Full Title Can slow breathing exercises improve seizure control in people with refractory epilepsy? A hypothesis.

Studies on various medical conditions have shown that poor health is associated with lower parasympathetic tone. People with epilepsy appear to have decreased parasympathetic tone, with a greater decrease in those with intractable seizures than in those with well-controlled epilepsy. Slow breathing exercises have been shown to increase parasympathetic tone in healthy volunteers. Slow breathing exercises have been shown to improve a number of medical conditions including asthma, hypertension, anxiety states, and posttraumatic stress disorder. We hypothesize that slow breathing exercises in people with epilepsy can lead to an increase in parasympathetic tone and an accompanying reduction in seizure frequency. The slow breathing exercises, probably through baroreceptors, chemoreceptors, and pulmonary stretch receptors, affect cortical activity and hence seizure thresholds. It is also possible that slow breathing exercises might reduce seizure frequency by reducing anxiety. The hypothesis can be tested by employing devices and protocols that have been used to reduce breathing rates and have been shown to improve health outcomes in other medical conditions.

Yuen AW, Sander JW. Epilepsy Behav. 2010 Aug;18(4):331-4. Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK. alan@yuen.co.uk

Weight training is a method commonly used to increase strength. The purpose of this investigation was to examine the effect of breathing technique during weight training on heart rate (HR) and blood pressure (BP). After completing a health history questionnaire, 30 subjects (16 men: 21.25 +/- 1.21 years, 180.26 +/- 2.36 cm, 84.31 +/- 19.32 kg; and 14 women: 21.29 +/- 2.37 years, 170.08 +/- 2.15 cm, 137.36 +/- 62.31 kg) were familiarized and tested for an estimated 1 repetition maximum, on the chest press and leg press lifts using each of the 2 breathing techniques, hold breath (HB), and controlled breathing. Lifts were examined using each breathing technique with 1 set of 10 repetitions on separate days. Data were collected during the push phase on average of 3.72 times per set and again at 1 and 5 minutes post lift. Resting, during lift (peak, average); 1-minute and 5-minute post lift BP; and HR values were measured using the NIBP100A noninvasive BP system (Biopac Systems, Inc), for both breathing technique within each lift. The HB technique posted higher but statistically insignificant (p < 0.05) values for systolic BP (p = 0.420), diastolic BP (p = 0.531), and HR (p = 0.713) than the controlled breath technique. The HB technique used in this investigation produced minimal elevations in HR and BP and appears to be safe when performing the chest press and leg press lifts at a moderate resistance. Education on proper weight training techniques can help limit unwanted risks during these exercises.

Lepley AS, Hatzel BM. J Strength Cond Res. 2010 Aug;24(8):2179-83. Movement Science Department, Grand Valley State University, Allendale, Michigan, USA. leple013@umn.edu

This article reviews the etiology, clinical characteristics, and treatment of inflammatory bowel disease (IBD) and associated psychological sequelae in children and adolescents with this lifelong disease. Pediatric-onset IBD, consisting of Crohn's disease and ulcerative colitis, has significant medical morbidity and in many young persons is also associated with psychological and psychosocial challenges. Depression and anxiety are particularly prevalent and have a multifaceted etiology, including IBD-related factors such as cytokines and steroids used to treat IBD and psychosocial stress. A growing number of empirically supported interventions, such as cognitive behavioral therapy, hypnosis, and educational resources, help youth and their parents cope with IBD as well as the psychological and psychosocial sequelae. While there is convincing evidence that such interventions can help improve anxiety, depression, and health-related quality of life, their effects on IBD severity and course await further study.

Child Adolesc Psychiatr Clin N Am. 2010 Apr;19(2):301-18, ix. Szigethy E, McLafferty L, Goyal A. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. szigethye@upmc.edu