Arrotta Kayela, Babiker Selma, Lake Jeramiah, Thompson Nicolas, Lioi Anthony B, Najm Imad, Busch Robyn M
Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Department of Neurology, Cleveland Clinic, Cleveland, Ohio, USA.
Epilepsia. 2025 May 2. doi: 10.1111/epi.18445.
Readiness Brain Operation Optimization Training (ReBOOT) is a manualized cognitive prehabilitation program for patients considering epilepsy surgery designed to improve presurgical preparedness through education and reduce the impact of postsurgical cognitive changes with preemptive cognitive compensatory training. The purpose of this study was to understand the feasibility of cognitive prehabilitation, examine patient satisfaction with ReBOOT, and assess changes in compensatory strategy use following ReBOOT.
Seventeen participants (65% female, mean age = 41 years) considering epilepsy surgery were enrolled in ReBOOT, which includes two one-on-one psychoeducation sessions, four group sessions on cognitive compensatory strategies, and weekly goal setting to facilitate implementation of strategies. Patient retention, attendance, and goal completion were tracked. Participants also completed the Everyday Compensation Questionnaire pre- and postintervention along with a satisfaction survey postintervention. Aggregate ratings were examined, and paired samples t-test was used to assess change in compensatory strategy use postintervention.
Five participants withdrew shortly after consent, prior to starting ReBOOT, because of a change in surgical status/date or lack of desire to complete relevant study activities. Of the 12 remaining participants, only two missed one session. Participants indicated that they found ReBOOT to be quite beneficial, reported satisfaction with the information and support provided by ReBOOT, and felt that ReBOOT was effective at preparing them for epilepsy surgery and potential postsurgical cognitive changes. Most participants made some (i.e., little to moderate) progress on their goals each week and demonstrated increased compensatory strategy use by the end of ReBOOT.
Findings indicate that cognitive prehabilitation is feasible. Participants reported high satisfaction with ReBOOT, reporting multiple benefits, and demonstrated increased compensatory strategy use following program completion. These results highlight cognitive prehabilitation for epilepsy surgery as a worthwhile pursuit and demonstrate that ReBOOT may serve as a useful clinical resource in the future following further validation of its efficacy.
准备就绪脑手术优化训练（ReBOOT）是一项针对考虑进行癫痫手术的患者的标准化认知预康复计划，旨在通过教育提高术前准备水平，并通过先发制的认知补偿训练减少术后认知变化的影响。本研究的目的是了解认知预康复的可行性，检查患者对ReBOOT的满意度，并评估ReBOOT后补偿策略使用的变化。
17名考虑进行癫痫手术的参与者（65%为女性，平均年龄 = 41岁）参加了ReBOOT，该计划包括两次一对一的心理教育课程、四次关于认知补偿策略的小组课程以及每周的目标设定以促进策略的实施。跟踪患者的留存率、出勤率和目标完成情况。参与者还在干预前后完成了日常补偿问卷以及干预后的满意度调查。检查综合评分，并使用配对样本t检验评估干预后补偿策略使用的变化。
5名参与者在同意后不久，即在开始ReBOOT之前退出，原因是手术状态/日期的改变或缺乏完成相关研究活动的意愿。在剩下的12名参与者中，只有两名错过了一次课程。参与者表示他们发现ReBOOT非常有益，对ReBOOT提供的信息和支持表示满意，并认为ReBOOT有效地帮助他们为癫痫手术和潜在的术后认知变化做好了准备。大多数参与者每周在目标上都取得了一些（即少量到中等程度）进展，并在ReBOOT结束时表现出补偿策略使用的增加。
研究结果表明认知预康复是可行的。参与者对ReBOOT报告了高度满意度，称有多种益处，并在计划完成后表现出补偿策略使用的增加。这些结果突出了癫痫手术的认知预康复作为一项值得追求的目标，并表明在其疗效得到进一步验证后，ReBOOT未来可能成为一种有用的临床资源。
