Evidence map›Paper›PMID 42390279›Full record

SynthesisEpilepsia2026

Systematic review and meta-analysis of lifestyle modification interventions and their impact on seizure reduction and quality of life.

Elizabeth Spurgeon, Alina Ivanuik, Shivanee Sodani, Elizabeth Butler, David Martinez, Mary Schleicher, Spence Sylvester, Robert Saper, Imad Najm, Dennis Lal

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Epilepsia, 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

10 authors.

Elizabeth SpurgeonEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0009-0000-3471-5379
Alina IvanuikMayo Clinic Florida, Jacksonville, Florida, USA.ORCID https://orcid.org/0000-0001-9912-3112
Shivanee SodaniRenown Institute for Neurosciences, Reno, Nevada, USA.ORCID https://orcid.org/0009-0006-7885-186X
Elizabeth ButlerEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0009-0008-2671-3937
David MartinezEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0009-0009-1367-1210
Mary SchleicherCleveland Clinic Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0001-7029-2780
Spence SylvesterEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0002-3077-1194
Robert SaperNancy J. And Michael F. Roizen Chair in Wellness, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0002-0992-6198
Imad NajmEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0001-5192-2089
Dennis LalEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0002-5173-9636

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study was undertaken to provide an overview of the research landscape and evaluate the impact of lifestyle modifications on seizure reduction and quality of life in people with epilepsy receiving standard medical treatment.

methodsFollowing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we conducted a systematic review of major databases (Medline, Embase, American Psychological Association PsycInfo, Cochrane Library, and Web of Science) through November 2025. After screening 5151 articles, 118 studies met inclusion criteria: prospective trials reporting seizure frequency in adults or mixed populations with epilepsy. Four epilepsy-trained reviewers independently assessed studies. A random-effects meta-analysis was performed on studies reporting ≥50% seizure reduction or data allowing its calculation. Short-term response was defined as the earliest postintervention time point, and long-term response as the final reported time point.

resultsThe 118 studies covered diet (n = 33), supplements (n = 20), biofeedback (n = 14), psychosocial/behavioral therapy (n = 13), yoga/meditation/mindfulness (n = 8), music therapy (n = 7), and others. Fifty-two (44%) included control groups, whereas 91 (77%) reported statistical analysis of seizure frequency. Among those, 68% showed significant seizure reduction. Quality of life was assessed in 31 studies, 68% reporting improvement. Seventy-one studies (60%) were included in the meta-analysis. Overall, the ≥50% seizure reduction response rate was 44% for short-term outcomes (95% confidence interval [CI] = 38%-50%) and 50% for long-term outcomes (95% CI = 44%-56%). Dietary interventions had the largest evidence base (n = 33), with short- and long-term response rates of 40% and 51%, respectively. Meditation/yoga/mindfulness had the highest response rate (62% short term, 79% long term), whereas exercise and supplements had the lowest (30%-35%). SIGNIFICANCE: Lifestyle modifications may offer beneficial, adjunctive effects on seizure control. However, the current evidence is limited by variability in study design and quality. Larger, well-designed trials with standardized outcomes are needed to clarify how these interventions can complement epilepsy treatment. This systematic review and meta-analysis serves as a foundation for future research to better define the role of lifestyle interventions in epilepsy care.

Indexed as

EpilepsyLife StyleQuality of LifeSeizuresHumanscognitive behavioral therapylifestyle modificationsmusic therapynonpharmacologic treatmentseizure controlyoga

Identifiers

PMID42390279
PMCPMC13592488

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.