Cognitive Rehabilitation for Nonepileptic Seizures

(CRVWP Trial)

AG
MR
Overseen ByMadeleine R Lefkowitz, BS
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: VA Office of Research and Development
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assist Veterans with psychogenic nonepileptic seizures (PNES), a condition causing real seizures without the electrical disruptions seen in epilepsy. The focus is on Cognitive Rehabilitation And Functional Treatment (CRAFT), which uses brain training exercises to enhance thinking skills and daily life. The trial will develop and test a workbook designed to boost cognitive function, gathering feedback from Veterans for improvement. Veterans diagnosed with PNES who experience thinking difficulties might be suitable candidates. Participants need access to a computer and the internet to join. As an unphased trial, this study offers Veterans a unique opportunity to contribute to innovative treatment development and potentially enhance their cognitive skills.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this cognitive rehabilitation protocol is safe for Veterans with PNES?

Research has shown that cognitive rehabilitation, a treatment similar to cognitive-behavioral therapy (CBT), yields promising results for people with psychogenic nonepileptic seizures (PNES). In previous studies, patients who received CBT experienced fewer seizures. For example, one study found that 16 out of 21 patients had a 50% reduction in their seizures.

Another study examined 50 patients who reported improvements after CBT. These findings suggest that cognitive treatments are generally well-tolerated and may help reduce the number of seizures. While these results are encouraging, it is important to note that this specific cognitive rehabilitation treatment is still under investigation. So far, similar therapies have not reported major harmful effects, which is a positive sign for safety.12345

Why are researchers excited about this trial?

Cognitive Rehabilitation And Functional Treatment (CRAFT) is unique because it directly addresses the cognitive and functional challenges faced by individuals with nonepileptic seizures, rather than just focusing on symptomatic relief. Traditional treatments often revolve around psychotherapy and medication to manage stress and anxiety. However, CRAFT introduces a rehabilitative approach that aims to improve cognitive skills and daily functioning, potentially offering a more holistic and sustainable solution. Researchers are excited about this treatment because it could fill a gap in care by enhancing patients' quality of life through targeted cognitive interventions.

What evidence suggests that this cognitive rehabilitation treatment is effective for nonepileptic seizures?

Research has shown that cognitive-behavioral therapy (CBT) can reduce the number of seizures in people with psychogenic nonepileptic seizures (PNES). In one study, about half of the patients who received CBT experienced a reduction in seizures by at least half. This trial will test the CRAFT method, a cognitive rehabilitation approach that has shown promise in helping Veterans with similar brain-related disorders improve their daily lives. These findings suggest that treatments focusing on thinking and behavior issues in PNES could greatly enhance patients' quality of life.12678

Who Is on the Research Team?

RA

Ryan A Van Patten, PhD

Principal Investigator

Providence VA Medical Center, Providence, RI

Are You a Good Fit for This Trial?

This trial is for veterans with a condition called PNES, where they experience seizures that aren't caused by epilepsy. Participants should have cognitive issues related to their condition and be interested in improving daily functioning.

Inclusion Criteria

U.S. Veteran
Able to provide informed consent
Reports cognitive difficulties
See 5 more

Exclusion Criteria

Acute psychosis (hallucinations or delusions)
Current active suicidality
A diagnosis of dementia or intellectual disability
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Cognitive Intervention Development

Development of a telehealth-based cognitive rehabilitation workbook informed by feedback from Veterans and treatment providers

Not specified

Pilot Testing

Pilot test the cognitive rehabilitation intervention in a single arm trial with Veterans

8-12 weeks
Telehealth sessions

Follow-up

Participants are monitored for safety and effectiveness after the intervention

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Cognitive Rehabilitation And Functional Treatment (CRAFT)

Trial Overview

The study tests a new approach called Cognitive Rehabilitation And Functional Treatment (CRAFT). It involves using a workbook designed with veteran input to improve thinking skills and day-to-day abilities.

How Is the Trial Designed?

1

Treatment groups

Experimental Treatment

Group I: InterventionExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials
1,691
Recruited
3,759,000+

Citations

Cognitive-behavioral therapy for psychogenic nonepileptic ...

Our findings suggest that cognitive-behavioral therapy is more effective than standard medical care alone in reducing seizure frequency in PNES patients.

outcomes of patients with psychogenic nonepileptic seizures ...

We conducted a retrospective chart review of 50 patients who received CBT for PNES to determine self-reported non-epileptic seizure (NES) ...

Outcomes in the Treatment of Psychogenic Nonepileptic ...

For seizure frequency, 10 patients had data for “seizures per day in the last 6 months” and 5 participants (50%) improved by 50% or more in the ...

Cognitive Rehabilitation for Veterans With PNES

Cognitive re-habilitation improves daily functioning in Veterans with related neuropsychiatric disorders and has a high chance of success in ...

Treatment of Psychogenic Nonepileptic Seizures

A meta‐analytic review of the effectiveness of psychological treatment of functional/dissociative seizures on non‐seizure outcomes in adults. Article. Full ...

Cognitive Behavioral Therapy (CBT) in Psychogenic Non- ...

In this study, 16 out of 21 patients experienced a 50% reduction in seizures, and 11 out of 17 were seizure free at the end of treatment, with ...

Cognitive Behavioural Therapy in Adults with Psychogenic ...

Outcomes in the treatment of psychogenic nonepileptic seizures (PNES) with CBTip: Response in seizure frequency, depression, anxiety, and ...

Cognitive Behavioral Therapy Reduces the Impact of ...

Cognitive behavioral therapy (CBT) gives patients with dissociative seizures longer periods of seizure freedom, less bothersome seizures, ...