Abstracts

Rationale: Risk of cognitive decline following epilepsy surgery can be a significant barrier for patients pursuing surgery, and post-surgical cognitive changes can impact quality of life, surgical satisfaction, and functional independence. Readiness Brain Operation Optimization Training (ReBOOT) is a cognitive prehabilitation intervention that provides patients with psychoeducation and cognitive strategies prior to surgery to increase pre-surgical preparedness and post-surgical functional independence in the circumstance that a patient experiences cognitive decline after surgery. The purpose of this study was to examine pilot data to understand feasibility and patient satisfaction with ReBOOT.

Methods: ReBOOT is comprised of six virtual sessions; two sessions are one-on-one with an intervention lead and four sessions occur within a group; see Figure 1 for detailed program description. At the time of this writing, eight patients have been enrolled in ReBOOT (though recruitment is ongoing, and results will be updated to include additional patients at the AES conference). Attendance and retention were tracked to understand feasibility of ReBOOT. Following participation in the program, patients completed a questionnaire rating their satisfaction with ReBOOT on several Likert scales and provided qualitative feedback. Patients also completed a brief survey rating the usefulness of each ReBOOT session.

Results: Two participants decided to withdraw from ReBOOT shortly after consent; one because he was no longer pursuing surgery and the other did not want to complete questionnaires. Of the six remaining participants, five had 100% attendance rate and one had an attendance rate of 83%. Patients indicated that they found ReBOOT to be either “beneficial” or “very beneficial” and reported satisfaction with the information and support provided by ReBOOT. They endorsed that ReBOOT was enjoyable and effective at preparing them for epilepsy surgery. They all indicated that they would recommend ReBOOT to other patients considering surgery. See Table 2 for mean ratings on satisfaction questionnaire. Of the six sessions, patients found the individual wrap-up session to be most useful. Themes from qualitative feedback highlighted the importance of peer support, as patients appreciated getting to know other patients preparing for epilepsy surgery, as well as talking to patients that have already gone through surgery.

Conclusions: Preliminary results suggest that patients are generally able and willing to complete ReBOOT. Patients reported satisfaction with the program, endorsing multiple benefits of ReBOOT. These findings suggest that cognitive prehabilitation interventions are a worthwhile pursuit and that ReBOOT, the first standardized prehabilitation program for epilepsy surgery, may serve as an essential resource in the future with further validation of its efficacy.

Funding: This work was funded by a Society of Clinical Neuropsychology Early Career Pilot Study Award and Cleveland Clinic’s Epilepsy Center.