Efficacy of adjunctive Yoga Nidra in patients with functional dissociative seizures receiving structured psychoeducation (YOGA-FDS): a pilot randomised controlled trial.

BACKGROUND

Functional dissociative seizures (FDS) are paroxysmal seizure-like events with no electrographic abnormalities. Structured psychoeducation is considered a standard component of FDS management. Yoga Nidra (YN) is a guided meditative relaxation technique that has shown benefit in other neuropsychiatric conditions, but its adjunctive role in FDS has not been studied.

OBJECTIVE

To evaluate whether adjunctive YN provides additional benefit over structured brief psychoeducation alone in reducing monthly FDS frequency.

METHODS

This open-label, randomised controlled pilot trial enrolled 50 FDS patients aged ≥13 years, randomised 1:1 to receive brief psychoeducation plus YN (n = 25) or brief psychoeducation plus sham YN (n = 25). All participants received structured psychoeducation; the intervention group additionally practised standardised audio-guided YN. The primary outcome was the change in monthly FDS frequency. Secondary outcomes included 6-month FDS episode count, seizure freedom duration, HAM-A, HAM-D, WSAS, and QOLIE-31 scores. Outcomes were assessed at 6 months by a blinded evaluator.

RESULTS

Between January 2021 and February 2022, 72 patients were screened, and 22 were excluded. Fifty patients were randomly assigned to receive brief psychoeducation plus YN (n = 25) or brief psychoeducation plus sham YN (n = 25), of whom primary outcome data were available for 48 patients at 6 months (23 patients in the brief psychoeducation plus YN group and 25 in the brief psychoeducation plus sham YN group). Median monthly FDS frequency reduced from 6 (IQR 2.5-45) to 0.5 (0-1) in the brief psychoeducation plus YN group and from 7 (3.5-45) to 0.5 (01.7) in the sham group; between-group difference was not statistically significant (p = 0.88).

CONCLUSION

Both groups demonstrated substantial clinical improvement during follow-up in seizure frequency, mood symptoms, functioning and quality of life; however, adjunctive YN did not provide measurable additional benefit over the control condition. Larger studies are needed to clarify the role of adjunctive YN in the management of functional dissociative seizures.