Purpose: 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. This study aims at comparing HRV changes occurring in two groups of patients suffering from Temporal Lobe Epilepsy (TLE). To that aim, we evaluated patients differentiated by the right or left location of the epileptic foci. Materials and Methods: Fifty-two adult patients with a diagnosis of TLE were enrolled. Each patient underwent a 20-min EEG + EKG recording in resting state. According to the localization of epileptic focus, patients were divided into two subgroups: right TLE (R-TLE) and left TLE (L-TLE). HRV parameters were calculated with a short-lasting analysis of EKG recordings. Time-domain and frequency domain-related, as well as non-linear analysis, parameters, were compared between the two groups. Results: Compared to the R-TLE group, L-TLE subjects showed a significant decrease in low frequency (LF) (p < 0.01) and low frequency/high-frequency ratio (LF/HF) (p < 0.001) as well as increased HF values (p < 0.01), a parameter indicative of the presence of an increased cardiac vagal tone. These results were also confirmed in the subgroup analysis that took into account the seizure types, responses to antiepileptic drugs, seizure frequencies, and etiology. Conclusions: The main finding of the study is that, compared to R-TLE, L-TLE is associated with increased cardiac vagal tone. These results indicate that patients with TLE exhibit a lateralized cardiac autonomic control. L-TLE patients may have a lower risk of developing cardiac dysfunctions and less susceptible to develop Sudden Death for Epilepsy (SUDEP).

中文翻译：

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房间隔心率变异性分析揭示了颞叶癫痫患者心脏自主控制的横向化。

目的：颞叶是认知的关键枢纽，在调节自主神经功能中也起着核心作用。该区域的病变通常与心率（HR）和血压（BP）调节异常有关。心率变异性（HRV）的分析可用于评估心脏副交感神经系统活动。这项研究旨在比较两组患有颞叶癫痫（TLE）的患者的HRV变化。为此，我们评估了按癫痫病灶的左右位置区分的患者。材料和方法：纳入了52例诊断为TLE的成年患者。每位患者在静息状态下均进行20分钟的脑电图+心电图记录。根据癫痫病灶的定位，患者分为两个亚组：右TLE（R-TLE）和左TLE（L-TLE）。通过对心电图记录进行持久分析来计算HRV参数。比较了两组的时域和频域相关参数以及非线性分析参数。结果：与R-TLE组相比，L-TLE受试者的低频（LF）（p <0.01）和低频/高频比（LF / HF）（p <0.001）显着降低，并且HF值增加（p <0.01），该参数表明存在心脏迷走神经张力增加。这些结果在亚组分析中得到了证实，该亚组分析考虑了癫痫发作的类型，对抗癫痫药的反应，癫痫发作的频率和病因。结论：该研究的主要发现是，与R-TLE相比，L-TLE与心脏迷走神经张力增加有关。这些结果表明TLE患者表现出侧向的心脏自主神经控制。L-TLE患者发生心脏功能障碍的风险可能较低，并且不易发生癫痫猝死（SUDEP）。