Abstract

Ictal and interictal activity within the autonomic nervous system is characterized by a sympathetic overshoot in people with epilepsy. This autonomic dysfunction is assumed to be driven by alterations in the central autonomic network. In this study, exercise-induced changes of the interrelation of central and peripheral autonomic activity in patients with epilepsy was assessed. 21 patients with epilepsy (16 seizure-free), and 21 healthy matched controls performed an exhaustive bicycle ergometer test. Immediately before and after the exercise test, resting state electroencephalography measurements (Brain Products GmbH, 128-channel actiCHamp) of 5 min were carried out to investigate functional connectivity assessed by phase locking value in source space for whole brain, central autonomic network and visual network. Additionally, 1-lead ECG (Brain products GmbH) was performed to analyze parasympathetic (root mean square of successive differences (RMSSD) of the heart rate variability) and sympathetic activity (electrodermal activity (meanEDA)). MeanEDA increased (p < 0.001) and RMSSD decreased (p < 0.001) from pre to post-exercise in both groups. Correlation coefficients of meanEDA and central autonomic network functional connectivity differed significantly between the groups (p = 0.004) after exercise. Both patients with epilepsy and normal control subjects revealed the expected physiological peripheral autonomic responses to acute exhaustive exercise, but alterations of the correlation between central autonomic and peripheral sympathetic activity may indicate a different sympathetic reactivity after exercise in patients with epilepsy. The clinical relevance of this finding and its modulators (seizures, anti-seizure medication, etc.) still needs to be elucidated.

中文翻译：

---

社区癫痫患者组中运动引起的中枢和外周交感神经活动与健康对照组不同

摘要

癫痫患者的自主神经系统发作期和发作间期活动的特点是交感神经过度兴奋。这种自主神经功能障碍被认为是由中枢自主网络的改变引起的。在这项研究中，评估了运动引起的癫痫患者中枢和外周自主神经活动相互关系的变化。 21 名癫痫患者（16 名无癫痫发作）和 21 名健康匹配对照者进行了详尽的自行车测力计测试。运动测试前后立即进行 5 分钟的静息态脑电图测量（Brain Products GmbH，128 通道 actiCHamp），以研究全脑、中枢自主网络和视觉网络的源空间锁相值评估的功能连接性。此外，还进行 1 导联心电图 (Brain products GmbH) 来分析副交感神经（心率变异性的连续差均方根 (RMSSD)）和交感神经活动（皮电活动 (meanEDA)）。 从运动前到运动后，两组的平均 EDA 均增加 ( p  < 0.001)，RMSSD 均减少 ( p < 0.001)。运动后，各组之间的平均 EDA 和中央自主网络功能连接的相关系数存在显着差异 ( p  = 0.004)。癫痫患者和正常对照受试者均显示出对急性力竭运动的预期生理外周自主神经反应，但中枢自主神经和外周交感神经活动之间相关性的改变可能表明癫痫患者运动后的不同交感神经反应。这一发现及其调节剂（癫痫发作、抗癫痫药物等）的临床相关性仍需阐明。