Posted 10.23.2015 | by AMRA

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Epileptic disorders are neurological disorders characterized by recurrent seizures. About 30% of people with epilepsy are drug resistant, meaning that despite trials of at least two different anti-epileptic medications, they are unable to rid themselves of seizures. Because people with epilepsy are prone to depression and anxiety, and because stress plays a significant role in provoking seizures, people with epilepsy may benefit from mindfulness-based interventions (MBIs).

In a randomized, controlled study, Tang, et al. [Neurology] tested the impact of a MBI on quality of life, seizure frequency, and cognition in drug-resistant epileptics.

The researchers recruited 60 drug-resistant epileptics (53% female, average age = 35) from neurology practices in Hong Kong, and randomly assigned them to either a 6-week MBI program that included social support or a 6-week program of social support (SS) alone. Both interventions provided didactic information about epilepsy along with the opportunity to share experiences related to seizures and their management. The MBI also offered practice in the body scan, mindful breathing, listening, and eating, and non-judgmental awareness of thoughts.

Both interventions were offered in four 2.5-hour biweekly classes, and in addition, MBI participants were encouraged to practice mindfulness for 45 minutes per day at home. Participants kept daily diaries of seizure frequency for 6 weeks prior to the intervention and during a 6-week post-intervention follow-up. They also completed a battery of self-report and cognitive measures at baseline and post-intervention.

Both groups showed significant improvement on a 100-point Quality of Life (QOL) scale, but a significantly greater percentage of MBI participants (37%) showed clinically meaningful QOL improvement (a 12-point or greater increase) compared to SS participants (13%). Both groups significantly reduced their symptoms of depression and anxiety, but MBI participants reduced their symptoms significantly more (anxiety partial η2= 0.11; depression partial η2=0.67). These between-group differences were large enough to be clinically meaningful for anxiety, but not for depression.

The MBI participants reduced their seizure frequency (partial η2= 0.31) by a significantly greater percent (40%) than did SS participants (19%). The researchers also measured the participants’ ability to recall a list of unrelated words after a time delay and after hearing a list of interfering words. MBI participants significantly improved more on this measure, both after delay (partial η2= 0.31) and interference (partial η2= 0.10). Mindfulness may have increased their ability to attend to and retain verbal information, or the increase may be due to improved neurological functioning given their decreased seizure frequency.

This randomized, controlled study demonstrates that a standardized six-week mindfulness training improves short-term seizure control and quality of life in a drug-resistant epileptic population better than a social support program alone. Reduced emotional reactivity to seizure symptoms may be instrumental in both reducing seizure frequency and improving emotional well-being.

Reference:

Tang, V., Poon, W. S., & Kwan, P. (2015). Mindfulness-based therapy for drug-resistant epilepsy an assessor-blinded randomized trial. Neurology, 85(13), 1100-1107.

[Link to abstract]