Authors :
Presenting Author: Suparna Krishnaiengar, MD – University of Florida College of Medicine- Jacksonville
Achyutha Madamangalam, BS – University of Florida-Gainesville
Venkat Srikar Lavu, MBBS – University of Arkansas at Little Rock
Shachie Aranke, MD – Charlie Norwood V.A. Medical Center, Augusta, GA
Sundaravadivel Balasubramanian, PhD – Medical University of South Carolina, Charleston, SC
Rationale:
Epilepsy, a pervasive neurological disorder characterized by recurrent, unprovoked seizures, presents a significant unmet clinical need, particularly in pharmacoresistant cohorts. Electroencephalogram (EEG) remains an indispensable diagnostic and monitoring modality providing insights into cerebral electrophysiological dynamics and interictal epileptiform discharges. Mind-body interventions, specifically yogic breathing (YB), also known as Pranayama, are gaining traction as potential neuromodulatory adjuncts. This scoping review aims to systematically delineate existing literature on Pranayama's effects on EEG and its translational relevance in epilepsy.
Methods:
A comprehensive scoping review was executed across PubMed, Scopus, Web of Science, and Embase from inception through May 2025. The search strategy combined MeSH terms and free-text, including "Pranayama,” “EEG,” and "epilepsy." Inclusion criteria focused on peer-reviewed original research, systematic reviews, and randomized controlled trials examining Pranayama's impact on human EEG, emphasizing neurophysiological effects pertinent to seizure pathophysiology. Studies solely detailing meditation were excluded. Data extraction focused on methodological rigor, Pranayama techniques, quantitative EEG parameters (e.g. spectral power, coherence, epileptiform activity), reported effects, and relevance to epileptic phenomena.
Results:
Preliminary findings consistently indicate Pranayama induces significant, reproducible alterations in cerebral electrical activity. Commonly reported EEG modifications include increased alpha (8-12 Hz) and theta (4-7 Hz) band power, indicative of enhanced relaxed wakefulness and meditative states. Some studies also report gamma (30-100 Hz) oscillation modulation. Putative mechanisms involve profound autonomic nervous system modulation, specifically augmented parasympathetic tone via vagal afferent activation, and direct influences on cortical excitability and neural synchronization. The stress reducing effects of Pranayama may also contribute to seizure reduction. While direct evidence of Pranayama reducing seizure frequency or attenuating interictal epileptiform discharges in epilepsy cohorts remains nascent, observed EEG patterns and neurophysiological effects may suggest a mechanistic basis for its therapeutic integration.
Conclusions:
This scoping review substantiates that Pranayama elicits demonstrable effects on EEG parameters, promoting brain states conducive to neuromodulation and potential adaptive neuroplasticity. These neurophysiological shifts necessitate rigorous translational investigation into Pranayama's potential as a non-pharmacological adjunctive therapeutic modality in epilepsy management. Future research should prioritize meticulously designed, adequately powered randomized controlled trials employing objective EEG biomarkers and long-term seizure outcome measures to definitively ascertain the clinical efficacy and safety of Pranayama interventions in epilepsy populations.
Funding: None