Sheryl R Haut1, Richard B Lipton2, Susannah Cornes2, Alok K Dwivedi2, Rachel Wasson2, Sian Cotton2, Jeffrey R Strawn2, Michael Privitera2. 1. From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH. shaut@montefiore.org. 2. From Montefiore-Einstein Epilepsy Center (S.R.H.) and Departments of Neurology (S.R.H., R.B.L.) and Epidemiology and Population Health (R.B.L.), Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY; University of California (S. Cornes), San Francisco, CA; Division of Biostatistics & Epidemiology (A.K.D.), Department of Biomedical Sciences, Paul L. Foster School of Medicine and Biostatistics & Epidemiology Consulting Lab, Office of Research Resources, Texas Tech University Health Sciences Center, El Paso, TX; and Departments of Family and Community Medicine (R.W.), Integrative Medicine UC Cancer Institute (S. Cotton), Psychiatry and Behavioral Neuroscience (J.R.S.), and Neurology (M.P.), University of Cincinnati College of Medicine, OH.
Abstract
OBJECTIVE: To evaluate the effect of a stress-reduction intervention in participants with medication-resistant epilepsy. METHODS:Adults with medication-resistant focal epilepsy (n = 66) were recruited from 3 centers and randomized to 1 of 2 interventions: (1) progressive muscle relaxation (PMR) with diaphragmatic breathing, or (2) control focused-attention activity with extremity movements. Following an 8-week baseline period, participants began 12 weeks of double-blind treatment. Daily self-reported mood and stress ratings plus seizure counts were completed by participants using an electronic diary, and no medication adjustments were permitted. The primary outcome was percent reduction in seizure frequency per 28 days comparing baseline and treatment; secondary outcomes included stress reduction and stress-seizure interaction. RESULTS: In the 66 participants in the intention-to-treat analysis, seizure frequency was reduced from baseline in both treatment groups (PMR: 29%, p < 0.05; focused attention: 25%, p < 0.05). PMR and focused attention did not differ in seizure reduction (p = 0.38), although PMR was associated with stress reduction relative to focused attention (p < 0.05). Daily stress was not a predictor of seizures. CONCLUSIONS: Both PMR and the focused-attention groups showed reduced seizure frequency compared to baseline in participants with medication-resistant focal seizures, although the 2 treatments did not differ. PMR was more effective than focused attention in reducing self-reported stress. CLINICALTRIALSGOV IDENTIFIER: NCT01444183.
RCT Entities:
OBJECTIVE: To evaluate the effect of a stress-reduction intervention in participants with medication-resistant epilepsy. METHODS: Adults with medication-resistant focal epilepsy (n = 66) were recruited from 3 centers and randomized to 1 of 2 interventions: (1) progressive muscle relaxation (PMR) with diaphragmatic breathing, or (2) control focused-attention activity with extremity movements. Following an 8-week baseline period, participants began 12 weeks of double-blind treatment. Daily self-reported mood and stress ratings plus seizure counts were completed by participants using an electronic diary, and no medication adjustments were permitted. The primary outcome was percent reduction in seizure frequency per 28 days comparing baseline and treatment; secondary outcomes included stress reduction and stress-seizure interaction. RESULTS: In the 66 participants in the intention-to-treat analysis, seizure frequency was reduced from baseline in both treatment groups (PMR: 29%, p < 0.05; focused attention: 25%, p < 0.05). PMR and focused attention did not differ in seizure reduction (p = 0.38), although PMR was associated with stress reduction relative to focused attention (p < 0.05). Daily stress was not a predictor of seizures. CONCLUSIONS: Both PMR and the focused-attention groups showed reduced seizure frequency compared to baseline in participants with medication-resistant focal seizures, although the 2 treatments did not differ. PMR was more effective than focused attention in reducing self-reported stress. CLINICALTRIALSGOV IDENTIFIER: NCT01444183.
Authors: Mia T Minen; Kaitlyn Morio; Kathryn Berlin Schaubhut; Scott W Powers; Richard B Lipton; Elizabeth Seng Journal: Cephalalgia Date: 2019-12-23 Impact factor: 6.292
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: Mia T Minen; Adama Jalloh; Emma Ortega; Scott W Powers; Mary Ann Sevick; Richard B Lipton Journal: Pain Med Date: 2019-02-01 Impact factor: 3.750
Authors: Mia T Minen; Benjamin W Friedman; Samrachana Adhikari; Sarah Corner; Scott W Powers; Elizabeth K Seng; Corita Grudzen; Richard B Lipton Journal: Gen Hosp Psychiatry Date: 2021-01-08 Impact factor: 3.238
Authors: Mia T Minen; Samrachana Adhikari; Jane Padikkala; Sumaiya Tasneem; Ashley Bagheri; Eric Goldberg; Scott Powers; Richard B Lipton Journal: Headache Date: 2020-11-16 Impact factor: 5.887
Authors: Prisca R Bauer; Else A Tolner; Mark R Keezer; Michel D Ferrari; Josemir W Sander Journal: Nat Rev Neurol Date: 2021-07-26 Impact factor: 42.937