Study of the Link Between Structural Alterations in the Hypothalamus and Cardiac Dysautonomia in Drug-resistant Epilepsy

Condition(s) studied

Investigational drug(s) / intervention(s)

MRI scan: Patients will be recruited and included by the epileptologist in the clinical neurophysiology department, after verification of the inclusion criteria. The patient will then undergo an MRI scan on the 7T machine at Lille University Hospital during the Amiens shifts. The anonymized images will be transmitted to Amiens-Picardie University Hospital via an existing secure system. The images will be processed in Amiens under the supervision of Prof. Constans.

electrocardiogram: Heart rate variability parameters will be calculated from the patients' electrocardiograms, performed as part of their care under the supervision of Prof. Szurhaj.

Study summary

Patients with drug-resistant epilepsy may have cardiac dysautonomia, with reduced heart rate variability and increased sympathetic tone. This condition is part of the concept of "epileptic heart" and could be a risk factor for sudden death, one of the main causes of excess mortality in patients with severe epilepsy in adulthood. The mechanism of this cardiac impairment is poorly understood. The hypothalamus, due to its role as the subcortical conductor of the autonomic nervous system and its known links with the limbic system, particularly the amygdala and hippocampus, is a candidate for a key intermediary role in the impact of seizures on cardiorespiratory function. The investigators wish to investigate the hypothesis that cardiac dysautonomia in patients with drug-resistant epilepsy is correlated with structural changes in the hypothalamus. The investigators wish to study in 7Tesla MRI the volume of the different hypothalamic nuclei, the amygdalo- hypothalamic and hypothalamo-bulbar connectivity, as well as the metabolic content in spectroscopy in patients with drug-resistant epilepsy, and correlate these data with the sympathetic and parasympathetic tones of these patients.

Eligibility

Primary outcome measure(s)

• Correlation coefficient between the volume of the posterior hypothalamic nucleus with the degree of cardiac autonomic function impairment — 5 months
  Correlation coefficient between the volume of the posterior hypothalamic nucleus with the degree of cardiac autonomic function impairment across the entire cohort of patients with epilepsy

Trial sites (1)

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