Cognitive and Behavioral Interventions in Epilepsy

Overview

Journal Curr Neurol Neurosci Rep

Specialty Neurology

Date 2017 Apr 7

PMID 28382495

Citations 15

Authors

Beth A Leeman-Markowski

Steven C Schachter

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: Cognitive and behavioral treatments for epilepsy offer several advantages, as they are relatively low cost, are non-invasive, lack serious side effects, and facilitate patient participation. Their role in the management of epilepsy, however, is unclear. The following manuscript will critically review the efficacy data regarding psychological treatments for seizure reduction.

Recent Findings: Encouraging results have been found for the cognitive behavioral therapy-based Reiter/Andrews approach and mindfulness or arousal-based programs (e.g., yoga, meditation, relaxation, and biofeedback). Most studies attained responder rates between 45 and 90%. Cognitive and behavioral interventions may be considered as low-risk adjuncts to standard therapies. Efficacy data are limited, however, by small numbers of subjects, inadequate randomization, controls, and blinding, brief trial durations, varying methodologies, and variability in the presentation of results. Additional clinical trials are warranted.

Citing Articles

Influence of mindfulness meditation on intracranial EEG parameters in epileptic and non-epileptic brain areas.

Cummins D, Schulman Z, Maher C, Tortolero L, Saad A, Nunez Martinez L Epilepsy Behav. 2024; 161:110150.

PMID: 39536363 PMC: 11773388. DOI: 10.1016/j.yebeh.2024.110150.

Proceedings of the 2022 "Lifestyle Intervention for Epilepsy (LIFE)" symposium hosted by Cleveland Clinic.

Spurgeon E, Saper R, Alexopoulos A, Allendorfer J, Bar J, Caldwell J Epilepsia Open. 2024; 9(5):1981-1996.

PMID: 39177045 PMC: 11450595. DOI: 10.1002/epi4.13037.

Enhancing quality of life in epilepsy with a digital intervention (emyna): Results of the ELAINE randomized controlled trial.

Meyer B, Betz L, Bruckner K, Holtkamp M Epilepsia Open. 2024; 9(5):1758-1771.

PMID: 39167060 PMC: 11450619. DOI: 10.1002/epi4.13014.

Anticipatory anxiety of seizures: What is the best treatment?.

Hingray C, Javelot H, Lach F, Tarrada A Epilepsy Behav Rep. 2024; 27:100673.

PMID: 38841320 PMC: 11152698. DOI: 10.1016/j.ebr.2024.100673.

Variation in prognosis and treatment outcome in juvenile myoclonic epilepsy: a Biology of Juvenile Myoclonic Epilepsy Consortium proposal for a practical definition and stratified medicine classifications.

Rubboli G, Beier C, Selmer K, Syvertsen M, Shakeshaft A, Collingwood A Brain Commun. 2023; 5(3):fcad182.

PMID: 37361715 PMC: 10288558. DOI: 10.1093/braincomms/fcad182.

References

Kaplan B . Biofeedback in epileptics: equivocal relationship of reinforced EEG frequency to seizure reduction. Epilepsia. 1975; 16(3):477-85. View

Kotchoubey B, Strehl U, Uhlmann C, Holzapfel S, Konig M, Froscher W . Modification of slow cortical potentials in patients with refractory epilepsy: a controlled outcome study. Epilepsia. 2001; 42(3):406-16. DOI: 10.1046/j.1528-1157.2001.22200.x. View

Nagai Y, Goldstein L, Fenwick P, Trimble M . Clinical efficacy of galvanic skin response biofeedback training in reducing seizures in adult epilepsy: a preliminary randomized controlled study. Epilepsy Behav. 2004; 5(2):216-23. DOI: 10.1016/j.yebeh.2003.12.003. View

Cott A, Pavloski R, Black A . Reducing epileptic seizures through operant conditioning of central nervous system activity: procedural variables. Science. 1979; 203(4375):73-5. DOI: 10.1126/science.758682. View

LUBAR J, Bahler W . Behavioral management of epileptic seizures following EEG biofeedback training of the sensorimotor rhythm. Biofeedback Self Regul. 1976; 1(1):77-104. DOI: 10.1007/BF00998692. View

Tang V, Michaelis R, Kwan P . Psychobehavioral therapy for epilepsy. Epilepsy Behav. 2014; 32:147-55. DOI: 10.1016/j.yebeh.2013.12.004. View

McLaughlin D, McFarland K . A randomized trial of a group based cognitive behavior therapy program for older adults with epilepsy: the impact on seizure frequency, depression and psychosocial well-being. J Behav Med. 2010; 34(3):201-7. DOI: 10.1007/s10865-010-9299-z. View

Puskarich C, Whitman S, Dell J, Hughes J, ROSEN A, Hermann B . Controlled examination of effects of progressive relaxation training on seizure reduction. Epilepsia. 1992; 33(4):675-80. DOI: 10.1111/j.1528-1157.1992.tb02346.x. View

Nagai Y, Trimble M . Long-term effects of electrodermal biofeedback training on seizure control in patients with drug-resistant epilepsy: two case reports. Epilepsy Res. 2013; 108(1):149-52. DOI: 10.1016/j.eplepsyres.2013.10.004. View

10.

Matsuoka H, Nakamura M, Ohno T, Shimabukuro J, Suzuki T, Numachi Y . The role of cognitive-motor function in precipitation and inhibition of epileptic seizures. Epilepsia. 2005; 46 Suppl 1:17-20. DOI: 10.1111/j.0013-9580.2005.461006.x. View

11.

STERMAN M, Goodman S, Kovalesky R . Effects of sensorimotor EEG feedback training on seizure susceptibility in the rhesus monkey. Exp Neurol. 1978; 62(3):735-47. DOI: 10.1016/0014-4886(78)90281-9. View

12.

Goldstein L, McAlpine M, Deale A, Toone B, Mellers J . Cognitive behaviour therapy with adults with intractable epilepsy and psychiatric co-morbidity: preliminary observations on changes in psychological state and seizure frequency. Behav Res Ther. 2003; 41(4):447-60. DOI: 10.1016/s0005-7967(02)00025-6. View

13.

Dewhurst E, Novakova B, Reuber M . A prospective service evaluation of acceptance and commitment therapy for patients with refractory epilepsy. Epilepsy Behav. 2015; 46:234-41. DOI: 10.1016/j.yebeh.2015.01.010. View

14.

Dahl J, Melin L, Lund L . Effects of a contingent relaxation treatment program on adults with refractory epileptic seizures. Epilepsia. 1987; 28(2):125-32. DOI: 10.1111/j.1528-1157.1987.tb03637.x. View

15.

STERMAN M, Friar L . Suppression of seizures in an epileptic following sensorimotor EEG feedback training. Electroencephalogr Clin Neurophysiol. 1972; 33(1):89-95. DOI: 10.1016/0013-4694(72)90028-4. View

16.

Walker J . Using QEEG-guided neurofeedback for epilepsy versus standardized protocols: enhanced effectiveness?. Appl Psychophysiol Biofeedback. 2009; 35(1):29-30. DOI: 10.1007/s10484-009-9123-0. View

17.

Persinger M . Transcendental Meditation and general meditation are associated with enhanced complex partial epileptic-like signs: evidence for "cognitive" kindling?. Percept Mot Skills. 1993; 76(1):80-2. DOI: 10.2466/pms.1993.76.1.80. View

18.

Orme-Johnson D . Transcendental meditation does not predispose to epilepsy. Med Hypotheses. 2005; 65(1):201-2. DOI: 10.1016/j.mehy.2005.02.003. View

19.

Lantz D, STERMAN M . Neuropsychological assessment of subjects with uncontrolled epilepsy: effects of EEG feedback training. Epilepsia. 1988; 29(2):163-71. DOI: 10.1111/j.1528-1157.1988.tb04414.x. View

20.

DiIorio C, Escoffery C, McCarty F, Yeager K, Henry T, Koganti A . Evaluation of WebEase: an epilepsy self-management Web site. Health Educ Res. 2008; 24(2):185-97. DOI: 10.1093/her/cyn012. View