Heart Rate Variability in Insulo-Opercular Epilepsy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Recording Procedures
2.3. HRV Analysis
2.4. Statistical Analysis
2.5. Age Correction Methods
- -
- For RMSSD: y = 75.78 − 1.618x + 0.011x2, r = 0.9982
- -
- For pNN50: y = 60 − 1.89x + 0.015x2, r = 0.9989
- -
- For LF: y = 310.114 − 6.6771x + 0.03857x2, r = 0.9964
- -
- For HF: y = 271.214 − 7.4701x + 0.05407x2, r = 0.9983,
3. Results
3.1. Patients and Demographics
3.2. Part 1: Evaluating the HRV in IOE Patients
3.2.1. HRV Differences between IOE, TLE, and Healthy Control Groups
3.2.2. Correlation between HRV Parameters and the SUDEP-7 Score
3.2.3. Exploratory Subanalysis
IOE Group
TLE Group
3.3. Part 2: HRV in All Patients with an Epileptogenic Zone Involving the Insulo-Opercular Region Irrespective of Post-Surgical Seizure Outcome
3.3.1. Differences in HRV Values between Patients with an Epileptogenic Zone, which Included the Insulo-Opercular Region versus Healthy Controls
3.3.2. Other Subgroup Analyses
3.3.3. Correlation between HRV Parameters and the Risk of SUDEP
4. Discussion
4.1. HRV in IOE
4.2. Effect of Insulo-Opercular Epilepsy Surgery on HRV
4.3. HRV in TLE
4.4. Effect of TLE Surgery on HRV
4.5. Correlation between Parasympathetic Parameters (RMSDD and pNN50) and the SUDEP-7 Score
4.6. Limitations and Future Perspectives
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
SUDEP-7 Risk Factor Inventory (Over Past 12 Months) at Presurgical Period | ||||||||
---|---|---|---|---|---|---|---|---|
IOE Patient | More than 3TCS | 1 or More TCS | 1 or More sz of Any Type | >50 sz of Any Type/Month | Duration > 30 yrs | Current Use of 3 or More AEDs | Mental Retardation, IQ < 70, or too Impaired to Test | Score |
I1 | 0 | 0 | 0 | 2 | 3 | 1 | 0 | 6 |
I2 | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 2 |
I3 | 0 | 0 | 0 | 2 | 0 | 0 | 0 | 2 |
I4 | 0 | 1 | 1 | 0 | 0 | 1 | 0 | 3 |
I5 | 0 | 1 | 1 | 0 | 3 | 1 | 0 | 6 |
I6 | 0 | 0 | 1 | 0 | 3 | 1 | 0 | 5 |
I7 | 0 | 0 | 0 | 2 | 0 | 0 | 0 | 2 |
I8 | 0 | 0 | 0 | 2 | 0 | 0 | 0 | 2 |
I9 | 0 | 0 | 0 | 2 | 0 | 0 | 0 | 2 |
I10 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 2 |
I11 | 0 | 0 | 0 | 2 | 0 | 0 | 0 | 2 |
I12 | 0 | 1 | 1 | 0 | 0 | 1 | 0 | 3 |
I13 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 1 |
I14 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 2 |
I15 | 0 | 1 | 0 | 2 | 0 | 1 | 0 | 4 |
I16 | 0 | 1 | 1 | 0 | 0 | 1 | 0 | 3 |
TLE patient | More than 3TCS | 1 or more TCS | 1 or more sz of any type | >50 sz of any type/month | Duration > 30 yrs | Current use of 3 or more AEDs | Mental retardation, IQ < 70, or too impaired to test | Score |
T1 | 0 | 0 | 1 | 0 | 3 | 0 | 0 | 4 |
T2 | 0 | 0 | 1 | 0 | 3 | 1 | 0 | 5 |
T3 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 1 |
T4 | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 2 |
T5 | 0 | 0 | 1 | 0 | 3 | 1 | 0 | 5 |
T6 | 0 | 0 | 1 | 0 | 3 | 1 | 0 | 4 |
T7 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 1 |
T8 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 1 |
T9 | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 2 |
T10 | 2 | 0 | 1 | 0 | 0 | 1 | 0 | 4 |
T11 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 2 |
T12 | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 2 |
T13 | 2 | 0 | 1 | 0 | 0 | 1 | 0 | 4 |
T14 | 2 | 0 | 1 | 0 | 0 | 1 | 0 | 4 |
T15 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | 1 |
T16 | 20 | 0 | 1 | 0 | 0 | 0 | 0 | 3 |
First Part | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
IOE Group | Pre-op Matched Control | Post-op Matched Control | Matched TLE Group | |||||||
Code | S | Preop Age | Postop Age | Code | Age | Code | Age | Code | Preop Age | Postop Age |
I1 | F | 47 | 54 | C25 | 49 | C1 | 53 | T1 | 43 | 50 |
I2 | F | 19 | 19 | C26 | 19 | C26 | 19 | T2 | 21 | 22 |
I3 | M | 38 | 49 | C30 | 37 | C24 | 44 | T3 | 35 | 41 |
I4 | F | 32 | 36 | C14 | 31 | C9 | 36 | T4 | 31 | 32 |
I5 | F | 36 | 40 | C21 | 36 | C2 | 39 | T5 | 43 | 50 |
I6 | F | 38 | 50 | C2 | 38 | C5 | 52 | T6 | 40 | 50 |
I7 | M | 36 | 42 | C23 | 35 | C8 | 40 | T7 | 33 | 40 |
I8 | F | 37 | 54 | C15 | 38 | C7 | 52 | T8 | 39 | 42 |
I9 | F | 28 | 33 | C28 | 27 | C14 | 31 | T9 | 29 | 30 |
I10 | M | 31 | 35 | C4 | 33 | C27 | 33 | T10 | 28 | 35 |
I11 | M | 34 | 35 | C20 | 33 | C29 | 38 | T11 | 32 | 36 |
I12 | F | 23 | 28 | C6 | 24 | C18 | 28 | T12 | 24 | 29 |
I13 | F | 35 | 37 | C33 | 36 | C22 | 36 | T13 | 38 | 41 |
I14 | M | 46 | 54 | C24 | 44 | C10 | 53 | T13 | 46 | 50 |
I15 | F | 32 | 38 | C31 | 32 | C15 | 38 | T15 | 28 | 36 |
I16 | F | 21 | 23 | C3 | 20 | C19 | 23 | T16 | 22 | 26 |
Second Part | ||||||||||
IOE Group | Preop Matched Control | |||||||||
Code | S | Preop Age | Postop Age | Code | Age | |||||
I1 | F | 47 | 54 | C25 | 49 | |||||
I2 | F | 19 | 19 | C26 | 19 | |||||
I3 | M | 38 | 49 | C30 | 37 | |||||
I4 | F | 32 | 36 | C14 | 31 | |||||
I5 | F | 36 | 40 | C21 | 36 | |||||
I6 | F | 38 | 50 | C2 | 38 | |||||
I7 | M | 36 | 42 | C23 | 35 | |||||
I8 | F | 37 | 54 | C15 | 38 | |||||
I9 | F | 28 | 33 | C28 | 27 | |||||
I10 | M | 31 | 35 | C4 | 33 | |||||
I11 | M | 34 | 35 | C20 | 33 | |||||
I12 | F | 23 | 28 | C6 | 24 | |||||
I13 | F | 35 | 37 | C33 | 36 | |||||
I14 | M | 46 | 54 | C24 | 44 | |||||
I15 | F | 32 | 38 | C31 | 32 | |||||
I16 | F | 21 | 23 | C3 | 20 | |||||
I17 | 2 | 37 | 40 | C9 | 36 | |||||
I18 | 2 | 39 | 46 | C32 | 42 | |||||
I19 | 1 | 35 | 42 | C27 | 33 | |||||
I20 | 2 | 54 | 56 | C1 | 53 | |||||
I21 | 2 | 27 | 37 | C28 | 27 | |||||
I22 | 2 | 52 | 54 | C5 | 52 | |||||
I23 | 1 | 25 | 34 | C11 | 27 | |||||
I24 | 2 | 30 | 36 | C22 | 36 | |||||
I25 | 1 | 30 | 32 | C17 | 29 | |||||
I26 | 2 | 23 | 38 | C19 | 23 | |||||
I27 | 1 | 40 | 42 | C29 | 38 |
IOE Group | Pre-Operative HRV Measures | Post-Operative HRV Measures | ||||||
---|---|---|---|---|---|---|---|---|
Subject | RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) | RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) |
I1 | 39.10 | 18.00 | 314.10 | 144.70 | 17.10 | .30 | 582.00 | 104.70 |
I2 | 20.00 | .50 | 179.80 | 248.70 | 42.80 | 5.90 | 1529.70 | 193.20 |
I3 | 30.60 | 6.70 | 447.30 | 424.00 | 69.30 | 28.20 | 979.00 | 1305.20 |
I4 | 30.40 | 7.80 | 281.80 | 189.30 | 46.30 | 22.60 | 1780.10 | 595.30 |
I5 | 63.10 | 44.00 | 691.40 | 1396.80 | 18.90 | 3.00 | 95.90 | 32.50 |
I6 | 48.80 | 30.50 | 755.00 | 797.70 | 55.60 | 31.00 | 801.20 | 1292.80 |
I7 | 34.30 | 12.90 | 578.20 | 880.20 | 31.90 | 8.50 | 1263.90 | 680.70 |
I8 | 25.20 | 1.40 | 222.20 | 241.20 | 34.40 | 5.00 | 455.20 | 555.10 |
I9 | 24.50 | 2.40 | 746.60 | 347.10 | 49.80 | 20.80 | 1378.80 | 440.10 |
I10 | 44.90 | 20.10 | 808.00 | 526.40 | 34.00 | 9.50 | 2299.20 | 495.90 |
I11 | 34.60 | 7.20 | 784.10 | 196.80 | 13.20 | .30 | 333.20 | 33.10 |
I12 | 59.00 | 28.10 | 2749.50 | 1032.80 | 44.00 | 19.10 | 941.90 | 1000.10 |
I13 | 12.60 | .30 | 68.60 | 77.40 | 20.20 | 1.80 | 287.20 | 80.00 |
I14 | 42.30 | 20.80 | 763.70 | 364.90 | 43.40 | 16.40 | 484.10 | 395.10 |
I15 | 26.50 | 5.20 | 718.10 | 302.40 | 38.80 | 15.60 | 1590.80 | 537.60 |
I16 | 73.70 | 40.30 | 2647.60 | 3411.30 | 72.40 | 33.40 | 2926.30 | 2333.00 |
I17 | 17.70 | .00 | 118.80 | 146.70 | 35.20 | 11.90 | 517.30 | 487.80 |
I18 | 13.20 | .90 | 207.50 | 36.50 | 38.50 | 18.10 | 472.80 | 226.10 |
I19 | 41.60 | 21.60 | 2285.30 | 831.40 | 10.60 | .20 | 110.00 | 32.60 |
I20 | 20.30 | .00 | 38.80 | 208.80 | 18.60 | .00 | 386.10 | 105.50 |
I21 | 46.60 | 27.40 | 559.10 | 1268.50 | 45.00 | 21.10 | 2592.20 | 749.60 |
I22 | 9.50 | .00 | 297.00 | 20.10 | 44.90 | 15.20 | 799.80 | 846.70 |
I23 | 28.50 | 6.40 | 1260.80 | 214.40 | 6.00 | .00 | 173.40 | 8.40 |
I24 | 59.40 | 29.80 | 1378.90 | 1462.00 | 60.20 | 35.30 | 866.70 | 1088.30 |
I25 | 33.00 | 12.50 | 503.60 | 408.00 | 25.80 | 4.60 | 785.20 | 246.40 |
I26 | 47.90 | 16.30 | 408.90 | 1114.00 | 27.70 | 3.70 | 337.80 | 311.30 |
I27 | 5.10 | .00 | 31.80 | 4.30 | 29.70 | 6.80 | 372.50 | 315.30 |
TLE Group | Pre-Operative HRV Measures | Post-Operative HRV Measures | ||||||
Subject | RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) | RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) |
T1 | 23.60 | 3.90 | 133.80 | 130.40 | 32.30 | 9.40 | 327.10 | 211.10 |
T2 | 38.20 | 16.50 | 374.50 | 559.80 | 25.10 | 4.40 | 504.40 | 163.70 |
T3 | 16.90 | .50 | 397.20 | 78.90 | 23.70 | 1.40 | 510.60 | 178.50 |
T4 | 23.70 | 1.40 | 365.90 | 162.60 | 29.20 | 3.00 | 248.00 | 228.20 |
T5 | 29.40 | 6.00 | 836.00 | 430.30 | 15.50 | .30 | 680.70 | 103.50 |
T6 | 25.90 | 5.20 | 1527.60 | 200.30 | 40.70 | 12.80 | 1143.00 | 283.20 |
T7 | 40.30 | 16.40 | 969.20 | 697.70 | 28.70 | 5.90 | 512.50 | 293.30 |
T8 | 33.20 | 9.50 | 1042.80 | 333.50 | 14.50 | .20 | 496.30 | 74.70 |
T9 | 38.10 | 16.20 | 1465.40 | 358.50 | 25.90 | 4.50 | 479.80 | 276.00 |
T10 | 32.70 | 9.30 | 664.80 | 317.30 | 16.10 | .20 | 202.70 | 48.50 |
T11 | 33.30 | 10.10 | 1740.10 | 274.00 | 24.00 | 5.20 | 1499.50 | 159.60 |
T12 | 68.40 | 35.00 | 867.10 | 477.50 | 83.60 | 49.70 | 1049.80 | 951.00 |
T14 | 20.00 | 1.90 | 232.30 | 69.20 | 10.80 | .00 | 124.10 | 26.40 |
T13 | 54.80 | 31.50 | 1717.40 | 1024.20 | 35.90 | 12.70 | 960.70 | 373.80 |
T15 | 12.60 | .30 | 68.60 | 77.40 | 20.20 | 1.80 | 287.20 | 80.00 |
T16 | 43.00 | 18.80 | 2884.50 | 934.10 | 56.00 | 30.90 | 2907.30 | 1896.70 |
Control Group | HRV Parameters | |||||||
Subject | RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) | ||||
C1 | 19.60 | 1.50 | 195.70 | 76.00 | ||||
C2 | 18.30 | 1.00 | 314.00 | 122.20 | ||||
C3 | 57.20 | 30.40 | 2308.00 | 741.40 | ||||
C4 | 62.90 | 40.10 | 866.80 | 2409.00 | ||||
C5 | 10.50 | .00 | 178.50 | 51.00 | ||||
C6 | 52.90 | 28.60 | 1772.00 | 1049.50 | ||||
C7 | 13.80 | .00 | 263.50 | 28.00 | ||||
C8 | 26.10 | 4.90 | 461.10 | 275.40 | ||||
C9 | 37.30 | 10.80 | 953.10 | 343.80 | ||||
C10 | 11.40 | .00 | 346.10 | 43.60 | ||||
C11 | 21.90 | 1.50 | 336.20 | 136.00 | ||||
C12 | 40.70 | 21.90 | 658.50 | 627.50 | ||||
C131 | 12.30 | .00 | 420.10 | 57.70 | ||||
C14 | 38.40 | 9.60 | 565.10 | 326.80 | ||||
C15 | 57.60 | 12.30 | 270.90 | 488.50 | ||||
C16 | 41.40 | 19.30 | 932.30 | 451.90 | ||||
C17 | 50.50 | 26.10 | 701.50 | 1000.70 | ||||
C18 | 59.20 | 31.10 | 1486.50 | 1955.40 | ||||
C19 | 32.00 | 5.50 | 595.70 | 476.90 | ||||
C20 | 17.70 | 1.20 | 523.40 | 105.00 | ||||
C21 | 30.80 | 7.30 | 288.20 | 345.00 | ||||
C22 | 47.30 | 24.10 | 972.20 | 461.90 | ||||
C23 | 23.80 | .60 | 226.90 | 160.20 | ||||
C24 | 16.60 | .30 | 195.70 | 98.20 | ||||
C25 | 39.10 | 10.70 | 175.50 | 110.10 | ||||
C26 | 72.80 | 36.50 | 3018.80 | 1876.60 | ||||
C27 | 51.60 | 29.00 | 1086.20 | 919.60 | ||||
C28 | 38.80 | 7.00 | 213.20 | 388.90 | ||||
C29 | 22.70 | 2.60 | 143.70 | 156.90 | ||||
C30 | 31.00 | 5.20 | 590.30 | 257.50 | ||||
C31 | 15.90 | .70 | 457.50 | 80.40 | ||||
C32 | 13.20 | .00 | 169.70 | 52.30 | ||||
C33 | 39.20 | 19.20 | 973.70 | 1188.70 |
Pt | S/Lat | AO (yo) | Presurgical Period | D1 (Years) | Postsurgical Period | SUDEP-7 Score at A1 | Presurgical Evaluation | Surgery | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
A1 (yo) | ASM | D2 (Months) | ASM | Operculo-INS Lesion on MRI | MEG | icEEG | Resected Areas | Engel | |||||
17 | F/R | 20 | 37 | LEV, LTG | 17 | 43 | LEV, LTG. ESL | 1 | no | Non-localizing | R Mid-, post-INS, F-P-T opercula | R INS + F-P-T opercula | IIIa |
18 | F/L | 32 | 39 | PGB | 7 | 83 | PHT | 1 | no | L ant-T, mid-, post-lateral T | L INS, F-T opercula | L INS + T-opercula sparing Wernicke’s area | IIIa |
19 | M/L | 21 | 35 | LTG, VPA | 14 | 62 | CBZ, PHT | 4 | yes | L STG, ant-INS, IFG | L ant-INS, IFG | Ant-INS (IFG was not resected re language area) | IIIa |
20 | F/L | 12 | 54 | PHT, CBZ, LEV | 42 | 5 | LEVLCMLTG | 3 | no | N/A (Both PET and ictal SPECT showed a L INS focus) | L post-INS, | L post-INS | IIIa |
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Pt | S/Lat | AO (yo) | Presurgical Period | D1 (Years) | Postsurgical Period | SUDEP-7 Score at A1 | Presurgical Evaluation | Surgery | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
A1 (yo) | ASM | D2 (Months) | ASM | Operculo-INS Lesion on MRI | MEG | icEEG | Resected Areas | Engel | |||||
1 | F/R | 13 | 46 | TPM, CBZ, LEV, LCM | 33 | 64 | LEV, LCM | 6 | yes | no spike | N/A | R superior INS + F-P opercula | Ia |
2 | F/L | 10 | 19 | OXC, PHT, PER | 9 | 6 | PHT, OXC | 2 | no | L operculo-INS | L ant-INS, F-operculum | L ant-INS | IId |
3 | M/L | 29 | 37 | PHT, CLB | 8 | 142 | None | 2 | no | L post-INS, L mesial T | L post-INS | post-INS | Ib |
4 | F/L | 4 | 31 | LEV, CBZ, CLB | 27 | 29 | CBZ, CLB | 3 | yes | no spike | N/A | L INS + F-P opercula | Ia |
5 | F/L | 5 | 36 | LCM, CLB, CBZ, TPM | 31 | 25 | CBZ | 6 | no | L F-T opercula-INS | L ant-INS, IFG, STG | L 2/3 ant-INS + partial F-T opercula | Ia |
6 | F/L | 3 | 49 | CBZ, LTG, CLB | 46 | 12 | CBZ, LTG, CLB | 5 | yes | L post-INS, P operculum | L post-INS | L INS | Ia |
7 | M/R | 26 | 35 | PHT, LTG | 9 | 60 | OXC | 2 | no | R F operculum, ant-INS | R F operculum (Note: ant INS electrode in wrong position | R ant-INS + F operculum | Ia |
8 | F/R | 18 | 37 | CBZ, LTG | 19 | 204 | CBZ, CLB | 2 | yes | NA | NA | R INS + F-P opercula | Ia |
9 | F/R | 9 | 27 | TPM, LCM | 12 | 58 | None | 2 | no | Junction between R ant-INS and orbitoF | Junction between R ant-INS and orbitoF | R ant-INS + F operculum | Ia |
10 | M/L | 16 | 30 | CBZ, CLB | 14 | 28 | CBZ | 2 | No (but subtle T2/FLAIR hypersignal in ant-INS, hypometabolic on PET) | L orbito-F | N/A | L lateral orbito-frontal cortex and operculum + ant-INS (pathology showed dyslamination) | Ia |
11 | M/L | 24 | 33 | LTG, CBZ | 9 | 6 | LTG, CBZ | 2 | yes (L ant-INS cavernoma) | N/A | N/A | L INS | Ia |
12 | F/R | 5 | 24 | TPM, CLB, LCM | 19 | 70 | OXC, TPM, CLB | 3 | yes (TSC) | R operculo-INS | N/A | R INS + F-P-T opercula | Ib |
13 | F/R | 21 | 35 | CBZ, TPM | 14 | 18 | CBZ, TPM | 1 | no | R superior ant-INS, F operculum, STG | R ant-INS, IFG | R ant-INS + F operculum | Ia |
14 | M/R | 35 | 46 | PGB, OXC | 11 | 93 | PGB, LCM, CNZ | 2 | no | cluster in R ant-INS/R orbitofrontal operculum; a few dipoles in medial frontal gyrus | Diffuse, non-localizing | R ant-INS + F operculum + orbitoF | Ia |
15 | F/R | 14 | 32 | LTG, CBZ, CLB | 18 | 66 | CBZ, LTG | 4 | no | R inf pre-CG, R mesial T | R inf CG, post INS | R inf central gyrus, R post INS | Ia |
16 | F/R | 10 | 21 | OXC, TPM, LTG, CLB | 11 | 4 | BRV | 3 | yes | NA | R T operculum, inf + ant INS | R T + F opercula +INS | Ia |
Pt | S | Lat | AO (yo) | D1 (Years) | Presurgical Period | Postsurgical Period | SUDEP-7 Score at A1 | ||
---|---|---|---|---|---|---|---|---|---|
A1 (yo) | ASM | D2 (Months) | ASM | ||||||
T1 | F | L | 33 | 9 | 42 | LTG, CLB, VPA, PGB | 92 | NONE | 2 |
T2 | F | L | 2 | 19 | 21 | CBZ, LEV | 14 | NONE | 1 |
T3 | M | L | 19 | 15 | 34 | LEV, LTG, CLB | 41 | LEV, LTG | 3 |
T4 | F | L | 27 | 4 | 31 | Pb, PGB, PHT | 104 | PGB, LCM | 2 |
T5 | F | R | 2 | 32 | 34 | PHT, TPM, LTG | 77 | PHT, LCM | 5 |
T6 | F | L | 0.7 | 39 | 40 | VPA, CBZ | 120 | NONE | 4 |
T7 | M | L | 11 | 22 | 33 | TPM, LTG | 22 | LTG, CLB | 1 |
T8 | F | L | 13 | 26 | 39 | CBZ | 13 | CBZ | 1 |
T9 | F | R | 25 | 4 | 29 | LCM, LEV, OXC | 16 | LEV, OXC | 2 |
T10 | M | R | 25 | 3 | 28 | LTG, LCM, LEV, LZP | 64 | LCM, CLB | 4 |
T11 | M | R | 17 | 15 | 32 | CBZ | 24 | CBZ, LZP | 1 |
T12 | F | L | 23 | 1 | 24 | LTG, LEV, CLB | 60 | LTG | 2 |
T13 | F | L | 33 | 3 | 36 | CLB, TPM, OXC, LTG | 48 | OXC, TPM, CLB | 4 |
T14 | M | L | 30 | 16 | 46 | OXC, BRV, Pb | 71 | OXC, Pb, GPN, LCM | 4 |
T15 | F | L | 4 | 24 | 28 | TPM, LTG | 79 | LEV | 1 |
T16 | F | R | 19 | 3 | 22 | TPM | 18 | OXC | 3 |
Preoperative age (years) (Median; IQR; range) | 35 (10) range (19–54) |
Postoperative age (years) (Median; IQR; range) | 38 (15) range (19–56) |
Gender (Number) | |
Male | 9 |
Female | 18 |
Lateralization of epileptic focus (Number) | |
Right | 15 |
Left | 12 |
Epilepsy duration (years) Median (IQR) | range (6–42) |
Revised SUDEP-7 score median (IQR) | 2 (2) range (1–6) |
Elapsed time from surgery to postoperative EKG (months) | 29 (58) range (4–204) |
Resected zone (Number) | |
Limited to insulo-opercular areas | 20 |
Temporo-insulo-opercular areas | 7 |
Surgical outcome (Number) | |
Good outcome | 23 |
Poor outcome | 4 |
Studied Periods | Pre-Operative Period | Post-Operative Period | |||||||
---|---|---|---|---|---|---|---|---|---|
Group | HRV Measures | RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) | RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) |
IOE (n = 16) | Median | 34.45 | 10.35 | 704.75 | 336.00 | 40.80 | 12.55 | 960.45 | 516.75 |
IQR | 22.30 | 23.18 | 489.13 | 651.68 | 25.80 | 18.65 | 1113.10 | 793.43 | |
TLE (n = 16) | Median | 32.95 | 9.4 | 851.55 | 325.40 | 25.50 | 4.45 | 507.50 | 194.80 |
IQR | 16.15 | 14.08 | 1144.00 | 400.77 | 17.80 | 11.30 | 730.35 | 204.90 | |
CTL (n = 16) | Median | 38.60 | 8.45 | 490.45 | 335.90 | 29.05 | 5.2 | 403.60 | 301.10 |
IQR | 36.45 | 25.20 | 709.08 | 859.35 | 33.50 | 20.50 | 754.75 | 404.05 | |
p value (IOE vs. TLE vs. CTL) | 0.625 | 0.776 | 0.538 | 0.646 | 0.246 | 0.231 | 0.124 | 0.163 | |
Preop vs. postop | IOE group | 0.679 | 0.796 | 0.121 | 0.918 | ||||
TLE group | 0.215 | 0.313 | 0.070 | 0.379 | |||||
IOE group (n = 16) | |||||||||
Group | HRV measures | Pre-Operative period | Post-Operative period | ||||||
RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) | RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) | ||
L IOE (n = 7) | Median | 34.60 | 7.80 | 691.40 | 424.00 | 42.80 | 9.50 | 979.00 | 1446.90 |
IQR | 18.40 | 23.80 | 502.30 | 600.90 | 36.70 | 25.20 | 1446.90 | 495.90 | |
R IOE (n = 9) | Median | 34.30 | 12.90 | 718.10 | 347.10 | 38.80 | 15.60 | 941.90 | 537.60 |
IQR | 25.80 | 22.55 | 1437.50 | 763.55 | 20.85 | 16.55 | 1015.15 | 590.50 | |
CTL for L IOE (n = 7) | Median | 31.00 | 7.30 | 565.10 | 326.80 | 22.70 | 2.60 | 314.00 | 156.90 |
IQR | 44.60 | 35.30 | 552.80 | 1754.40 | 35.00 | 28.70 | 907.70 | 821.40 | |
CTL for R IOE (n = 9) | Median | 39.10 | 10.70 | 270.90 | 388.90 | 32.00 | 5.50 | 461.10 | 326.80 |
IQR | 34.85 | 23.25 | 1168.40 | 791.30 | 35.75 | 17.45 | 516.75 | 422.90 | |
p value | L vs. R | 0.634 | 0.634 | 0.874 | 0.874 | 0.958 | 0.832 | 0.874 | 0.711 |
L IOE vs. CTL | 0.848 | 0.749 | 0.749 | 0.848 | 0.482 | 0.522 | 0.406 | 0.848 | |
R IOE vs. CTL | 1.000 | 0.724 | 0.402 | 0.895 | 0.508 | 0.354 | 0.102 | 0.161 | |
p value preop vs. postop | L IOE | 0.866 | 1.000 | 0.176 | 0.866 | ||||
R IOE | 0.767 | 0.678 | 0.314 | 0.953 | |||||
TLE group (n = 16) | |||||||||
Group | HRV measures | Pre-Operative period | Post-Operative period | ||||||
RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) | RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) | ||
L TLE (n = 12) | Median | 29.55 | 7.35 | 632.15 | 237.15 | 26.90 | 4.80 | 507.50 | 194.80 |
IQR | 18.88 | 14.95 | 1140.70 | 447.45 | 13.93 | 10.38 | 730.35 | 190.87 | |
R TLE (n = 4) | Median | 35.40 | 12.75 | 1150.70 | 394.40 | 21.00 | 2.40 | 580.25 | 189.75 |
IQR | 11.55 | 11.33 | 1822.13 | 480.55 | 32.83 | 24.07 | 2704.60 | 1429.28 | |
CTL for L TLE (n = 12) | Median | 34.70 | 7.40 | 490.45 | 208.85 | 24.40 | 3.75 | 308.50 | 216.15 |
IQR | 31.63 | 16.70 | 639.95 | 802.98 | 40.53 | 21.08 | 771.73 | 424.60 | |
CTL for R TLE (n = 4) | Median | 48.00 | 18.85 | 577.50 | 565.15 | 35.20 | 7.55 | 580.40 | 401.85 |
IQR | 28.68 | 30.60 | 1715.75 | 1636.13 | 26.57 | 22.03 | 586.80 | 635.57 | |
p value | L vs. R | 0.467 | 0.467 | 0.275 | 0.225 | 0.72 | 0.67 | 0.90 | 1.00 |
L TLE vs. CTL | 0.773 | 0.862 | 0.817 | 0.773 | 0.861 | 0.795 | 0.356 | 0.862 | |
R TLE vs. CTL | 0.917 | 0.602 | 0.175 | 0.602 | 0.386 | 0.386 | 1.000 | 0.386 | |
p value preop vs. postop | L TLE | 0.433 | 0.480 | 0.239 | 0.480 | ||||
R TLE | 0.73 | 0.715 | 0.144 | 0.715 |
Group | HRV Measures | Preoperative Period | Postoperative Period | ||||||
---|---|---|---|---|---|---|---|---|---|
RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) | RMSSD (ms) | pNN50 (%) | LF (ms2) | HF (ms2) | ||
Group 1a (n = 7) | Median | 25.20 | 2.40 | 281.80 | 248.70 | 42.80 | 15.60 | 1378.80 | 537.60 |
IQR | 10.40 | 7.50 | 538.30 | 157.80 | 15.40 | 17.60 | 1135.60 | 402.10 | |
CTL 1a (n = 7) | Median | 39.20 | 12.30 | 590.30 | 488.50 | 38.40 | 10.80 | 565.10 | 343.80 |
IQR | 19.20 | 23.40 | 2037.10 | 861.90 | 41.00 | 23.80 | 708.70 | 390.30 | |
p value: Group 1a vs. CTL 1a | 0.002 | 0.007 | 0.142 | 0.018 | 0.749 | 0.749 | 0.142 | 0.406 | |
p value: Preop vs. postop | 0.018 | 0.018 | 0.018 | 0.043 | |||||
Group 1b (n = 9) | Median | 44.90 | 20.80 | 763.70 | 797.70 | 34.00 | 9.50 | 801.20 | 495.90 |
IQR | 24.20 | 19.95 | 1093.00 | 933.95 | 31.80 | 23.40 | 1372.90 | 1077.55 | |
CTL 1b (n = 9) | Median | 23.80 | 1.20 | 314.00 | 122.20 | 19.60 | 1.50 | 314.00 | 122.20 |
IQR | 28.85 | 19.00 | 483.80 | 595.65 | 27.75 | 16.95 | 612.55 | 550.20 | |
p value: Group 1b vs. CTL 1b | 0.027 | 0.024 | 0.031 | 0.047 | 0.222 | 0.144 | 0.102 | 0.310 | |
p value: Preop vs. postop | 0.038 | 0.011 | 0.859 | 0.086 |
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Tran, T.P.Y.; Pouliot, P.; Assi, E.B.; Rainville, P.; Myers, K.A.; Robert, M.; Bouthillier, A.; Keezer, M.R.; Nguyen, D.K. Heart Rate Variability in Insulo-Opercular Epilepsy. Brain Sci. 2021, 11, 1505. https://doi.org/10.3390/brainsci11111505
Tran TPY, Pouliot P, Assi EB, Rainville P, Myers KA, Robert M, Bouthillier A, Keezer MR, Nguyen DK. Heart Rate Variability in Insulo-Opercular Epilepsy. Brain Sciences. 2021; 11(11):1505. https://doi.org/10.3390/brainsci11111505
Chicago/Turabian StyleTran, Thi Phuoc Yen, Philippe Pouliot, Elie Bou Assi, Pierre Rainville, Kenneth A. Myers, Manon Robert, Alain Bouthillier, Mark R. Keezer, and Dang Khoa Nguyen. 2021. "Heart Rate Variability in Insulo-Opercular Epilepsy" Brain Sciences 11, no. 11: 1505. https://doi.org/10.3390/brainsci11111505