Cardio-oncology & otherCohort study
Distinct Subdivisions of the Cingulo-Insular Region and Their Role in Modulating the Cardiac Sympathetic-Parasympathetic Balance
- prospective observational study
Authors' conclusion
Within the cingulo-insular region, the anterior cingulate gyrus is associated with a relative cardio-parasympathetic dominance, while the posterior insula is linked to a relative cardio-sympathetic dominance. These findings provide a deeper understanding of the neural modulation of cardio-autonomic balance, and may have implications for the prevention and treatment of cardio-autonomic dysfunction in neurological disorders.
Study context
- Population
- Patients with drug-resistant epilepsy undergoing stereo-electroencephalography with electrical cortical stimulation of the cingulo-insular regionpatients analyzed (70 electrode contacts, 287 trials)
- Participants
- 33 patients
- Exposure
- Heart rate variability before and after electrical cortical stimulation of subdivisions of the cingulo-insular region
Main finding
As reported in the abstract
- Stimulation of the anterior cingulate gyrus enhanced parasympathetic activity, correlated with increased local phase-amplitude coupling strength
Observational data: associations, not effects.
Further findings
pNN50, left anterior cingulate gyrus stimulation
| Comparison | median difference (%) (95% CI) | P value | |
|---|---|---|---|
| left anterior cingulate gyrus stimulation · stimulation increased pNN50 | −5.00 (−17.99 to −0.16) | P = 0.044 | |
| −20−10010Difference, % (linear scale) |
SD of all normal-to-normal intervals, right anterior cingulate gyrus stimulation
| Comparison | median difference (ms) (95% CI) | P value | |
|---|---|---|---|
| right anterior cingulate gyrus stimulation · stimulation increased SD of all normal-to-normal intervals | −14.22 (−26.68 to −1.63) | P = 0.019 | |
| −40−20020Difference, ms (linear scale) |
SD2, right anterior cingulate gyrus stimulation
| Comparison | median difference (ms) (95% CI) | P value | |
|---|---|---|---|
| right anterior cingulate gyrus stimulation · stimulation increased SD2 | −19.49 (−33.26 to −3.22) | P = 0.013 | |
| −40−20020Difference, ms (linear scale) |
SD1/SD2 ratio, left posterior insula stimulation
| Comparison | median difference (95% CI) | P value | |
|---|---|---|---|
| left posterior insula · stimulation decreased SD1/SD2 ratio | 0.08 (0.03–0.15) | P = 0.005 | |
| −0.100.10.2Difference (linear scale) |
Power in the high-frequency range, right posterior insula stimulation
| Comparison | median difference (ms 2) (95% CI) | P value | |
|---|---|---|---|
| right posterior insula · stimulation decreased high-frequency power | 25.30 (3.98–49.35) | P = 0.013 | |
| −200204060Difference, ms 2 (linear scale) |
Approximate entropy, right posterior insula stimulation
| Comparison | median difference (95% CI) | P value | |
|---|---|---|---|
| right posterior insula · stimulation decreased approximate entropy | 0.15 (0.04–0.29) | P = 0.004 | |
| −0.200.20.4Difference (linear scale) |
Parasympathetic component of heart rate variability and short-term R-R interval with posterior insula stimulation
- stimulation of the posterior insula significantly reduced the parasympathetic component of heart rate variability and short-term R-R interval
Original publication
Summarised from the published abstract; every number is checked against it