title: Cardiac Autonomic Dysfunction in Patients With Infantile Spasm and the Effect of Adrenocorticotropic Hormone Treatment.
abstract: Infantile spasm is an age-dependent epileptic-encephalopathy syndrome. Cardiac autonomic function is frequently altered in epilepsy. In this study, we examined heart rate variability in patients with infantile spasm before and after treatment. Nineteen patients with infantile spasm and 13 healthy comparisons were enrolled in the study. Cardiac rhythm was recorded with a Holter device for 24 hours before adrenocorticotropic hormone (ACTH) (Synacthen depot) and B6 vitamin administration and 1 month after treatment. Heart rate variability analysis found lower heart rate variability parameters in patients with infantile spasm at the onset of the syndrome, prior to treatment with ACTH. The time domain parameters of heart rate variability values showed a statistically significant increase following ACTH treatment. Our data suggest that patients with infantile spasm exhibit lower heart rate variability parameters, and the treatment of spasms with ACTH and B6 together diminished the autonomic dysfunction in our cohort.
authors.affiliation: Department of Pediatric Neurology, Akdeniz University Hospital, Antalya, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Gencpinar
authors.affiliation: Department of Pediatric Cardiology, Ankara Children's Hematology and Oncology Research and Training Hospital, Ankara, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Kocabas
authors.affiliation: Department of Pediatric Neurology, Akdeniz University Hospital, Antalya, Turkey.
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Duman
authors.affiliation: Department of Pediatric Neurology, Katip Çelebi University Hospital, İzmir, Turkey.
authors.forename: Nihal Olgaç
authors.initials: NO
authors.lastname: Dündar
authors.affiliation: Department of Pediatric Neurology, Akdeniz University Hospital, Antalya, Turkey shaspolat@akdeniz.edu.tr.
authors.forename: Senay
authors.initials: S
authors.lastname: Haspolat
authors.affiliation: Department of Pediatric Cardiology, Akdeniz University Hospital, Antalya, Turkey.
authors.forename: Fırat
authors.initials: F
authors.lastname: Kardelen
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use*; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D002675:Child, Preschool; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007223:Infant; D008297:Male; D013036:Spasms, Infantile / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000324:Adrenocorticotropic Hormone
keywords: ACTH treatment; autonomic dysfunction; heart rate variability; infantile spasm