Yoga may alleviate the burden of epilepsy and improve overall quality of life (QoL) by reducing felt stigma in 6 months among adult patients, according to study findings published in the journal Neurology.
Epilepsy is associated with symptoms of anxiety and depression and perceived stigma. For patients in resource-limited countries, these symptoms go largely unaddressed.
Researchers conducted a prospective, assessor-blinded, parallel randomized controlled trial at the All India Institute of Medical Sciences in India between 2018 and 2020. Patients (N=160; aged 18 to 60) diagnosed with epilepsy who scored 4 or more on the Kalifi Stigma Scale for Epilepsy (KSSE) were randomly assigned in a 1:1 ratio to receive either yoga therapy plus psychoeducation (n=80) or sham yoga plus psychoeducation (n=80) over 7 sessions lasting 45 to 60 minutes each for 3 months.
The yoga module comprised loosening practices, breathing exercises, meditation, and positive affirmations whereas the sham yoga module comprised exercises without instruction about breathing or attention to body movements and sensations. The psychoeducation module comprised information about epilepsy, guidelines about medication compliance, self-care strategies, and psychosocial aspects about the disease such as myths and superstitions.
“
This intervention was efficacious in managing neuropsychiatric comorbidities in epilepsy.
The primary outcome of interest was the change in KSSE score and secondary outcomes included seizure frequency, QoL, anxiety, depression, mindfulness, trait rumination, cognitive impairment, and emotion regulation. The researchers assessed outcomes at baseline, 3 months, and 6 months. To compare each group, the researchers utilized parametric/non-parametric ANCOVA and chi-square tests.
At baseline, the median KSSE scores were 7 among the yoga recipients and 6 among the sham recipients (P =.222).
At 6 months, compared with control individuals, patients who did yoga therapy reported significant reductions to their KSSE scores (median, 4 vs 7; P =.022). This trend indicated that yoga had a significant effect on stigma about epilepsy (Cohen’s d, 0.23; 95% CI, -0.08 to 0.55; P =.006).
The yoga intervention also had a significant effect on seizure frequency, in which both groups had a median of 1seizure per week at baseline, but at 6 months, patients in the yoga group reported 0.25 seizures per week relative to 0.75 seizures among those in the sham group (P =.001).
The proportion of individuals who reported a reduction greater than >50% (odds ratio [OR], 4.11; 95% CI, 1.34-14.69; P =.01) or complete reduction (OR, 7.4; 95% CI, 1.75-55.89; P =.005) in weekly seizures was greater among those who did yoga compared with control individuals.
Compared with sham yoga, the yoga intervention was also associated with significant improvements from baseline in Generalized Anxiety Disorder-7 (GAD-7) scores (P <.001), Mindful Attention and Awareness Scale (MAAS) scores (P <.001), and MOntreal Cogitative Assessment (MOCA) scores (P =.002).
This study was limited by the lack of a passive control and the small sample size.
The researchers wrote, “This sham controlled trial demonstrated that yoga based intervention in conjunction with psychoeducation can reduce epilepsy related stigma, anxiety symptoms and cognitive impairment in persons with epilepsy. Simultaneously, it may also improve the overall quality of life and trait mindfulness in these groups of patients.”
“This intervention was efficacious in managing neuropsychiatric comorbidities in epilepsy,” they concluded.
