Utilizing Multimodal Imaging to Visualize Potential Mechanism for Sudden Death in Epilepsy

摘要: Abstract Sudden death in epilepsy, or SUDEP, is a fatal condition that accounts for more than 4000 deaths each year. Limited clinical and preclinical data on sudden suggests critical contributions from autonomic, cardiac, respiratory pathways. Recent animal (rat) studies kainic acid induced seizure models explored potential mechanism such severe cardiorespiratory dysregulation being linked to reflux laryngospasm. Here, we expand those previous investigations utilize multimodal approach provide visual evidence of reflux-initiated laryngospasm subsequent distress seizing rats. We used systemic acutely induce activity Long Evans rats, under urethane anesthesia. recorded electroencephalography (EEG), electrocardiography (ECG), chest plethysmography esophageal pH signals during simultaneous fast MRI scans the rat stomach esophagus. images, conjunction with electrophysiology were identify progression, movement up esophagus, changes, death. In all cases death, recordings alongside images visualized Severe cardiac (ST segment elevation), (intermittent apnea) brain (EEG narrowing due hypoxia) changes observed only after reached larynx, which strongly onset following reflux. Additionally, absence esophagus animals survived acute seizure, provided causal relationship between The complimentary information coming insight into reflux, laryngospasm, obstructive apnea, animals. results carry significance as they outline may be relevant SUDEP humans.