Brain training cuts epileptic seizures

Researchers have developed a “brain training” technique that is aimed mainly at the 30 per cent of epilepsy patients who are resistant to traditional drug treatment.

One in 100 people suffer with epilepsy – 50 million people worldwide – and about half of those taking part in clinical trials reported the technique reduced seizures by 50 per cent or more.

Invented by Dr Yoko Nagai, Wellcome Trust Research Fellow at the Brighton and Sussex Medical School, run jointly by the universities of Brighton and Sussex, and University College London, the technique is seen as an alternative to medication by teaching patients to train their brains to be more alert.

Previous mental techniques have been aimed at relaxing the brain to reduce seizures but her research found the opposite was true – that training patients to increase their levels of alertness actually helped them to calm their brain and reduce seizures.

Using an animated computer programme that responds to a person’s level of alertness, volunteers were shown how to increase their alertness by learning to move a computer-generated animated figure towards a desired goal.

Dr Yoko Nagai

Photo by Jesse Orrico on Unsplash

It relies on ‘lie detector’ technology with sensors attached to patients’ fingers. Patients focus on the computer figure and the sensors pick up brain and body activity including emotional distress and alteration in sweat gland and these, in turn, signal the figure to move.

It teaches the patient to acquire a sense of control by concentrating on the screen activity.

In their previous randomised controlled trial with 18 patients, 60% of drug resistant patients demonstrated more than 50% seizure reduction after a month of therapy and two who went on to keep a record for three years after their ‘training’ continued to have a greatly reduced number of seizures with learned techniques. One volunteer reported being free of seizures for the first time since developing epilepsy six years previous.

For the current trials, 40 patients with drug-resistant temporal lobe epilepsy, aged 18 to 70, were recruited into a controlled trails from three screening centres in the UK. Some 45 per cent of patients demonstrated a reduction in seizures of 50 per cent or more. The current study also identified a key relationship wherein the strength of neural coupling (functional connectivity) between ventral frontal cortex and a mesial temporolimbic centre (right amygdala) enhances the capacity to suppress seizures. The finding also implies that abnormal integrity of this network interaction may promote the propagation of seizures in a manner gated way by autonomic, and probably, emotional state. This putative contribution of fronto-amygdala connectivity to the neurodynamics of epileptogenesis warrants further investigations.

Dr Nagai said: “Our clinical study provides evidence for autonomic biofeedback therapy as an effective and potent behavioural intervention for patients with drug-resistant epilepsy. This approach is non-pharmacological, non-invasive and seemingly side-effect free.”

Dr Nagai is now hoping to facilitate more collaborations on developing a simple on-line digital computer programme that patients can use anytime and anywhere in the world.