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Front Neurol 2018 20;9:969. Epub 2018 Nov 20.

Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Brain-derived neurotrophic factor (BDNF) and insulin-like growth factor 1 (IGF-1) may regulate the autonomic nervous system (ANS) in epilepsy. The present study investigated the role of IGF-1 and BDNF in the regulation of autonomic functions and cerebral autoregulation in patients with epilepsy. A total of 57 patients with focal epilepsy and 35 healthy controls were evaluated and their sudomotor, cardiovagal, and adrenergic functions were assessed using a battery of ANS function tests, including the deep breathing, Valsalva maneuver, head-up tilting, and Q-sweat tests. Read More

Seizure 2018 Nov 22;64:1-5. Epub 2018 Nov 22.

Department of Neurology, University of Pécs, H-7623, Rét u. 2., Pécs, Hungary; PTE-MTA Clinical Neuroscience MR Research Group, H-7623, Rét u. 2, Hungary. Electronic address:

Purpose: To comprehensively analyze ictal piloerection (IP) in a large number of subjects.

Methods: We performed a systematic review on case report studies of patients diagnosed with IP (1929-2017) with additional cases included from the Department of Neurology of University of Pécs, the National Institute of Clinical Neurosciences, and Odense University Hospital. Each included case was characterized regarding patient history, IP seizure characteristics, diagnostic work-up, and therapy. Read More

Clin Auton Res 2018 Oct 30. Epub 2018 Oct 30.

Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, P.O. Box 540, 2130 AM, Hoofddorp, The Netherlands.

Purpose: Adequate epileptic seizure detection may have the potential to minimize seizure-related complications and improve treatment evaluation. Autonomic changes often precede ictal electroencephalographic discharges and therefore provide a promising tool for timely seizure detection. We reviewed the literature for seizure detection algorithms using autonomic nervous system parameters. Read More

Clin Auton Res 2018 Oct 16. Epub 2018 Oct 16.

National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, 100084, China.

Objective: Epilepsy and seizures can have dramatic effects on cardiac function. The aim of the present study was to investigate deceleration capacity, acceleration capacity and their 24-h fluctuations of heart rate variability in patients with drug-resistant epilepsy.

Methods: Deceleration capacity, acceleration capacity of heart rate and their 24-h dynamics derived from the phase rectified signal averaging method as well as traditional measures were analyzed in 39 patients with drug-resistant epilepsy and 33 healthy control subjects using 24-h electrocardiogram recordings. Read More

Front Neurol 2018 26;9:793. Epub 2018 Sep 26.

Department of Electrical Engineering and Computer Science, Case School of Engineering, Case Western Reserve University, Cleveland, OH, United States.

Seizure-related autonomic dysregulation occurs in epilepsy patients and may contribute to Sudden Unexpected Death in Epilepsy (SUDEP). We tested how different types of seizures affect baroreflex sensitivity (BRS) and heart rate variability (HRV). We hypothesized that BRS and HRV would be reduced after bilateral convulsive seizures (BCS). Read More

PLoS One 2018 25;13(9):e0204339. Epub 2018 Sep 25.

Institute of Clinical Physiology, National Research Council of Italy (CNR), Pisa, Italy.

Epilepsy is often associated with modifications in autonomic nervous system, which usually precede the onset of seizures of several minutes. Thus, there is a great interest in identifying these modifications enough time in advance to prevent a dangerous effect and to intervene. In addition, these changes can be a risk factor for epileptic patients and can increase the possibility of death. Read More

J Cardiovasc Electrophysiol 2018 Sep 19. Epub 2018 Sep 19.

Department of Heart Rhythm Management, University of Occupational and Environmental Health, Kitakyushu, Japan.

Background: Recently, certain forms of early repolarization (ER) on electrocardiograms (ECGs) have been considered a possible marker of increased sudden cardiac death risk. The frequency, characteristics, and clinical follow-up with which these forms of ER are present in epilepsy patients, and whether or not abnormal ER contributes to sudden unexplained death in epilepsy patients (SUDEP) is unknown.

Methods And Results: The amplitude of J peak and ST-segment morphology after ER on 12-lead ECGs were assessed in 354 epilepsy patients (age, 33 ± 16 years; 54% men) and 140 age- and sex-matched control subjects (age, 31 ± 12 years; 50% men). Read More

Neurophysiol Clin 2018 Oct 15;48(5):277-286. Epub 2018 Sep 15.

NeuroPain Team, Inserm U 1028/CNRS, UMR 5292, University of Lyon, Lyon Neuroscience Research Centre (CRNL), 69677 Bron, France.

Objective: Differential diagnosis between sleep-related epileptic seizures and NREM parasomnia remains challenging. Pathophysiological markers to differentiate both conditions are needed. Activation of autonomic system is present in arousal reactions and epileptic seizures. Read More

Epilepsy Res 2018 Oct 6;146:151-159. Epub 2018 Aug 6.

National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, 100084, Beijing, China; Man-Machine-Environment Engineering Institute, School of Aerospace Engineering, Tsinghua University, 100084, Beijing, China; Precision Medicine & Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute, 518055, Shenzhen, China; Center of Epilepsy, Beijing Institute for Brain Disorders, 100069, Beijing, China. Electronic address:

Objective: The aim of this study was to investigate the variations and the circadian rhythm of multi-domain parameters of heart rate variability (HRV) in patients with drug-resistant epilepsy.

Methods: Time domain HRV parameters of 24-hour data, frequency and non-linear domain HRV parameters were calculated using a 24-hour ambulatory electrocardiogram (ECG) from subjects in a resting and awake state (5-min data from 9:00-10:00 a.m. Read More

Expert Rev Med Devices 2018 Aug 17;15(8):527-539. Epub 2018 Aug 17.

a Department of Neurology , Ghent University Hospital , Gent , Belgium.

Introduction: Vagus nerve stimulation (VNS) has become a valuable treatment option for refractory epilepsy and depression. To improve clinical efficacy and minimize side effects, novel device technology for VNS is under development and investigation. Areas covered: For epilepsy, the AspireSR®, and SenTiva™ VNS therapy systems are the two most recently developed VNS devices. Read More

Epilepsy Behav 2018 Jul 26;84:166-172. Epub 2018 May 26.

Dept. of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, United Kingdom; Dept. of Clinical and Experimental Epilepsy, National Hospital for Neurology & Neurosurgery, National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, United Kingdom; Epilepsy Society Research Centre, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, United Kingdom. Electronic address:

Objective: Autonomic dysregulation is a possible pathomechanism of sudden unexpected death in epilepsy (SUDEP). Cardiac arrhythmias and autonomic symptoms are most commonly associated with seizures arising from the temporal lobes. The aim of this study was to investigate whether simultaneous seizure activity in both temporal lobes affects the autonomic nervous system differently from seizure activity in one temporal lobe as assessed by heart rate variability (HRV). Read More

Wiad Lek 2018;71(2 pt 2):413-416

Katedra I Klinika Neurologii, Wydział Lekarski Z Oddziałem Lekarsko-Dentystycznym W Zabrzu, Śląski Uniwersytet Medyczny w Katowicach, Zabrze, Polska.

Mutations leading to disorders within ion (mainly potassium and sodium) channels, have different degrees of expression in the brain and in the heart, which can cause simultaneous occurrence of disorders in both organs. This is manifested by the occurrence of epileptic seizures and cardiac electrical disturbances, further exacerbated by stimulation of autonomic structures within the central nervous system. In all patients with unclear paroxysmal disorders, and in those with unexplained sudden cardiac death, consideration should be given to the possibility of occurrence of genetically determined disorders in the ion channels. Read More

Eur J Neurol 2018 05;25(5):e59-e60

Goethe-University, Frankfurt, Germany.

Int J Neural Syst 2018 Nov 22;28(9):1850006. Epub 2018 Feb 22.

* Institute of Biomedical Engineering, Department of Electrical and Electronic Engineering, Imperial College London, SW7 2AZ, UK.

Objective: Vagus Nerve Stimulation (VNS) has shown great promise as a potential therapy for a number of conditions, such as epilepsy, depression and for Neurometabolic Therapies, especially for treating obesity. The objective of this study was to characterize the left ventral subdiaphragmatic gastric trunk of vagus nerve (SubDiaGVN) and to analyze the influence of intravenous injection of gut hormone cholecystokinin octapeptide (CCK-8) on compound nerve action potential (CNAP) observed on the same branch, with the aim of understanding the impact of hormones on VNS and incorporating the methods and results into closed loop implant design.

Methods: The cervical region of the left vagus nerve (CerVN) of male Wistar rats was stimulated with electric current and the elicited CNAPs were recorded on the SubDiaGVN under four different conditions: Control (no injection), Saline, CCK1 (100[Formula: see text]pmol/kg) and CCK2 (1000[Formula: see text]pmol/kg) injections. Read More

PLoS One 2018 28;13(3):e0194910. Epub 2018 Mar 28.

Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States of America.

Vagus nerve stimulation (VNS) is an approved therapy for treatment of epilepsy and depression. While also shown to be promising in several preclinical and clinical studies to treat cardiovascular diseases, optimal therapeutic stimulation paradigms are still under investigation. Traditionally, parameters such as frequency, current, and duty cycle are used to adjust the efficacy of VNS therapy. Read More

J Physiol Sci 2018 Jul 14;68(4):307-320. Epub 2018 Mar 14.

Department of Physiology and Pharmacology, State University of New York Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA.

This review traces the examination of autonomic, cardiovascular, and respiratory derangements associated with seizure activity in the clinical and preclinical literature generally, and in the author's animal model specifically, and concludes with the author's views on the potential mechanisms for sudden death in epilepsy (SUDEP). An animal model that employs kainic acid-induced seizures on a background of urethane anesthesia has permitted unprecedented access to the behavior of autonomic, cardiovascular, and respiratory systems during seizure activity. The result is a detailed description of the major causes of death and how this animal model can be used to develop and test preventative and interventional strategies. Read More

Seizure 2018 04 6;57:11-13. Epub 2018 Mar 6.

Department of Neurology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Referral Centre of the Ministry of Health of the Republic of Croatia for Epilepsy, Zagreb, Croatia. Electronic address:

J Pediatr 2018 May 6;196:38-44. Epub 2018 Mar 6.

Fetal Medicine Institute, Children's National Health System, Washington, DC; The George Washington University School of Medicine, Washington, DC; Neonatology, Children's National Health System, Washington, DC. Electronic address:

Objective: To evaluate whether infants with hypoxic-ischemic encephalopathy and evidence of autonomic dysfunction have aberrant physiological responses to care events that could contribute to evolving brain injury.

Study Design: Continuous tracings of heart rate (HR), blood pressure (BP), cerebral near infrared spectroscopy, and video electroencephalogram data were recorded from newborn infants with hypoxic-ischemic encephalopathy who were treated with hypothermia. Videos between 16 and 24 hours of age identified 99 distinct care events, including stimulating events (diaper changes, painful procedures), and vagal stimuli (endotracheal tube manipulations, pupil examinations). Read More

Seizure 2018 Feb 8;55:48-56. Epub 2018 Jan 8.

Institute of Psychiatry, Psychology & Neuroscience, Division of Neuroscience, King's College London, UK.

Purpose: To estimate the incidence of pre-ictal heart rate (HR) manifestations and to identify clinical and study-related factors modulating the estimate.

Methods: We searched articles recording concurrent pre-ictal EEG and HR in adults and children with epilepsy. Pre-ictal HR changes were classified as HR reduction (HRR) or increase (HRI). Read More

EBioMedicine 2018 Jan 13;27:112-122. Epub 2017 Dec 13.

Brighton and Sussex Medical School, University of Sussex, United Kingdom.

Background: Thirty-percent of patients with epilepsy are drug-resistant, and might benefit from effective noninvasive therapeutic interventions. Evidence is accumulating on the efficacy of autonomic biofeedback therapy using galvanic skin response (GSR; an index of sympathetic arousal) in treating epileptic seizures. This study aimed to extend previous controlled clinical trials of autonomic biofeedback therapy with a larger homogeneous sample of patients with temporal lobe epilepsy. Read More

Ann Indian Acad Neurol 2017 Oct-Dec;20(4):403-407

Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.

Progressive loss of heart rate variability (HRV) and complexity are associated with increased risk of mortality in patients with cardiovascular disease and are a candidate marker for patients at risk of sudden cardiac death. HRV is influenced by the cardiac autonomic nervous system (ANS), although it is unclear which arm of the ANS (sympathetic or parasympathetic) needs to be perturbed to increase the complexity of HRV. In this case-control study, we have analyzed the relation between modulation of vagus nerve stimulation (VNS) and changes in complexity of HRV as a function of states of vigilance. Read More

Front Immunol 2017 2;8:1452. Epub 2017 Nov 2.

Laboratoire Inter-Universitaire de Psychologie, Personnalité, Cognition et Changement Social LIP/PC2S-EA4145, University Savoie Mont Blanc, Chambéry, France.

The vagus nerve (VN) is the longest nerve of the organism and a major component of the parasympathetic nervous system which constitutes the autonomic nervous system (ANS), with the sympathetic nervous system. There is classically an equilibrium between the sympathetic and parasympathetic nervous systems which is responsible for the maintenance of homeostasis. An imbalance of the ANS is observed in various pathologic conditions. Read More

Vet J 2017 Oct 20;228:41-45. Epub 2017 Oct 20.

Department of Internal Medicine, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine 'Ion Ionescu de la Brad' Iaşi, 8 Mihail Sadoveanu Alley, Iaşi RO-700489, Romania. Electronic address:

Autonomic nervous system (ANS) activity in the interictal period (InIp) in dogs with presumed idiopathic epilepsy (pIE) was assessed using heart rate variability (HRV) analysis. The HRVs obtained from 28 pIE dogs with interictal epileptic discharges (InIEd; 11 with treatment and 17 without treatment) detected on electroencephalography (EEG) were compared with those obtained from 13 healthy dogs. On electrocardiographic (ECG) study, the P wave dispersion (PWD; P<0. Read More

Epilepsy Res 2017 12 29;138:88-97. Epub 2017 Oct 29.

Departament of Physiology, Universidade Federal de São Paulo, São Paulo, SP 04039-032, Brazil. Electronic address:

Brain injuries are often associated with the later development of epilepsy. Evidence suggests that morphological and functional changes occur in the remaining neural tissue during a silent (or latent) period in which no seizures are expressed. It is believed that this silent (reorganization) period may provide a therapeutic window for modifying the natural history of disease progression. Read More

eNeuro 2017 Sep-Oct;4(5). Epub 2017 Oct 30.

Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY 40536.

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in individuals with refractory acquired epilepsy. Cardiorespiratory failure is the most likely cause in most cases, and central autonomic dysfunction has been implicated as a contributing factor to SUDEP. Neurons of the nucleus tractus solitarius (NTS) in the brainstem vagal complex receive and integrate vagally mediated information regarding cardiorespiratory and other autonomic functions, and GABAergic inhibitory NTS neurons play an essential role in modulating autonomic output. Read More

Clin Auton Res 2017 Oct 25. Epub 2017 Oct 25.

Autonomic and Movement Disorders Unit, Biocruces Research Institute, Barakaldo, Bizkaia, Spain.

The vagus nerve is responsible for the parasympathetic innervation of the major thoracic and abdominal organs. It also carries sensory afferent fibres from these viscera and reaches different brain structures. These connections have proven useful in the treatment of different diseases. Read More

Epilepsy Res 2017 11;137:163-164

Department of Neurology, Division of Epilepsy Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, United States; Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford Neuroscience Health Center, 213 Quarry Road, MC 5979 (room 2856), Palo Alto, CA 94304-5979, United States. Electronic address:

Front Physiol 2017 5;8:765. Epub 2017 Oct 5.

Department of Electrical and Electronic Engineering, Institute of Biomedical Engineering, Federal University of Santa Catarina, Florianópolis, Brazil.

Epilepsy is a neurological disorder that causes changes in the autonomic nervous system. Heart rate variability (HRV) reflects the regulation of cardiac activity and autonomic nervous system tone. The early detection of epileptic seizures could foster the use of new treatment approaches. Read More

Pediatr Neurol 2017 Nov 20;76:60-65. Epub 2017 Jun 20.

ACCORDS (Adult and Child Consortium for Health Outcomes Research and Delivery Science), University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, Colorado; Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

Background: We hypothesized that children with Dravet syndrome may have additional common features beyond seizures and cognitive impairment. To address this gap in knowledge, we conducted a survey of caregivers of children with Dravet syndrome to identify and quantify their perception of associated symptoms in this population.

Methods: An electronic survey was developed in REDcap (Research Electronic Data Capture) and sent via e-mail to the participants on the Dravet Syndrome Foundation e-mail list. Read More

Cochrane Database Syst Rev 2017 10 5;10:CD001524. Epub 2017 Oct 5.

Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Clinical Sciences Centre for Research and Education, Lower Lane, Liverpool, UK, L9 7LJ.

Background: This is an updated version of the original Cochrane Review published in the Cochrane Library, Issue 5, 2015.Yoga may induce relaxation and stress reduction, and influence the electroencephalogram and the autonomic nervous system, thereby controlling seizures. Yoga would be an attractive therapeutic option for epilepsy if proved effective. Read More

J Physiol 2017 Nov 30;595(22):6887-6903. Epub 2017 Sep 30.

UCLA Neurocardiology Research Center of Excellence and UCLA Cardiac Arrhythmia Center, Los Angeles, Los Angeles, CA, USA.

Key Points: The evoked cardiac response to bipolar cervical vagus nerve stimulation (VNS) reflects a dynamic interaction between afferent mediated decreases in central parasympathetic drive and suppressive effects evoked by direct stimulation of parasympathetic efferent axons to the heart. The neural fulcrum is defined as the operating point, based on frequency-amplitude-pulse width, where a null heart rate response is reproducibly evoked during the on-phase of VNS. Cardiac control, based on the principal of the neural fulcrum, can be elicited from either vagus. Read More

BMC Neurol 2017 Aug 25;17(1):164. Epub 2017 Aug 25.

Department of Pediatrics, Chinese PLA General Hospital, Beijing, 100853, China.

Background: Acute autonomic neuropathy (AAN) is rare disorder with anecdotal report, especially for childhood onset patients. Misdiagnosis or delays in treatment can always be found in clinical practice. We conducted this study to give a description of the manifestations and treatment of AAN in children and therefore help clinicians to make the accurate diagnosis early so that the prognosis of the patients can be improved. Read More

J Neural Eng 2017 Dec;14(6):066010

Department of Biomedical Engineering, Duke University, Durham, NC, United States of America.

Objective: Neuromodulation of the central and peripheral nervous systems is becoming increasingly important for treating a diverse set of diseases-ranging from Parkinson's Disease and epilepsy to chronic pain. However, neuromodulation of the gastrointestinal (GI) tract has achieved relatively limited success in treating functional GI disorders, which affect a significant population, because the effects of stimulation on the enteric nervous system (ENS) and gut motility are not well understood. Here we develop an integrated neuromechanical model of the ENS and assess neurostimulation strategies for enhancing gut motility, validated by in vivo experiments. Read More

Heart Rhythm 2017 12 1;14(12):1771-1778. Epub 2017 Aug 1.

Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address:

Background: We recently reported that skin sympathetic nerve activity (SKNA) can be used to estimate sympathetic tone in humans. In animal models, vagal nerve stimulation (VNS) can damage the stellate ganglion, reduce stellate ganglion nerve activity, and suppress cardiac arrhythmia. Whether VNS can suppress sympathetic tone in humans remains unclear. Read More

Clin Neurophysiol 2017 09 27;128(9):1810-1819. Epub 2017 Jun 27.

Dycog Lab, Lyon Neuroscience Research Center - Inserm U 1028/CNRS UMR 5292, University of Lyon, France; Epilepsy and Functional Neurology Department, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Bron, France.

Objective: Due to limited information from scalp electroencephalographic (EEG) recordings, brain areas driving changes in cardiac rhythm during Temporal lobe (TL) seizures are not clearly identified. Using stereotactic EEG (SEEG) recordings, we aimed at identifying which of the brain regions involved in autonomic control trigger ictal tachycardia.

Methods: The neural activity of several mesial temporal lobe structures including amygdala, hippocampus, insula, and lateral temporal lobe recorded with SEEG were collected during 37 TL seizures in 9 patients, using indices based on High Frequency Activity (HFA). Read More

Clin Auton Res 2017 08 30;27(4):235-243. Epub 2017 Jun 30.

Department of Biological and Physical Sciences, Montana State University Billings, Billings, MT, 59101, USA.

Since Riley and Day first described the clinical phenotype of patients with familial dysautonomia (FD) over 60 years ago, the field has made considerable progress clinically, scientifically, and translationally in treating and understanding the etiology of FD. FD is classified as a hereditary sensory and autonomic neuropathy (HSAN type III) and is both a developmental and a progressive neurodegenerative condition that results from an autosomal recessive mutation in the gene IKBKAP, also known as ELP1. FD primarily impacts the peripheral nervous system but also manifests in central nervous system disruption, especially in the retina and optic nerve. Read More

Front Immunol 2017 31;8:618. Epub 2017 May 31.

Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.

Schizophrenia is one of the most debilitating mental disorders and is aggravated by the lack of efficacious treatment. Although its etiology is unclear, epidemiological studies indicate that infection and inflammation during development induces behavioral, morphological, neurochemical, and cognitive impairments, increasing the risk of developing schizophrenia. The inflammatory hypothesis of schizophrenia is also supported by clinical studies demonstrating systemic inflammation and microglia activation in schizophrenic patients. Read More

Front Neurol 2017 18;8:210. Epub 2017 May 18.

Department of Epileptology, University Hospital Bonn, Bonn, Germany.

Background: Sudden unexpected death in epilepsy (SUDEP) is probably due to an autonomic failure in the early postictal phase after bilateral convulsive seizures (BCS) in the majority of cases. The baroreflex sensitivity (BRS) is an established and reliable biomarker of autonomic function and sudden cardiac death.

Objective: To investigate whether postictal BRS depends on seizure type. Read More

Epilepsia 2017 07 26;58(7):1181-1189. Epub 2017 May 26.

Department of Neurology, Mayo Clinic, Rochester, Minnesota, U.S.A.

Objective: To validate predictive models for neural antibody positivity and immunotherapy response in epilepsy.

Methods: We conducted a retrospective study of epilepsy cases at Mayo Clinic (Rochester-MN; Scottsdale-AZ, and Jacksonville-FL) in whom autoimmune encephalopathy/epilepsy/dementia autoantibody testing profiles were requested (06/30/2014-06/30/2016). An Antibody Prevalence in Epilepsy (APE) score, based on clinical characteristics, was assigned to each patient. Read More

Am J Physiol Heart Circ Physiol 2017 Aug 5;313(2):H354-H367. Epub 2017 May 5.

Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee.

Vagus nerve stimulation (VNS) currently treats patients with drug-resistant epilepsy, depression, and heart failure. The mild intensities used in chronic VNS suggest that primary visceral afferents and central nervous system activation are involved. Here, we measured the activity of neurons in the nucleus of the solitary tract (NTS) in anesthetized rats using clinically styled VNS. Read More

Epilepsia 2017 06 2;58(6):e87-e90. Epub 2017 May 2.

Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York, U.S.A.

Seizure spread into autonomic and respiratory brainstem regions is thought to play an important role in sudden unexpected death in epilepsy (SUDEP). As the clinical dataset of cases of definite SUDEP available for study grows, evidence points to a sequence of events that includes postictal apnea, bradycardia, and asystole as critical events that can lead to death. One possible link between the precipitating seizure and the critical postictal sequence is seizure-driven laryngospasm sufficient to completely obstruct the airway for an extended period, but ictal laryngospasm is difficult to fully assess. Read More

Epilepsy Res 2017 07 24;133:83-88. Epub 2017 Apr 24.

Medical Sciences Post-graduate Program, Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil; Neurology Division, Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil; Applied Neurosciences Center (CeNAp), Federal University of Santa Catarina, (UFSC), Florianópolis, SC, Brazil. Electronic address:

Autonomic dysfunction may account for sudden unexpected death in patients with epilepsy (PWE). On the other hand, low cardiovascular fitness, which may affect autonomic function, is a risk factor for sudden death and all-cause mortality in the general population. Little is known about autonomic variables and cardiovascular response to exercise in PWE. Read More

Isr Med Assoc J 2017 Feb;19(2):79-84

Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Modena, Italy.

Background: Cannabidiol (CBD)-based treatments for several diseases, including Tourette's syndrome, multiple sclerosis, epilepsy, movement disorders and glaucoma, are proving to be beneficial and the scientific clinical background of the drug is continuously evolving.

Objectives: To investigate the short-term effect of CBD-enriched hemp oil for relieving symptoms and improving the life quality (QOL) in young girls with adverse drug effects (ADRs) following human papillomavirus (HPV) vaccine.

Methods: In this anecdotal, retrospective, "compassionate-use", observational, open-label study, 12 females (age 12-24 years) with severe somatoform and dysautonomic syndrome following HPV vaccination were given sublingual CBD-rich hemp oil drops, 25 mg/kg per day supplemented by 2-5 mg/ml CBD once a week until a maximum dose of 150 mg/ml CBD per day was reached over a 3 month period. Read More

Epilepsia 2017 06 25;58(6):1015-1022. Epub 2017 Apr 25.

National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China.

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. Read More

Brain Dev 2017 Aug 13;39(7):621-624. Epub 2017 Apr 13.

Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Paroxysmal sympathetic hyperactivity (PSH) is a dysautonomic condition that is associated with various types of acquired brain injuries. Traumatic brain lesions have been documented as the leading cause of PSH. However, detailed clinical features of pediatric PSH caused by intrinsic brain lesions remain to be elusive. Read More

Neuroscience 2017 05 18;350:23-38. Epub 2017 Mar 18.

The Heart Research Institute, 7 Eliza Street, Sydney 2042 New South Wales, Australia; Department of Physiology, University of Sydney, Sydney 2006 New South Wales, Australia. Electronic address:

The incidence of sudden unexpected death in epilepsy (SUDEP) is highest in people with chronic and drug-resistant epilepsy. Chronic spontaneous recurrent seizures cause cardiorespiratory autonomic dysfunctions. Pituitary adenylate cyclase-activating polypeptide (PACAP) is neuroprotective, whereas microglia produce both pro- and anti-inflammatory effects in the CNS. Read More

Conf Proc IEEE Eng Med Biol Soc 2016 08;2016:1834-1837

Vagus nerve stimulation (VNS) is a therapy on medically refractory epilepsy, and recently reported to improve cognitive function including learning and memory. The thalamo-cortical system may underlie such VNS-induced cognitive improvements. Thus, the present study targeted the auditory cortex and thalamus in rats, and investigated whether and how VNS modulates stimulus-specific adaptation (SSA) of the neural activity in these nuclei. Read More

Herz 2017 Apr;42(2):171-175

Neurologische Klinik, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.

The heart and brain are constantly interacting under normal physiological conditions. This interaction is under the control of the autonomic nervous system with parasympathetic and sympathetic nerve fibers including the participating brain structures. Pathological conditions, such as epilepsy and ischemic cerebral stroke influence heart function, especially the frequency and may result in severe arrhythmia. Read More

Epilepsy Res 2017 03 9;131:28-36. Epub 2017 Feb 9.

Nervive, Inc., 526 S. Main St., Suite 801-A, Akron, OH 44311, United States; National Center for the Investigation of Imaging and Medical Instrumentation, Universidad Autónoma Metropolitana, Mexico City, Mexico.

Purpose: As part of our efforts to develop a non-invasive facial nerve stimulator as an emergency treatment for ischemic stroke, we considered possible safety consequences if the technology was misapplied to stroke mimics, e.g., seizure. Read More