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J Neurosci Res 2021 Jun 9. Epub 2021 Jun 9.

Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.

Epilepsy is a debilitating disorder of uncontrollable recurrent seizures that occurs as a result of imbalances in the brain excitatory and inhibitory neuronal signals, that could stem from a range of functional and structural neuronal impairments. Globally, nearly 70 million people are negatively impacted by epilepsy and its comorbidities. One such comorbidity is the effect epilepsy has on the autonomic nervous system (ANS), which plays a role in the control of blood circulation, respiration and gastrointestinal function. Read More

Ann Clin Transl Neurol 2021 May 28. Epub 2021 May 28.

IRCCS Istituto Giannina Gaslini, Genova, Italy.

The influence of the central nervous system and autonomic system on cardiac activity is being intensively studied, as it contributes to the high rate of cardiologic comorbidities observed in people with epilepsy. Indeed, neuroanatomic connections between the brain and the heart provide links that allow cardiac arrhythmias to occur in response to brain activation, have been shown to produce arrhythmia both experimentally and clinically. Moreover, seizures may induce a variety of transient cardiac effects, which include changes in heart rate, heart rate variability, arrhythmias, asystole, and other ECG abnormalities, and can trigger the development of Takotsubo syndrome. Read More

J Pers Med 2021 Apr 17;11(4). Epub 2021 Apr 17.

Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan.

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. Read More

Front Pediatr 2021 29;9:648927. Epub 2021 Mar 29.

Pediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep, and Long-Term Ventilation Unit, Academic Department of Pediatrics and Genetic Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Congenital central hypoventilation syndrome (CCHS) is a rare disorder whose clinical phenotype is closely related to genotype. A retrospective analysis has been conducted on 22 patients with CCHS, who were referred to the Pediatric Pulmonology and Respiratory Intermediate Care Unit of Bambino Gesù Children's Hospital (Italy) for a multidisciplinary follow-up program between 2000 and 2020. Apnea and cyanosis were the most frequent symptoms at onset (91%). Read More

Appl Neuropsychol Adult 2021 Apr 12:1-15. Epub 2021 Apr 12.

Psychology Department, Virginia Tech, Blacksburg, VA, USA.

Laterality of motor symptom onset in Parkinson's disease is both well-known and under-appreciated. Treatment of disorders that have asymmetric pathological features, such as stroke and epilepsy, demonstrate the importance of incorporating hemispheric lateralization and specialization into therapy and care planning. These practices could theoretically extend to Parkinson's disease, providing increased diagnostic accuracy and improved treatment outcomes. Read More

Epilepsy Behav 2021 05 7;118:107940. Epub 2021 Apr 7.

Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, Ontario, Canada; Department of Pathology and Lab Medicine, London Health Sciences Centre, Western University, London, Ontario, Canada. Electronic address:

Objective: To describe morphological characteristics of the brainstem nuclei in response to chronic vagus nerve stimulation (VNS) in patients with refractory epilepsy.

Background: VNS is a treatment option for individuals with medically refractory epilepsy. While treatment with VNS may achieve up to 50% seizure reduction and is protective against sudden unexpected death in epilepsy (SUDEP), its mechanism of action is not fully understood. Read More

Epilepsy Behav 2021 05 24;118:107931. Epub 2021 Mar 24.

APHP, Department of Neurosurgery, Sorbonne University, La Pitié-Salpêtrière Hospital, Paris, France; Paris Brain Institute, INSERM, CNRS, Sorbonne University, UMR S 1127, Paris Brain Institute, ICM, F-75013 Paris, France. Electronic address:

Purpose: Vagus nerve stimulation (VNS) implantation is increasingly proposed in outpatient procedure. Some epilepsy syndromes are associated with severe neurodevelopmental disabilities (intellectual disability, autism) and often motor or sensory handicaps, making ambulatory surgery more complex.

Methods: We prospectively assessed the feasibility and safety of outpatient VNS implantation in 26 adult patients with drug-resistant epilepsy with severe intellectual disability between December 2017 and October 2020. Read More

Nat Commun 2021 03 9;12(1):1539. Epub 2021 Mar 9.

Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA.

Vagus nerve stimulation (VNS) is thought to affect neural activity by recruiting brain-wide release of neuromodulators. VNS is used in treatment-resistant epilepsy, and is increasingly being explored for other disorders, such as depression, and as a cognitive enhancer. However, the promise of VNS is only partially fulfilled due to a lack of mechanistic understanding of the transfer function between stimulation parameters and neuromodulatory response, together with a lack of biosensors for assaying stimulation efficacy in real time. Read More

Epileptic Disord 2021 Feb;23(1):17-39

Stichting Epilepsie Instellingen Nederland - SEIN, Achterweg 5, 2103 SW, Heemstede, The Netherlands, NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, UK, Department of Neurology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

People with epilepsy have a three-fold increased risk of dying prematurely, and a significant proportion is due to sudden cardiac death or acute myocardial infarctions. The causes of increased cardiovascular morbidity and mortality in epilepsy are manifold and include acute or remote effects of epileptic seizures, the longstanding epilepsy itself or antiseizure treatments. Seizure-related cardiac arrhythmias are common and comprise bradyarrhythmia and asystole, atrial fibrillation and ventricular tachycardia. Read More

Epilepsia 2021 Apr 23;62(4):960-972. Epub 2021 Feb 23.

Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.

Objective: Daytime and nighttime patterns affect the dynamic modulation of brain and body functions and influence the autonomic nervous system response to seizures. Therefore, we aimed to evaluate 24-hour patterns of electrodermal activity (EDA) in patients with and without seizures.

Methods: We included pediatric patients with (a) seizures (SZ), including focal impaired awareness seizures (FIAS) or generalized tonic-clonic seizures (GTCS), (b) no seizures and normal electroencephalography (NEEG), or (c) no seizures but epileptiform activity in the EEG (EA) during vEEG monitoring. Read More

Front Neurol 2020 5;11:632510. Epub 2021 Feb 5.

Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.

To systematically identify and critically appraise studies that investigate the autonomic characteristics of Sudden Unexpected Death in Epilepsy (SUDEP) in the pediatric population. We also wanted to explore how this information would be relevant to the management of epilepsy in patients with Rett Syndrome. Using PRISMA guidelines, a systematic review of PubMed, Scopus, Cochrane, PsycINFO, Embase, and Web of Science databases was performed to identify eligible studies. Read More

Epilepsy Behav 2021 04 17;117:107810. Epub 2021 Feb 17.

Melbourne School of Psychological Sciences, University of Melbourne, VIC 3010, Australia.

Joint Bone Spine 2021 05 3;88(3):105149. Epub 2021 Feb 3.

INSERM UMRS 938, service de rhumatologie, Sorbonne Université, hôpital Saint-Antoine, AP-HP, Paris, France. Electronic address:

The vagus nerve is the main nerve of the parasympathetic autonomic nervous system. Beyond its vegetative functions, the vagus nerve possesses anti-inflammatory and analgesic properties. Initially developed in the treatment of refractory epilepsy, vagus nerve stimulation (VNS) is currently being evaluated in several musculoskeletal diseases. Read More

Epilepsy Behav 2021 03 21;116:107728. Epub 2021 Jan 21.

Northwestern Memorial Hospital, Chicago, IL 60611, USA.

Purpose: Many patients with epilepsy are unable to completely control seizures with medication alone. Vagus nerve stimulation is an effective nonpharmacologic option for treatment-resistant epilepsy. AutoStim technology is a relatively new VNS feature that provides extra stimulations in response to tachycardia, which often precedes seizures. Read More

Int J Mol Sci 2020 Dec 27;22(1). Epub 2020 Dec 27.

Biomedical Research and Translational Medicine, Masonic Medical Research Institute, 2150 Bleecker St., Utica, NY 13501, USA.

Neurological disorders including depression, anxiety, post-traumatic stress disorder (PTSD), schizophrenia, autism and epilepsy are associated with an increased incidence of cardiovascular disorders and susceptibility to heart failure. The underlying molecular mechanisms that link neurological disorders and adverse cardiac function are poorly understood. Further, a lack of progress is likely due to a paucity of studies that investigate the relationship between neurological disorders and cardiac electrical activity in health and disease. Read More

Epilepsy Behav 2021 01 1;114(Pt A):107577. Epub 2020 Dec 1.

Department of Psychiatry, University of Melbourne, Austin Health, Heidelberg, VIC 3084, Australia; The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC 3084, Australia. Electronic address:

Objectives: Why a patient might present with psychogenic nonepileptic seizures (PNES) as opposed to another functional neurological symptom is unknown. A recent review suggested that patients with PNES and functional motor disorders (FMD) differ on demographic and clinical factors of potential aetiological and mechanistic significance, arguing they might represent different disorders, though direct comparisons are limited. We sought to determine whether these factors differed in patients presenting with FMD and PNES at our clinic, as well as whether preceding medical complaints would differ between the two, particularly those affecting the limbs or head. Read More

Life Sci 2021 Jan 28;265:118826. Epub 2020 Nov 28.

Neuropharmacology Research Strength, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia. Electronic address:

Epilepsy is a neurologicaldisorder characterized by persistent predisposition to recurrent seizurescaused by abnormal neuronal activity in the brain. Epileptic seizures maydevelop due to a relative imbalance of excitatory and inhibitory neurotransmitters. Expressional alterations of receptors and ion channelsactivated by neurotransmitters can lead to epilepsy pathogenesis. Read More

Croat Med J 2020 Oct;61(5):422-428

Mario Habek, University Hospital Center Zagreb, Department of Neurology, Referral Center for Autonomic Nervous System Disorders, Kišpatićeva 12, HR-10000 Zagreb, Croatia,

Aim: To estimate the incidence of postural orthostatic tachycardia syndrome (POTS) in the population of Zagreb, Croatia, and to determine the patients' demographic and clinical characteristics.

Methods: From 2012-2017, we identified patients with POTS by a retrospective analysis of medical records at University Hospital Center Zagreb. Crude incidence rates were directly standardized by age according to the European and World Standard Population. Read More

Mult Scler Relat Disord 2021 Jan 27;47:102604. Epub 2020 Oct 27.

Department of Neurology, First Affiliated Hospital, Guangxi Medical University, Nanning, P. R. China, 530021. Electronic address:

Background: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune nervous system disease that has become increasingly recognized. This retrospective study is aimed to analyze the relations between clinical manifestations and blood brain barrier (BBB) integrity in anti-NMDAR encephalitis patients.

Methods: Anti-NMDAR encephalitis patients were admitted to the First Affiliated Hospital of Guangxi Medical University from April 2014 to April 2020. Read More

Niger J Clin Pract 2020 Oct;23(10):1437-1442

Department of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria.

Background: Cardiac autonomic neuropathy (CAN) resulting from seizures has been implicated in sudden unexpected death in epilepsy in persons with epilepsy (PWE), however, there are no previous studies of CAN in PWE from Nigeria.

Objectives: This study sought to determine the frequency and pattern of CAN in adult PWE in a tertiary hospital in South-western Nigeria and to determine the relationship between seizure variables and CAN.

Methods: A cross-sectional study of 80 adult PWE and 80 matched controls aged between 18 and 60 years was carried out between March 2012 and June 2013 at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. Read More

Medicina (Kaunas) 2020 Sep 23;56(10). Epub 2020 Sep 23.

Department of Macroscopic and Clinical Anatomy, Medical University of Graz, 8010 Graz, Austria.

Left sided non-recurrent laryngeal nerves (NRLN) are very rarely observed during surgery in the head and neck region. Arising directly from the cervical aspect of the vagus nerve, the NRLN lies in a vulnerable position distant from its normal location. NRLNs are normally associated with embryological branchial arch aberrations and subsequent vascular anomalies. Read More

Rozhl Chir 2020 ;99(7):304-310

Introduction: Vagus nerve stimulation is a palliative treatment for patients with refractory epilepsy to reduce the frequency and intensity of seizures. A bipolar helical electrode is placed around the left vagus nerve at the cervical level and is connected to the pulse generator placed in a subcutaneous pocket, most commonly in the subclavian region.

Methods: Between March 1998 and October 2019, we performed 196 procedures related to the vagal nerve stimulation at the Neurosurgery Department in Motol University Hospital. Read More

Epilepsy Behav 2020 11 14;112:107373. Epub 2020 Sep 14.

Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address:

Objectives: The objective of the study were to examine the safety and efficacy of vagus nerve stimulation (VNS) for reducing seizure frequency and antiepileptic drugs (AEDs) in children younger than six years and to examine long-term VNS efficacy for children who receive the device at ages 1-3 and at ages 4-6.

Methods: We conducted a 10-year retrospective analysis of VNS implantations at UPMC Children's Hospital of Pittsburgh. Relevant data were collected within 12 months of VNS implantation and at six months, one, two, and four years after VNS implantation. Read More

Front Neurol 2020 14;11:842. Epub 2020 Aug 14.

Department of Neurology, "SS Annunziata" Hospital, Chieti, Italy.

The temporal lobe, a critical hub for cognition, also plays a central role in the regulation of autonomic cardiovascular functions. Lesions in this area are usually associated with abnormalities in the regulation of heart rate (HR) and blood pressure (BP). The analysis of the heart rate variability (HRV) is useful to evaluate the cardiac parasympathetic nervous system activity. Read More

Clin Neurol Neurosurg 2020 10 26;197:106187. Epub 2020 Aug 26.

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China. Electronic address:

Objectives: This study described the clinical characteristics of autoimmune neurological diseases with dual seropositive antibodies of CASPR2 and LGI1.

Patients And Methods: Three patients, with antibodies targeting both CASPR2 and LGI1 (EUROIMMUN, FA 112d-1, Germany), hospitalized in Department of Neurology, Xuanwu Hospital, Capital Medical University from June 2016 to June 2019 were collected in this study. We summarized the clinical characteristics of patients with CASPR2 and LGI1 antibodies from a targeted literature review. Read More

Front Neurol 2020 7;11:713. Epub 2020 Aug 7.

Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.

Psychogenic non-epileptic seizures (PNES) may resemble epileptic seizures. There are few data about ictal ANS activity alterations induced by PNES in patients with pure PNES (pPNES) compared to PNES with comorbid epilepsy (PNES/ES). We aimed to compare heart rate variability (HRV) parameters and hence autonomic regulation in PNES in epileptic and non-epileptic patients. Read More

J Neurol Sci 2020 11 12;418:117095. Epub 2020 Aug 12.

Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy. Electronic address:

Objective: Some antiepileptic drugs (AEDs), like sodium channel blockers are significantly associated with autonomic dysfunction in patients with epilepsy. Unlike other sodium-blockers AEDs, lacosamide (LCM) is a third generation AEDs which enhances the slow inactivation of voltage-gated sodium channels. So far, data about LCM on autonomic nervous system are still unknown. Read More

PLoS One 2020 21;15(8):e0218357. Epub 2020 Aug 21.

Department of Neurology and Neurobiology of Ageing, Kanazawa University, Kanazawa, Ishikawa, Japan.

Objective: Mental health is an essential issue during adolescence. The number of students who use counseling services is increasing in universities. We attempted to confirm the characteristics of the students who access counseling services using both psychological tests and pulse rate variability (PRV) for better support for students' academic success. Read More

J Med Genet 2020 Jul 31. Epub 2020 Jul 31.

Unit of Neuromuscular and Neurodegenerative Diseases, Department of Neuroscience and Neurorehabilitation, IRCCS Bambino Gesù Children's Hospital, Roma, Italy.

Background: Dominant and recessive variants in the gene on chromosome 2q37.3 are associated with several phenotypes, although only three syndromes are currently listed in the OMIM classification: hereditary sensory and autonomic neuropathy type 2 and spastic paraplegia type 30, both recessively inherited, and mental retardation type 9 with dominant inheritance.

Methods: In this retrospective multicentre study, we describe the clinical, neuroradiological and genetic features of 19 Caucasian patients (aged 3-65 years) harbouring heterozygous variants, and extensively review the available literature to improve current classification of -related disorders. Read More