Serum levels of brain-derived neurotrophic factor and insulin like growth factor 1 are associated with autonomic dysfunction and impaired cerebral autoregulation in impaired cerebral autoregulation in patients with epilepsy

Shu Fang Chen, Shuo Bin Jou, Nai Ching Chen, Hung Yi Chuang, Chi Ren Huang, Meng Han Tsai, Teng Yeow Tan, Wan Chen Tsai, Chiung Chih Chang, Yao Chung Chuang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

17 Scopus citations

Abstract

Background: Brain-derived neurotrophic factor (BDNF) and insulin-like growth factor 1 (IGF-1) may regulate the autonomic nervous system (ANS) in epilepsy. The present study investigated the role of IGF-1 and BDNF in the regulation of autonomic functions and cerebral autoregulation in patients with epilepsy. Methods: A total of 57 patients with focal epilepsy and 35 healthy controls were evaluated and their sudomotor, cardiovagal, and adrenergic functions were assessed using a battery of ANS function tests, including the deep breathing, Valsalva maneuver, head-up tilting, and Q-sweat tests. Cerebral autoregulation was measured by transcranial doppler during the breath-holding test and the Valsalva maneuver. Interictal serum levels of BDNF and IGF-1 were measured with enzyme-linked immunosorbent assay kits. Results: During interictal period, reduced serum levels of BDNF and IGF-1, impaired autonomic functions, and decreased cerebral autoregulation were noted in patients with epilepsy compared with healthy controls. Reduced serum levels of BDNF correlated with age, adrenergic and sudomotor function, overall autonomic dysfunction, and the autoregulation index calculated in Phase II of the Valsalva maneuver, and showed associations with focal to bilateral tonic-clonic seizures. Reduced serum levels of IGF-1 were found to correlate with age and cardiovagal function, a parameter of cerebral autoregulation (the breath-hold index). Patients with a longer history of epilepsy, higher seizure frequency, and temporal lobe epilepsy had lower serum levels of IGF-1. Conclusions: Long-term epilepsy and severe epilepsy, particularly temporal lobe epilepsy, may perturb BDNF and IGF-1 signaling in the central autonomic system, contributing to the autonomic dysfunction and impaired cerebral autoregulation observed in patients with focal epilepsy.

Original languageEnglish
Article number969
JournalFrontiers in Neurology
Volume9
Issue numberNOV
DOIs
StatePublished - 20 11 2018

Bibliographical note

Publisher Copyright:
© 2018 Chen, Jou, Chen, Chuang, Huang, Tsai, Tan, Tsai, Chang and Chuang.

Keywords

  • Autonomic nervous system dysfunction
  • Brain-derived neurotrophic factor
  • Cerebral autoregulation
  • Epilepsy
  • Insulin-like growth factor 1

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