Risk factor of sudden unexpected death in epilepsy from heart rate variability in epilepsy children

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K19655
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Pediatrics
• Research Institution: Oita University
• Principal Investigator: Okanari Kazuo 大分大学, 医学部, 助教 (90527657)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: てんかん / 突然死 / SUDEP / 心拍変動 / 自律神経機能異常

Outline of Final Research Achievements

Sudden Unexpected Death in Epilepsy (SUDEP) is the most important epilepsy-related cause of premature death. Multifactorial processes contribute to SUDEP. One of background factors of SUDEP is acquired autonomic dysfunction. We aim to clarify correlation autonomic function and clinical factors. Heart rate variability (HRV) is used as an index of autonomic function. We used HF and LF/HF of HRV parameters to analyze autonomic function. Both HF and LF/HF correlated with duration of epilepsy in epilepsy children. During the early time of epilepsy, there was a group of extremely high or low HF, LF/HF in epilepsy children. Our future direction is that we will clarify the group of extremely high or low HF, LF/HF in epilepsy children during the early time of epilepsy. It may be possible to identify the population predisposed to SUDEP by analyzing chronological change after onset of epilepsy, and the characteristics of the group with abnormal HRV.

Free Research Field

小児神経学

Academic Significance and Societal Importance of the Research Achievements

SUDEPを起こしやすい集団または集団の特徴が明らかになることで、突然死しやすい集団に対し、てんかん外科や迷走神経刺激療法など侵襲的ではあるが発作軽減効果の高い治療選択をより積極的に勧める指標になること、ウエアラブルモニタリングでHRVをモニタリングし、危険を予測したり、回避できるようになるかもしれない。
SUDEPのハイリスク集団を同定しリスクを小さくすることができれば、てんかん患者とその家族を身体的、精神的なストレスから解放することができる。SUDEPの予防は常に不安を抱えて生活するてんかん患者のみならず、その家族、とりまく社会に対して、大きな影響を与えうるものと考える。