Evidence map›Paper›PMID 41617228›Full record

ArticleBMJ open2026

Breathing control training as a treatment for functional seizures (BREATHS trial): a multicentre, assessor-blinded, randomised controlled efficacy and acceptability trial study protocol.

Richard Kanaan, Rod Duncan, Cathrine Mihalopoulos, Sabine Braat, Terence J O'Brien, Dennis Velakoulis, Patrick Kwan, Roger T Mulder, Mark Cook, Saul Mullen and 11 more

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Richard KanaanDepartment of Psychiatry, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia richard.kanaan@unimelb.edu.au.ORCID http://orcid.org/0000-0003-0992-1917
Rod DuncanNew Zealand Brain Research Institute, Christchurch, Canterbury, New Zealand.
Cathrine MihalopoulosSchool of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.ORCID http://orcid.org/0000-0002-7127-9462
Sabine BraatCentre for Epidemiology and Biostatistics, University of Melbourne School of Population and Global Health, Carlton, Victoria, Australia.ORCID http://orcid.org/0000-0003-1997-3999
Terence J O'BrienDepartment of Neuroscience, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
Dennis VelakoulisDepartment of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Patrick KwanDepartment of Neurology, Alfred Health, Melbourne, Victoria, Australia.
Roger T MulderNew Zealand Brain Research Institute, Christchurch, Canterbury, New Zealand.
Mark CookThe University of Melbourne St Vincent's Department of Medicine, Fitzroy, Victoria, Australia.
Saul MullenDepartment of Neurology, Bladin-Berkovic Comprehensive Epilepsy Program, Austin Health, Heidelberg, Victoria, Australia.
Deeanne MayneFND Hope Australia, Perth, Western Australia, Australia.
Gina OliverDepartment of Psychiatry, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia.
Dina EleftheriadisDepartment of Psychiatry, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia.ORCID http://orcid.org/0000-0002-0671-8422
Ozayr AmeenDepartment of Neurology, Christchurch Hospital, Christchurch, Canterbury, New Zealand.
Mary Lou ChattertonSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.ORCID http://orcid.org/0000-0003-4902-9448
Wendyl D'SouzaThe University of Melbourne St Vincent's Department of Medicine, Fitzroy, Victoria, Australia.
John-Paul NicoloDepartment of Neuroscience, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.ORCID http://orcid.org/0000-0002-0473-6475
Piero PeruccaDepartment of Neuroscience, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
Toby Winton-BrownAlfred Mental Health and Addictions, Alfred Hospital, Melbourne, Victoria, Australia.
Sophie ZaloumisMISCH (Methods and Implementation Support for Clinical Health) Research Hub, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia.
David BerlowitzThe University of Melbourne Department of Physiotherapy, Carlton, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFunctional seizures (FS) are events that resemble epileptic seizures, but are not attributed to brain pathology and are instead thought to be due to psychological factors. A small, multisite, open-label, single-arm, pilot trial of a breathing intervention known as breathing control training (BCT) found it to be safe and effective in reducing seizure frequency in FS. We propose a protocol for a study to confirm these results. METHODS AND ANALYSIS: A 24-week, multicentre, individually-randomised, assessor-blinded, two-arm, parallel-group efficacy and acceptability trial of BCT versus control (Befriending) in 220 participants ≥16 years of age with FS. Eligible participants will be randomly allocated to receive two sessions of either BCT or Befriending over a 4-week period. Sessions will be delivered by a respiratory physiotherapist at a clinical care site or via telehealth. They will complete assessments prior to commencing treatment and at 4, 12 and 24 weeks after their initial session of BCT/Befriending. The trial will be conducted alongside treatment as usual. An economic evaluation including cost-utility and cost-effectiveness analyses will be carried out from health sector and societal perspectives. ETHICS AND DISSEMINATION: The study has been approved by The Austin Health Human Research Ethics Committee (HREC/84335/Austin-2022) and the New Zealand Central Health and Disability Ethics Committee (2022 FULL 12324). Findings will be reported to trial participants and consumers; presented at local, national and international conferences; and disseminated by a peer-reviewed scientific journal.

Indexed as

Breathing ExercisesSeizuresAdolescentAdultCost-Benefit AnalysisCost-Effectiveness AnalysisFemaleHumansMaleMulticenter Studies as TopicPilot ProjectsRandomized Controlled Trials as TopicSingle-Blind MethodTreatment OutcomeYoung AdultClinical TrialFunctional Neurological DisorderSeizures

Identifiers

PMID41617228
PMCPMC12863316

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.