{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:31:40Z","timestamp":1760236300207,"version":"build-2065373602"},"reference-count":62,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["390044 and 148563"],"award-info":[{"award-number":["390044 and 148563"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","award":["DKN"],"award-info":[{"award-number":["DKN"]}],"id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: We aimed to evaluate heart rate variability (HRV) changes in insulo-opercular epilepsy (IOE) and after insulo-opercular surgery. Methods: We analyzed 5-min resting HRV of IOE patients before and after surgery. Patients\u2019 SUDEP-7 risk inventory scores were also calculated. Results were compared with age- and sex-matched patients with temporal lobe epilepsy (TLE) and healthy individuals. Results: There were no differences in HRV measurements between IOE, TLE, and healthy control groups (and within each IOE group and TLE group) in preoperative and postoperative periods. In IOE patients, the SUDEP-7 score was positively correlated with pNN50 (percentage of successive RR intervals that differ by more than 50 ms) (p = 0.008) and RMSSD (root mean square of successive RR interval differences) (p = 0.019). We stratified IOE patients into those whose preoperative RMSSD values were below (Group 1a = 7) versus above (Group 1b = 9) a cut-off threshold of 31 ms (median value of a healthy population from a previous study). In group 1a, all HRV values significantly increased after surgery. In group 1b, time-domain parameters significantly decreased postoperatively. Conclusions: Our results suggest that in IOE, HRV may be either decreased in parasympathetic tone or increased globally in both sympathetic and parasympathetic tones. We found no evidence that insulo-opercular surgeries lead to major autonomic dysfunction when a good seizure outcome is reached. The increase in parasympathetic tone observed preoperatively may be of clinical concern, as it was positively correlated with the SUDEP-7 score.<\/jats:p>","DOI":"10.3390\/brainsci11111505","type":"journal-article","created":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T20:48:36Z","timestamp":1636922916000},"page":"1505","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heart Rate Variability in Insulo-Opercular Epilepsy"],"prefix":"10.3390","volume":"11","author":[{"given":"Thi Phuoc Yen","family":"Tran","sequence":"first","affiliation":[{"name":"CHUM Research Center, University of Montreal, Montreal, QC H2X 0A9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Pouliot","sequence":"additional","affiliation":[{"name":"Safe Engineering Services and Technologies, Laval, QC H7L 6E8, Canada"},{"name":"Labeo Technologies, Montreal, QC H3V 1A2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elie Bou","family":"Assi","sequence":"additional","affiliation":[{"name":"CHUM Research Center, University of Montreal, Montreal, QC H2X 0A9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Rainville","sequence":"additional","affiliation":[{"name":"Department of Somatology, University of Montreal, Montreal, QC H3T 1J7, Canada"},{"name":"Research Centre of Institut Universitaire de G\u00e9riatrie de Montr\u00e9al, Montreal, QC H3C 3J7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7831-4593","authenticated-orcid":false,"given":"Kenneth A.","family":"Myers","sequence":"additional","affiliation":[{"name":"Research Institute of the McGill University Medical Centre, Montreal, QC H3H 2R9, Canada"},{"name":"Division of Neurology, Department of Pediatrics, Montreal Children\u2019s Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manon","family":"Robert","sequence":"additional","affiliation":[{"name":"CHUM Research Center, University of Montreal, Montreal, QC H2X 0A9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain","family":"Bouthillier","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, CHUM, University of Montreal, Montreal, QC H2X 0C1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark R.","family":"Keezer","sequence":"additional","affiliation":[{"name":"CHUM Research Center, University of Montreal, Montreal, QC H2X 0A9, Canada"},{"name":"Division of Neurology, CHUM, University of Montreal, Montreal, QC H2X 0C1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dang Khoa","family":"Nguyen","sequence":"additional","affiliation":[{"name":"CHUM Research Center, University of Montreal, Montreal, QC H2X 0A9, Canada"},{"name":"Division of Neurology, CHUM, University of Montreal, Montreal, QC H2X 0C1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/bs.pbr.2016.04.004","article-title":"Multimodal investigation of epileptic networks: The case of insular cortex epilepsy","volume":"226","author":"Zerouali","year":"2016","journal-title":"Prog. 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