Multiday cycles of heart rate are associated with seizure likelihood: An observational cohort study
title_fullStr Multiday cycles of heart rate are associated with seizure likelihood: An observational cohort study
title_full_unstemmed Multiday cycles of heart rate are associated with seizure likelihood: An observational cohort study
title_short Multiday cycles of heart rate are associated with seizure likelihood: An observational cohort study
title_sort multiday cycles of heart rate are associated with seizure likelihood: an observational cohort study
topic Research paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517288/
https://www.ncbi.nlm.nih.gov/pubmed/34649079
http://dx.doi.org/10.1016/j.ebiom.2021.103619
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