Autonomic nervous system functioning associated with psychogenic nonepileptic seizures: Analysis of heart rate variability

Kruijs, Sylvie J.M. van der; Vonck, Kristl; Langereis, Geert; Feijs, Lmg Loe; Bodde, Nynke M.G.; Lazeron, R.H.C.; Carrette, Evelien; Boon, Paul; Backes, Walter H.; Jansen, Jacobus F. A.; Aldenkamp, Albert P.; Cluitmans, P.J.M.

doi:10.1016/j.yebeh.2015.10.014

Cited by 47 publications

(36 citation statements)

References 31 publications

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“…Consistent with our findings in the FMD population, several studies have demonstrated impairments in HRV in patients with PNES, both during interictal[8] and peri-ictal periods[9, 20]. …”

Section: Discussionsupporting

confidence: 92%

Impaired resting vagal tone in patients with functional movement disorders

Maurer

Liu

LaFaver

et al. 2016

Parkinsonism & Related Disorders

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Introduction The autonomic nervous system plays an integral role in the maintenance of homeostasis during times of stress. The functioning of the autonomic nervous system in patients with functional movement disorders (FMD) is of particular interest given the hypothesis that converted psychological stress plays a critical role in FMD disease pathogenesis. We sought to investigate autonomic nervous system activity in FMD patients by examining heart rate variability (HRV), a quantitative marker of autonomic function. Methods 35 clinically definite FMD patients and 38 age- and sex-matched healthy controls were hospitalized overnight for continuous electrocardiogram recording. Standard time and frequency domain measures of HRV were calculated in the awake and asleep stages. All participants underwent a thorough neuropsychological battery, including the Hamilton Anxiety and Depression scales and the Beck Depression Inventory. Results Compared to controls, patients with FMD exhibited decreased root mean square of successive differences between adjacent NN intervals (RMSSD) (p = 0.02), a marker of parasympathetic activity, as well as increased mean heart rate (p = 0.03). These measures did not correlate with the depression and anxiety scores included in our assessment as potential covariates. Conclusion In this exploratory study, patients with FMD showed evidence of impaired resting state vagal tone, as demonstrated by reduced RMSSD. This decreased vagal tone may reflect increased stress vulnerability in patients with FMD.

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“…Consistent with our findings in the FMD population, several studies have demonstrated impairments in HRV in patients with PNES, both during interictal[8] and peri-ictal periods[9, 20]. …”

Section: Discussionsupporting

confidence: 92%

Impaired resting vagal tone in patients with functional movement disorders

Maurer

Liu

LaFaver

et al. 2016

Parkinsonism & Related Disorders

View full text Add to dashboard Cite

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“…One study showed a lower parasympathetic tone and higher sympathetic tone during PNES than at rest, with HRV markers correctly categorising over three quarters of ECG segments from patients with PNES as capturing the ictal or interictal state [26]. A more recent study using a slightly different approach and different time windows demonstrated an increase in heart rate variability (HRV) markers of sympathetic tone just prior to a PNES but suggested that the seizures themselves were associated with parasympathetic activation, consistent with the idea that PNES may provide some relief from heightened arousal or the stimuli giving rise to it [27].…”

Section: Physiological Changesmentioning

confidence: 68%

“…One of the studies of HRV changes during PNES already mentioned above suggested that the preictal rise of sympathetic activation was stopped by the dissociation from the adverse experience causing PNES or associated with having a seizure and replaced by parasympathetic activation in the ictal and postical phase of a PNES [27]. If confirmed in larger studies, this findings would provide strong support for the ICM.…”

Section: Testing the Icmmentioning

confidence: 71%

Understanding psychogenic nonepileptic seizures—Phenomenology, semiology and the Integrative Cognitive Model

Reuber

Brown

2017

Seizure

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“…The pulsation abnormality becomes evident as abnormal signal variation in the specific physiological frequency bands, especially respiratory and very low frequencies. These frequencies further overlap with autonomic disturbances known to be present in epilepsy (Ansakorpi et al., 2002, 2011; Liu et al., 2017; Suorsa et al., 2011; van der Kruijs et al., 2016). …”

Section: Discussionmentioning

confidence: 99%

Altered physiological brain variation in drug‐resistant epilepsy

et al. 2018

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IntroductionFunctional magnetic resonance imaging (fMRI) combined with simultaneous electroencephalography (EEG‐fMRI) has become a major tool in mapping epilepsy sources. In the absence of detectable epileptiform activity, the resting state fMRI may still detect changes in the blood oxygen level‐dependent signal, suggesting intrinsic alterations in the underlying brain physiology.MethodsIn this study, we used coefficient of variation (CV) of critically sampled 10 Hz ultra‐fast fMRI (magnetoencephalography, MREG) signal to compare physiological variance between healthy controls (n = 10) and patients (n = 10) with drug‐resistant epilepsy (DRE).ResultsWe showed highly significant voxel‐level (p < 0.01, TFCE‐corrected) increase in the physiological variance in DRE patients. At individual level, the elevations range over three standard deviations (σ) above the control mean (μ) CVMREG values solely in DRE patients, enabling patient‐specific mapping of elevated physiological variance. The most apparent differences in group‐level analysis are found on white matter, brainstem, and cerebellum. Respiratory (0.12–0.4 Hz) and very‐low‐frequency (VLF = 0.009–0.1 Hz) signal variances were most affected.ConclusionsThe CVMREG increase was not explained by head motion or physiological cardiorespiratory activity, that is, it seems to be linked to intrinsic physiological pulsations. We suggest that intrinsic brain pulsations play a role in DRE and that critically sampled fMRI may provide a powerful tool for their identification.

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Autonomic nervous system functioning associated with psychogenic nonepileptic seizures: Analysis of heart rate variability

Cited by 47 publications

References 31 publications

Impaired resting vagal tone in patients with functional movement disorders

Impaired resting vagal tone in patients with functional movement disorders

Understanding psychogenic nonepileptic seizures—Phenomenology, semiology and the Integrative Cognitive Model

Altered physiological brain variation in drug‐resistant epilepsy

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