Disorders

EPILEPSY - 2018

Professor Vaughan Macefield was the recipient of Brain Foundation grant funding in 2018

EPILEPSY

EPILEPSY
How The Brain Controls The Heart And Blood Vessels In Epilepsy
Professor Vaughan Macefield
Baker Heart & Diabetes Institute
Co-Investigators : Professor Terence O'Brien, Professor Luke Henderson

PROJECT SUMMARY:

In addition to the motor consequences of epilepsy, seizures result in cardiovascular and respiratory consequences that, in some individuals may lead to death. Indeed, Sudden Unexplained Death in Epilepsy (SUDEP) is one of the most poorly understood consequences of epilepsy. By definition, the mechanisms leading to DUSEP are unknown. This Brain Foundation grant builds on the work we have been doing in humans to understand how functional and structural changes in the brain lead to increased cardiovascular risk in various disease states, extending the work to epilepsy. We are the only group in the world using direct microelectrode recordings of sympathetic nerve activity (MSNA) in combination with functional magnetic resonance imaging (fMRI) of the brain to identify areas of the brain responsible for the generation of MSNA. Using this state-of-the-art brain imaging protocol, this research promises to identify changes in the brain associated with epilepsy that increase the probability of SUDEP in certain individuals. By documenting changes in areas of the brain involved in cardiovascular control we hope to be able to identify individuals at risk of SUDEP, ultimately preventing sudden death in epilepsy from occurring.

RESEARCH OUTCOME:

 Although we have undertaken some successful recordings in people with epilepsy using this approach, recruitment of suitable participants has been slow – and then COVID hit. Nevertheless, we predict that will be able to identify disturbances in the operation of the sympathetic connectome in certain people with epilepsy, just as we have in those with hypertension. In addition to these invasive studies, we have been assessing the changes in heart rate variability (HRV) in video-documented cases of SUDEP and non-SUDEP controls: HRV provides a non-invasive tool for examining autonomic control of the heart. Already, we have identified differences in HRV metrics in those individuals who succumbed to SUDEP; by assessing baseline HRV as well as MSNA we anticipate being able to identify changes in the brain associated with epilepsy that increase the probability of SUDEP in certain individuals. By documenting changes in areas of the brain involved in cardiovascular control we hope to be able to identify individuals at risk of SUDEP, ultimately preventing sudden death in epilepsy from occurring.

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