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.
Neurology. 2018 Mar 13;90(11):e963-e970. doi: 10.1212/WNL.0000000000005109. Epub 2018 Feb 14.
To evaluate the effect of a stress-reduction intervention in participants with medication-resistant epilepsy.
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.
In the 66 participants in the intention-to-treat analysis, seizure frequency was reduced from baseline in both treatment groups (PMR: 29%, < 0.05; focused attention: 25%, < 0.05). PMR and focused attention did not differ in seizure reduction ( = 0.38), although PMR was associated with stress reduction relative to focused attention ( < 0.05). Daily stress was not a predictor of seizures.
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.
NCT01444183.
评估减压干预对药物抵抗性癫痫患者的影响。
从 3 个中心招募了 66 名药物抵抗性局灶性癫痫成人患者，并将他们随机分为 2 组干预措施：（1）渐进性肌肉松弛（PMR）和膈肌呼吸，或（2）控制注意力的手部运动。在 8 周的基线期后，参与者开始接受 12 周的双盲治疗。参与者使用电子日记记录每日自我报告的情绪和压力评分以及发作次数，且不允许调整药物。主要结局是与基线相比，28 天内发作频率的百分比减少；次要结局包括压力减轻和压力-发作相互作用。
在意向治疗分析的 66 名参与者中，两组治疗组的发作频率均较基线减少（PMR：29%， < 0.05；集中注意力：25%， < 0.05）。PMR 和集中注意力在发作减少方面没有差异（ = 0.38），尽管 PMR 与集中注意力相比，与压力减轻相关（ < 0.05）。每日压力不是发作的预测因素。
与药物抵抗性局灶性癫痫患者的基线相比，PMR 和集中注意力组的发作频率均有所降低，尽管两种治疗方法无差异。PMR 比集中注意力更有效地减轻自我报告的压力。
NCT01444183。
