Abstracts

Rationale: Mindfulness practices have been associated with improved outcomes in patients with both epilepsy and psychogenic non-epileptic seizures (PNES). However, the degree of mindfulness in patients admitted to the Epilepsy Monitoring Unit and electrographic features during mindfulness practice in these patients has not previously been evaluated.

Methods: In this study, patients who were admitted to the Epilepsy Monitoring Unit with active video-EEG monitoring were consented to participate in a mindfulness task and complete the Short Form Five-Facet Mindfulness Questionnaire (FFMQ-SF), consisting of 24 questions over 5 mindfulness domains. The 5 domains include observing, describing, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience. On the day of admission, patients underwent mindfulness meditation under the guidance of a 10-minute recording developed by the University of California San Diego (UCSD) Center for Mindfulness.

Results: A total of 45 patients were recruited to participate in this study, including 23 patients diagnosed with epilepsy, 8 patients with psychogenic non-epileptic seizures (PNES), 13 patients with non-diagnostic studies, and 1 patient with physiologic events. The average score for all patients admitted to the EMU was 70.8±10.7 (mean±SD), which is over one standard deviation below the mean of external controls (81.8±8.0, n=211, Iani et al, J Ment Health, 2020). There was only one domain within the FFMQ-SF that was over one standard deviation below the external controls – “acting with awareness.” There was no significant difference between scores in patients diagnosed with epilepsy and patients diagnosed with PNES for overall scores, each of the five facet sub-scores, and each individual question in the FFMQ-SF (p >0.05, 2-way ANOVA with Sidak’s multiple comparisons test). A comorbid diagnosis of depression or anxiety was significantly greater in patients with PNES (100%) compared to patients with epilepsy (21.7%, p< 0.001, Fisher’s exact test). However, mindfulness scores for patients with these comorbid psychiatric diagnoses were not significantly different than patients without these comorbid psychiatric diagnoses (p=0.85, Mann-Whitney test). Preliminary analysis of EEG during the mindfulness activity between PNES and epilepsy patients found no differences in frequency of the posterior dominant rhythm, power at any frequency between 2-100 Hz in bilateral occipital leads, or presence of Stage N1 or N2 sleep stages.