Abstract
Introduction: The impact of physical activity on the frequency of seizures and interictal epileptiform discharges (IEDs) remains controversial. We aimed to evaluate the modulation of IEDs in patients with epilepsy during different types of physical activity (non-strenuous aerobic exercise, relaxation techniques).
Methodology: Quasiexperimental study, in adults with active epilepsy. A standardized protocol under EEG monitoring was applied, including 5 periods of 15 minutes: rest; aerobic exercise (AE) -modified Ruffier-Dickson; post-exercise (PAE); active relaxation technique (AR): Jacobson and Biofeedback; post AR. IEDs were counted in 3-minutes time windows exploring significant differences between periods (ANOVA), and between rest and each period (95% CI of the difference), for each patient. Heart rate variation during AE vs rest, and cardiac coherence in biofeedback were analyzed.
Results: We included 20 patients (M11/F9), age 30+7 years old (17-45), 18 with focal epilepsy; 11 (55%) with drug-resistant epilepsy. Among 13 patients with IEDs, 8 showed modulation. Compared to rest, Significant inhibition was seen in 3 during AE and in 1 post-AR; activation occurred during AR (1) and post-AR (1). In the interindividual comparison, 5 activated post-EA, 2 inhibited post-AR vs AR. Three patients with insufficient cardiac coherence presented low heart rate variation during AE.
Discussion: IEDs inhibition during AE is supported by the literature. Increase in IEDs immediately after the AE may be related with seizure occurrence during relaxation periods, frequently described in the outpatient setting. IEDs were rarely modified during this AR protocol.
Conclusions: Non-strenuous, aerobic physical exercise may have a favorable effect in seizure control.
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