Venus Tang1, Wai S Poon2, Patrick Kwan2. 1. From the Department of Clinical Psychology (V.T.), the Division of Neurosurgery, Department of Surgery, Faculty of Medicine (V.T., W.S.P.), and the Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine (P.K.), Prince of Wales Hospital, The Chinese University of Hong Kong; and the Departments of Medicine and Neurology (P.K.), The University of Melbourne, Royal Melbourne Hospital, Australia. venustang@gmail.com. 2. From the Department of Clinical Psychology (V.T.), the Division of Neurosurgery, Department of Surgery, Faculty of Medicine (V.T., W.S.P.), and the Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine (P.K.), Prince of Wales Hospital, The Chinese University of Hong Kong; and the Departments of Medicine and Neurology (P.K.), The University of Melbourne, Royal Melbourne Hospital, Australia.
Abstract
OBJECTIVE: To investigate the effectiveness of mindfulness-based therapy (MT) and social support (SS) in patients with drug-resistant epilepsy. METHODS: We performed an assessor-blinded randomized control trial. Sixty patients with drug-resistant epilepsy were randomly allocated to MT or SS (30 per group). Each group received 4 biweekly intervention sessions. The primary outcome was the change in the total score of the Patient-Weighted Quality of Life in Epilepsy Inventory (QOLIE-31-P). Secondary outcomes included seizure frequency, mood symptoms, and neurocognitive functions. The assessors were blinded to the patient's intervention grouping. Results were analyzed using general linear model with repeated measure. RESULTS: Following intervention, both the MT (n=30) and SS (n=30) groups had an improved total QOLIE-31-P, with an improvement of +6.23 for MT (95% confidence interval [CI] +4.22 to +10.40) and +3.30 for SS (95% CI +1.03 to +5.58). Significantly more patients in the MT group had a clinically important improvement in QOLIE-31-P (+11.8 or above) compared to those who received SS (11 patients vs 4 patients). Significantly greater reduction in depressive and anxiety symptoms, seizure frequency, and improvement in delayed memory was observed in the MT group compared with the SS group. CONCLUSIONS: We found benefits of short-term psychotherapy on patients with drug-resistant epilepsy. Mindfulness therapy was associated with greater benefits than SS alone in quality of life, mood, seizure frequency, and verbal memory. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that mindfulness-based therapy significantly improves quality of life in patients with drug-resistant epilepsy.
RCT Entities:
OBJECTIVE: To investigate the effectiveness of mindfulness-based therapy (MT) and social support (SS) in patients with drug-resistant epilepsy. METHODS: We performed an assessor-blinded randomized control trial. Sixty patients with drug-resistant epilepsy were randomly allocated to MT or SS (30 per group). Each group received 4 biweekly intervention sessions. The primary outcome was the change in the total score of the Patient-Weighted Quality of Life in Epilepsy Inventory (QOLIE-31-P). Secondary outcomes included seizure frequency, mood symptoms, and neurocognitive functions. The assessors were blinded to the patient's intervention grouping. Results were analyzed using general linear model with repeated measure. RESULTS: Following intervention, both the MT (n=30) and SS (n=30) groups had an improved total QOLIE-31-P, with an improvement of +6.23 for MT (95% confidence interval [CI] +4.22 to +10.40) and +3.30 for SS (95% CI +1.03 to +5.58). Significantly more patients in the MT group had a clinically important improvement in QOLIE-31-P (+11.8 or above) compared to those who received SS (11 patients vs 4 patients). Significantly greater reduction in depressive and anxiety symptoms, seizure frequency, and improvement in delayed memory was observed in the MT group compared with the SS group. CONCLUSIONS: We found benefits of short-term psychotherapy on patients with drug-resistant epilepsy. Mindfulness therapy was associated with greater benefits than SS alone in quality of life, mood, seizure frequency, and verbal memory. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that mindfulness-based therapy significantly improves quality of life in patients with drug-resistant epilepsy.
Authors: Adam M Goodman; Jane B Allendorfer; Heidi Heyse; Basia A Szaflarski; James C Eliassen; Erik B Nelson; Judd M Storrs; Jerzy P Szaflarski Journal: Hum Brain Mapp Date: 2019-04-29 Impact factor: 5.038
Authors: Rosa Michaelis; Venus Tang; Sarah J Nevitt; Janelle L Wagner; Avani C Modi; William Curt LaFrance; Laura H Goldstein; Milena Gandy; Rebecca Bresnahan; Kette Valente; Kirsten A Donald; Markus Reuber Journal: Cochrane Database Syst Rev Date: 2020-09-07
Authors: Rosa Michaelis; Venus Tang; Janelle L Wagner; Avani C Modi; William Curt LaFrance; Laura H Goldstein; Tobias Lundgren; Markus Reuber Journal: Cochrane Database Syst Rev Date: 2017-10-27
Authors: Mark W Lowerison; Colin B Josephson; Nathalie Jetté; Tolulope T Sajobi; Scott Patten; Tyler Williamson; Rob Deardon; Herman W Barkema; Samuel Wiebe Journal: JAMA Neurol Date: 2019-11-01 Impact factor: 18.302