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Byung-Woo Yoon, MD; Carlos A. Morillo, MD; David F. Cechetto, PhD; Vladimir Hachinski, MD, FRCPC, DScMed

Arch Neurol. 1997;54(6):741-744.

Abstract
Objective
To identify cerebral hemispheric lateralization in cardiac autonomic control.

Patients
Eight patients undergoing an intracarotid amobarbital sodium test as a presurgical evaluation of temporal lobe epilepsy.

Design
Power spectral analysis of heart rate variability before and after intracarotid amobarbital injection.

Setting
University hospital and research center.

Main Outcome Measure
The changes in the ratio of low-frequency (LF) (sympathetic) to high-frequency (HF) (parasympathetic) power (LF/HF ratio), a measure of sympathovagal balance, after hemispheric inactivation.

Results
The LF/HF ratio changed as follows: right preinactivation=3.81±0.96, postinactivation=3.40±1.23; left preinactivation=2.74±0.49, postinactivation=4.34±0.59 (mean±SEM). The test of interaction between laterality and inactivation using a 2-way repeated-measures analysis of variance was statistically significant (P=.001). The increased ratio on the left side (1.61±0.70) was statistically significant (P=.03), but the decrease on the right side (–0.40±0.46) was not (P.70).

Conclusions
These findings suggest that there is a cerebral lateralization in cardiac autonomic control and that the right cerebral hemisphere predominantly modulates sympathetic activity. This study may help identify subgroups of patients with intracranial disease at high risk of cardiac complications.

Author Affiliations
From the Departments of Clinical Neurological Sciences (Drs Yoon, Cechetto, and Hachinski), Medicine (Dr Morillo), and Physiology (Drs Cechetto and Hachinski), the University of Western Ontario, London, Ontario; Department of Neurology, Seoul National University, Seoul, Korea (Dr Yoon); and Department of Cardiology and Cardiovascular Sciences, Fundacion Cardiovascular, Bucaramanga, Colombia (Dr Morillo).

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