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BRIEF RESEARCH REPORT article

Front. Neurosci.
Sec. Autonomic Neuroscience
Volume 18 - 2024 | doi: 10.3389/fnins.2024.1373837

Heart Rate Variability as a Preictal Marker for Determining the Laterality of Seizure Onset Zone in Frontal Lobe Epilepsy

Provisionally accepted
Seho Lee Seho Lee 1Hayom Kim Hayom Kim 2,3Jin H. Kim Jin H. Kim 1Mingyeong So Mingyeong So 2,3Jung Bin Kim Jung Bin Kim 2,3*Dong-joo Kim Dong-joo Kim 1,2,4*
  • 1 Department of Brain and Cognitive Engineering, College of Engineering, Korea University, Seoul, Seoul, Republic of Korea
  • 2 Department of Neurology, Korea University Anam Hospital, Seoul, Republic of Korea
  • 3 Department of Neurology, College of Medicine, Korea University, Seoul, Seoul, Republic of Korea
  • 4 NeuroTx, Co., Ltd., Seoul, Republic of Korea

The final, formatted version of the article will be published soon.

    Determining the laterality of the seizure onset zone is challenging in frontal lobe epilepsy (FLE) due to the rapid propagation of epileptic discharges to the contralateral hemisphere. There is hemispheric lateralization of autonomic control, and heart rate is modulated by interactions between the sympathetic and parasympathetic nervous systems. Based on this notion, the laterality of seizure foci in FLE might be determined using heart rate variability (HRV) parameters.We explored preictal markers for differentiating the laterality of seizure foci in FLE using HRV parameters. Twelve patients with FLE (6 right FLE and 6 left FLE) were included in the analyses.A total of 551 (460 left FLE and 91 right FLE) 1-min epoch electrocardiography data were used for HRV analysis. We found that most HRV parameters differed between the left and right FLE groups.Among the machine learning algorithms applied in this study, the light gradient boosting machine was the most accurate, with an AUC value of 0.983 and a classification accuracy of 0.961. Our findings suggest that HRV parameter-based laterality determination models can be convenient and effective tools in clinical settings. Considering that heart rate can be easily measured in real time with a wearable device, our proposed method can be applied to a closed-loop device as a real-time monitoring tool for determining the side of stimulation.

    Keywords: frontal lobe epilepsy, Heart rate variability, laterality, Seizure onset zone, autonomic nervous system

    Received: 23 Jan 2024; Accepted: 16 Apr 2024.

    Copyright: © 2024 Lee, Kim, Kim, So, Kim and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jung Bin Kim, Department of Neurology, Korea University Anam Hospital, Seoul, Republic of Korea
    Dong-joo Kim, Department of Brain and Cognitive Engineering, College of Engineering, Korea University, Seoul, 136-713, Seoul, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.