Friday, October 9, 2015

Mindfulness and epilepsy

Short-term mindfulness-based therapy significantly improves quality of life and reduces anxiety and seizures in patients with drug-resistant epilepsy, researchers in Hong Kong report.

Their new study shows that patients with epilepsy receiving mindfulness therapy in addition to information and education fared better than those who received only social support.

The study drives home the point that epilepsy involves more than just seizures, the researchers say.
"It showed that mindfulness can improve well-being and reduce seizure frequency and it could easily be included in the treatment for drug-resistant epilepsy," said lead author Venus Tang, PhD, a clinical psychologist in the Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Chinese University of Hong Kong.

Mindfulness is a form of mental meditation that in recent years has been incorporated into psychotherapy. "It cultivates self-awareness of bodily conditions, here-and-now emotions, feelings and thoughts, using a nonjudgmental attitude, leading to an acceptance of who we are and what we are experiencing," explained Dr Tang.
Evidence suggests that practicing mindfulness has a wide range of possible health benefits, including improvements in mental well-being, physical conditions (such as chronic pain), and cognitive functions (such as learning)...

The concept of the mind-body connection is rooted in Chinese/Asian philosophy. In this culture, emotional well-being is accepted as an integral part of health.

"Each emotion is associated with an internal organ, which, if out of balance, will cause specific symptoms," said Dr Tang. "When these emotions become excessive, or dominant, or are repressed and turned inward, they can become pathological and cause disease. This concept is in line with the idea of mindfulness."
Dr Tang stressed that mindfulness is a way of living that can be practiced every minute, even every second, of every day. "For example, you can practice mindful breathing while you travel in your car, mindful walking while you stroll down the street, mindful listening while you watch TV."

A limitation of the study was that it didn't include an untreated control group, although the authors suggested that future research might include a waitlist control design. As well, the amount of time spent on mindfulness practice outside the therapeutic sessions was not measured.

Tang V, Poon WS, Kwan P. Mindfulness-based therapy for drug-resistant
epilepsy: An assessor-blinded randomized trial. Neurology. 2015 Sep



To investigate the effectiveness of mindfulness-based therapy (MT) and social support (SS) in patients with drug-resistant epilepsy.


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.


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.


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.


This study provides Class II evidence that mindfulness-based therapy significantly improves quality of life in patients with drug-resistant epilepsy.

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