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Characterizing vascular tone in nocturnal major motor seizures using wearable photoplethysmography
Mohammad Shahbakhti1, Anemoon T Bosch2, Xi Long3
1Stichting Epilepsie Instellingen Nederland (SEIN), 2103SW Heemstede, The Netherlands.
Insights
Seizures significantly alter peripheral vascular tone in children with epilepsy, causing vasoconstriction that continues after the event. This study used wearable photoplethysmography (PPG) to monitor these changes.
Area of Science:
- Neurology
- Cardiovascular Physiology
- Biomedical Engineering
Background:
- The effects of seizures on the peripheral vascular system are not well understood.
- Wearable photoplethysmography (PPG) offers a non-invasive method to assess vascular dynamics.
Purpose of the Study:
- To characterize peripheral vascular tone changes during seizures in children with refractory epilepsy.
- To investigate the impact of seizures on vascular tone using PPG.
Main Methods:
- Utilized data from the PROMISE trial, including children aged 4-16 with nocturnal major motor seizures.
- Analyzed 10-minute PPG segments covering baseline, pre-ictal, ictal, and post-ictal phases.
- Quantified amplitude modulation (AM) of the PPG signal as a proxy for peripheral vascular tone.
Main Results:
- Studied 135 seizure events across 13 pediatric participants.
- Observed a significant decrease in AM during the pre-ictal phase (p<0.05).
- Demonstrated a more pronounced AM reduction during ictal and post-ictal phases (p<0.001) compared to baseline.
Conclusions:
- Seizures induce peripheral vasoconstriction.
- This vasoconstrictive effect persists into the post-ictal period.
Objective:
The impact of seizures on the peripheral vascular system has not been well studied. Here, we used wearable photoplethysmography (PPG) to characterize peripheral vascular tone dynamics in children with refractory epilepsy.
Methods:
We used data from the PROMISE trial, which included children aged 4-16 years with nocturnal major motor seizures. We selected continuous 10-minute PPG segments, each spanning the seizure-free baseline, pre-ictal, ictal, and post-ictal phases. The amplitude modulation (AM) of the PPG signal, representing the slow variation in pulse amplitude and serving as a proxy for relative blood volume, was analyzed to characterize peripheral vascular tone. We applied a linear mixed-effects model to compare the AM across pre-ictal, ictal, and post-ictal phases relative to the baseline.
Results:
We studied 135 seizure events from 13 children (42% female; mean age: 9.7 ± 3.6 years). Our analysis revealed a significant AM decrease during the pre-ictal phase (p<0.05), with a more pronounced decrease during the ictal and post-ictal phases (p<0.001) relative to the baseline.
Significance:
Seizures impact peripheral vascular tone with signs of vasoconstriction that persists into the post-ictal phase.
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