• Ajit Mishra, Anu P John, Dhaval Shukla, Talakad N Sathyaprabha, and Devi Bhagavatula Indira BI Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India..
• Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India.
• World Neurosurg. 2018 Oct 1; 118: e951-e955.

IntroductionAutonomic nervous system dysfunction is a known entity in strokes involving insula. It causes significant morbidity and mortality. No study to date has demonstrated autonomic nervous system dysfunction in patients with insular glioma. This is an exploratory study to identify the subclinical autonomic dysfunctions in insular glioma.MethodsA total 50 patients with newly diagnosed insular glioma in the age group of 18-60 years were evaluated with heart rate variability (HRV). All the HRV parameters in patients with insular glioma were compared with normal healthy age- and sex-matched control patients.ResultsThere was a significant difference (P < 0.05) in most of the HRV parameters between patients and control patients. Patients with left insular glioma showed significantly increased heart rate (P = 0.027), low-frequency normalized units (P = 0.048), and also increased low-frequency/high-frequency ratio (P = 0.015), which indicates sympathetic dominance. Patients with seizures had significantly lower values of total power (P = 0.042). No significant difference was found in terms of the extent and size of the tumor or histopathologic grades of gliomas.ConclusionsPatients with insular gliomas have significant impairment of autonomic functions, with left insular glioma showing sympathetic dominance. Suppression of autonomic function is greater in those presenting with seizures.Copyright © 2018 Elsevier Inc. All rights reserved.

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