Electroencephalographic evidence of cortical network disruption preceding overt cardioinhibition during tilt-induced reflex syncope.

Oph&#xe9;lie Galli; Stanislas Lagarde; Samuel Medina Villalon; G&#xe9;raldine Daquin; Christian B&#xe9;nar; Jean-Claude Deharo; Fabrice Bartolomei

doi:10.1016/j.clinph.2026.2112371

PubMed · 42617512

Electroencephalographic evidence of cortical network disruption preceding overt cardioinhibition during tilt-induced reflex syncope.

Ophélie Galli·Stanislas Lagarde·Samuel Medina Villalon·Géraldine Daquin·Christian Bénar·Jean-Claude Deharo·Fabrice Bartolomei

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Abstract

OBJECTIVE: Reflex syncope is a common cause of transient loss of consciousness. However, the early cerebral mechanisms underlying cardiovascular changes remain poorly understood. Our objective was to investigate early cerebral changes by quantitatively analyzing EEG activity preceding overt cardioinhibition during tilt-induced reflex syncope. METHODS: EEG recordings from patients undergoing tilt testing were retrospectively analyzed. Patients who experienced reflex syncope were compared to those who did not. Spectral and functional connectivity analyses were performed across baseline, pre-cardioinhibition, and syncopal phases. RESULTS: Prior to the onset of cardioinhibitory pathological reflex, a significant increase in theta-band spectral power was observed in the right temporal region, accompanied by a widespread increase in functional connectivity within the same frequency band. These findings suggest the involvement of brain networks before cardioinhibition. CONCLUSIONS: EEG changes in the theta band (power and functional connectivity) were observed before overt cardioinhibition during tilt-induced reflex syncope. SIGNIFICANCE: Our findings support the hypothesis of cortical processing preceding cardioinhibition in reflex syncope. EEG may represent a valuable complementary tool for improving the understanding and diagnosis of these events.

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Humans Female Male Tilt-Table Test Electroencephalography Adult Syncope, Vasovagal Cerebral Cortex Middle Aged Retrospective Studies Nerve Net Syncope Heart Rate Central autonomic network EEG Reflex syncope Tilt-test Vasovagal Journal Article

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Ophélie Galli, Stanislas Lagarde, Samuel Medina Villalon, Géraldine Daquin, Christian Bénar, Jean-Claude Deharo, Fabrice Bartolomei. 2026-08-15. Electroencephalographic evidence of cortical network disruption preceding overt cardioinhibition during tilt-induced reflex syncope.. https://doi.org/10.1016/j.clinph.2026.2112371

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Journal Article resource Adult subject Central autonomic network subject Cerebral Cortex subject EEG subject Electroencephalography subject Female subject Heart Rate subject Humans subject Journal Article subject Male subject Middle Aged subject Nerve Net subject

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