Evidence map›Paper›PMID 36202052›Full record

ArticleEpilepsy & behavior : E&B2022

Carotid body stimulation as a potential intervention in sudden death in epilepsy.

Ethan N Biggs, Ryan B Budde, John G R Jefferys, Pedro P Irazoqui

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsy & behavior : E&B, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.0field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 10 citations in OpenAlex.

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  7. Sudden unexpected death in epilepsy.Current opinion in neurology · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Ethan N BiggsWeldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA. Electronic address: biggs6@purdue.edu.
Ryan B BuddeDepartment of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA.
John G R JefferysWeldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Department of Pharmacology, Oxford University, Oxford, UK.
Pedro P IrazoquiWeldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA. Electronic address: pip@jhu.edu.
Johns Hopkins University · US

Funding

Sequence of physiological events during oxygen conserving reflex activation leading to sudden death in epilepsyR01NS119390 · NINDS · PURDUE UNIVERSITY · PI KOLIATSOS, VASSILIS E · 2021 to 2025
$2.2M
NINDS NIH HHS R01 NS119390
6 · The paper itself

Abstract

objectiveTo investigate carotid body (CB) mechanisms related to sudden death during seizure. Ictal activation of oxygen-conserving reflexes (OCRs) can trigger fatal cardiorespiratory collapse in seizing rats, which presents like human sudden unexpected death in epilepsy (SUDEP). The CB is strongly implicated in OCR pathways; we hypothesize that modulating CB activity will provide insight into these mechanisms of death.

methodsLong-Evans rats were anesthetized with urethane. Recordings included: electrocorticography, electrocardiography, respiration via nasal thermocouple, and blood pressure (BP). The mammalian diving reflex (MDR) was activated by cold water delivered through a nasal cannula. Reflex and stimulation trials were repeated up to 16 times (4 pre-intervention, 12 post-intervention) or until death. In some animals, one or both carotid bodies were denervated. In some animals, the CB was electrically stimulated, both with and without MDR. Seizures were induced with kainic acid (KA).

resultsAnimals without seizure and with no CB modulation survived all reflexes. Non-seizing animals with CB denervation survived 7.1 ± 5.4 reflexes before death, and only 1 of 7 survived past the 12-trial threshold. Electrical CB stimulation without seizure and without reflex caused significant tachypnea and hypotension. Electrical CB stimulation with seizure and without reflex required higher amplitudes to replicate the physiological responses seen outside seizure. Seizing animals without CB intervention survived 3.2 ± 3.6 trials (per-reflex survival rate 42.0% ± 44.4%), and 0 of 7 survived past the 12-trial threshold. Seizing animals with electrical CB stimulation survived 10.5 ± 4.7 ictal trials (per-reflex survival rate 86.3% ± 35.0%), and 6 of 8 survived past the 12-trial threshold. SIGNIFICANCE: These results suggest that, during seizure, the ability of the CB to stimulate a restart of respiration is impaired. The CB and its afferents may be relevant to fatal ictal apnea and SUDEP in humans, and CB stimulation may be a relevant intervention technique in these deaths.

Indexed as

Carotid BodyEpilepsySudden Unexpected Death in EpilepsyAnimalsDeath, SuddenHumansMammalsRatsRats, Long-EvansSeizuresCarotid sinus nerveDiving reflexIctal apneaSeizureSUDEP

Identifiers

PMID36202052
PMCPMC10187768
OpenAlexW4300773910

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.