Systematic Review and Analysis of Lifestyle Modification Interventions on Seizure Reduction and Quality of Life
Abstract number :
2.271
Submission category :
8. Non-ASM/Non-Surgical Treatments (Hormonal, alternative, etc.)
Year :
2022
Submission ID :
2205026
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:27 AM
Authors :
Elizabeth Spurgeon, MD – Cleveland Clinic; Elizabeth Butler, PA-C - Cleveland Clinic; David Martinez, MD - Cleveland Clinic; Arthur Stefanski, BA - Cleveland Clinic; Mary Schleicher, RN, BSN, MLIS - Cleveland Clinic; Stephen Dombrowski, PhD - Cleveland Clinic; Robert Saper, MD, MPH - Cleveland Clinic; Imad Najm, MD - Cleveland Clinic; Dennis Lal, PhD - Cleveland Clinic
Rationale: The impact of lifestyle modifications on people with epilepsy is a growing field with various interventions that have shown potential for enhanced care. Evidence of these interventions has yet to be compiled for clinicians and patients. Although there are systematic reviews analyzing the effects of an individual intervention modality, to our knowledge, there is not yet a systematic review that compares the efficacy of these interventions to one another. This systematic review and analysis was conducted to evaluate the current evidence of lifestyle modifications on seizure reduction and quality of life in those with epilepsy with the continuation of standard medical treatment.
Methods: In concordance with the PRISMA guidelines, a systematic review utilizing MEDLINE, Embase, PsycINFO, Cochrane DSR, Cochrane Central, and Web of Science was conducted in March 2022. We screened 3,400 articles, removed 1,737 duplicates, and identified 103 studies that met predefined eligibility criteria. Included studies were prospective trials including case-only trials, randomized and nonrandomized controlled trials that consisted of adults or both adults and pediatric participants. It was required that seizure frequency be measured as a primary or secondary outcome. Three epilepsy trained authors independently reviewed the studies using Covidence, of which two selected the included studies, and the third resolved conflicting decisions.
Results: The most common lifestyle interventions tested in epilepsy patient cohorts were diet 27.2% (28/103), supplements 17.4% (18/103), psychological/cognitive therapy 12.6% (13/103), biofeedback with slow cortical potentials (SCP) or EEG 10.7% (11/103), music therapy 6.8% (7/103), physical exercise 5.82% (6/103), yoga 3.88% (4/103), and others (mindfulness, progressive muscle relaxation, Chinese medicine, educational programs, and reflexology) 15.5% (16/103). Fifty studies (48.5%) included a comparison cohort, forty-eight studies (46.6%) did not have a comparison cohort, and five studies (4.85%) utilized a cross-over design control. The patient population consisted of medically refractory epilepsy in 63 (61.1%) out of the 103 studies. Of the 70 studies that performed statistical analysis to detect level of significance, 72.8% (51/70) showed a reduction in seizure frequency, including 100% (4/4) of yoga, 90% (9/10) of biofeedback with SCP or EEG, 83.3% (5/6) of music, 60% (9/15) of diet, 53.8% (7/13) of psychological/cognitive therapy, 52.9% (9/17) of supplements, 40% (2/5) of exercise, 100% (1/1) of reflexology, 33.3% (1/3) of Chinese medicine, 66.7% (2/3) of progressive muscle relaxation, and 66.7 (2/3) of mindfulness. Quality of life was investigated in 23.3% (24/103) of the interventions, of which 66.7% (16/24) showed improvement.
Conclusions: This systematic review and analysis provides an evidence-based assessment of lifestyle modifications in the management of epilepsy. Preliminary results suggest beneficial lifestyle practices. A more detailed analysis will be performed to compare interventions.
Funding: Not applicable
Non-ASM