Association Of Aerobic Activity And Seizure Frequency In Adults With Epilepsy From The 2022 National Health Interview Survey

Seizures are the primary clinical feature of epilepsy, with controlling or reducing seizure frequency the primary goal of treatment. Pre-clinical models show that aerobic activity may be a non-pharmacological approach to reduce seizures, but the relationship between aerobic activity levels and seizure frequency is unclear. PURPOSE: To examine how the amount of aerobic activity is associated with seizure frequency in people with epilepsy and whether a dose-response relationship exists. METHODS: Cross-sectional data from the 2022 National Health Interview Survey of people with epilepsy (n = 290) were analyzed. Seizure frequency was measured with self-reported counts over the past 12 months. Aerobic activity was coded into groups based on the 2018 Physical Activity Guidelines: inactive (0 minutes/week), insufficiently active (1-149 minutes/week), and sufficiently active (≥150 minutes/week). A Poisson regression modeled the relationship between activity and seizure count, controlling for age, sex (male/female), BMI, and anti-epileptic medication usage (yes/no). Contrasts were used to evaluate differences in seizure frequency across activity levels. RESULTS: Reporting sufficient activity was significantly associated with lower seizure frequency compared to reporting inactivity (β = -0.59, SE = 0.21, p = 0.006; Incidence Rate Ratio: 0.55, 95% CI: 0.36 to 0.84). No significant association was found for those who reported insufficient activity compared to those who reported inactivity (p = 0.13) or those who reported sufficient activity (p = 0.30). A significant linear trend was observed across activity levels (β = -0.376, SE = 0.14, p = 0.007). CONCLUSIONS: The incident rate of seizures was 45% lower in the sufficiently active group compared to the inactive group, suggesting that regular aerobic exercise may be beneficial for seizure management. The significant negative trend observed across activity levels indicates a dose-response relationship, where higher aerobic activity was associated with lower seizure frequencies. Aerobic exercise could play a promising role in epilepsy management by potentially reducing seizure frequency, though causality cannot be inferred from the present design. Further research is needed to clarify the optimal activity levels for seizure reduction.