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).

Matherials and Methods:

Quasi experimental, repeated measures 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; 11/20 with drug-resistant epilepsy. Among 13 patients with IEDs, 8 showed modulation: 5 compared to rest and 6 in the intraindividual analysis between periods, showing either activation or inhibition. Compared to rest, significant inhibition was seen in 3 during AE and in 1 post-AR; activation occurred during AR (1) and postAR (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 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:

The present study provides a methodological frame to evaluate the electroencephalographic response to physical activity in epilepsy patients, supplying new evidence of inhibition of interictal discharges during non-strenuous physical activity in around 20% of patients.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )