Baird Grayson L, Harlow Lisa L, Machan Jason T, LaFrance W C
Lifespan Biostatistics Core, Rhode Island Hospital, United States; Diagnostic Imaging, The Warren Alpert Medical School of Brown University, United States; University of Rhode Island, Department of Psychology, United States.
Lifespan Biostatistics Core, Rhode Island Hospital, United States.
Epilepsy Behav. 2017 Aug;73:273-279. doi: 10.1016/j.yebeh.2017.04.015. Epub 2017 Jun 16.
The present study examined seizure clusters as a primary outcome in patients receiving treatment for PNES. Cluster reduction is examined longitudinally using frequency threshold and statistical definitions of seizure cluster for patients. Possible risk factors for clustering will be examined along with clustering as a risk factor for poorer secondary outcomes.
Participants were from a pilot randomized treatment trial for PNES where they received cognitive behavioral therapy-informed psychotherapy (CBT-ip), sertraline, combination therapy, or treatment as usual. Seizure data are from patients' seizure dairies.
Cluster reduction was observed for those receiving CBT-ip or combination treatment using all definitions of daily clusters and weekly clusters. No risk factors of clustering were observed. Those who were identified as having clusters during the trial had poorer secondary outcomes on several measures at baseline relative to those who were not identified as having clusters.
This is the first study known to the authors to not only examined seizure clusters as a primary outcome for those with PNES, but also the first study to suggest that CBT-ip and combination therapy may be effective in reducing the frequency of clusters.
本研究将癫痫发作丛集作为接受精神性非癫痫性发作（PNES）治疗患者的主要结局进行了考察。使用癫痫发作丛集的频率阈值和统计学定义对患者的丛集减少情况进行纵向研究。将对丛集的可能风险因素以及作为较差次要结局风险因素的丛集情况进行考察。
参与者来自一项PNES的试点随机治疗试验，他们接受了基于认知行为疗法的心理治疗（CBT-ip）、舍曲林、联合治疗或常规治疗。癫痫发作数据来自患者的癫痫发作日记。
使用每日丛集和每周丛集的所有定义，观察到接受CBT-ip或联合治疗的患者丛集减少。未观察到丛集的风险因素。在试验期间被确定有丛集的患者，在基线时的几项指标上相对于未被确定有丛集的患者有较差的次要结局。
这是作者所知的第一项不仅将癫痫发作丛集作为PNES患者的主要结局进行考察的研究，也是第一项表明CBT-ip和联合治疗可能有效降低丛集频率的研究。
