Related Experiment Video
Updated: Feb 28, 2026
Behavioral Characterization of Pentylenetetrazole-induced Seizures: Moving Beyond the Racine Scale
Published on: July 8, 2025
Cluster reduction in patients in a pilot treatment trial for psychogenic nonepileptic seizures
Grayson L Baird1, Lisa L Harlow2, Jason T Machan3
1Lifespan Biostatistics Core, Rhode Island Hospital, United States; Diagnostic Imaging, The Warren Alpert Medical School of Brown University, United States; University of Rhode Island, Department of Psychology, United States.
Introduction:
The present study examined seizure clusters as a primary outcome in patients receiving treatment for PNES. Cluster reduction is examined longitudinally using frequency threshold and statistical definitions of seizure cluster for patients. Possible risk factors for clustering will be examined along with clustering as a risk factor for poorer secondary outcomes.
Methods:
Participants were from a pilot randomized treatment trial for PNES where they received cognitive behavioral therapy-informed psychotherapy (CBT-ip), sertraline, combination therapy, or treatment as usual. Seizure data are from patients' seizure dairies.
Results:
Cluster reduction was observed for those receiving CBT-ip or combination treatment using all definitions of daily clusters and weekly clusters. No risk factors of clustering were observed. Those who were identified as having clusters during the trial had poorer secondary outcomes on several measures at baseline relative to those who were not identified as having clusters.
Discussion:
This is the first study known to the authors to not only examined seizure clusters as a primary outcome for those with PNES, but also the first study to suggest that CBT-ip and combination therapy may be effective in reducing the frequency of clusters.
