What are the effects of meditation on selected clinical outcomes in patients with Parkinson’s disease and epilepsy?

Protocol will include every other week physical (onsite) guided sessions and twice a week online guided sessions conducted by the meditation trainer throughout the period of 8 weeks of intervention. Thus the total number of guided sessions would be 20 out of which 4 sessions will be attended physically while the remaining 16 sessions would be attended virtually. Each guided session will have a duration of a minimum of 40 mins. Participants are expected to attend daily self-practice meditation sessions for 40 mins as instructed by the trainer who is an experienced trainer in meditation. This duration will be monitored though a self maintained daily log. .

Once the participants are selected both the participants and the accompanying care givers would be trained by the PI on using the online platforms (Zoom platform) for online training sessions based on the devices at hand.

Setting: In the event where the participants do not have the facility for online technology, it will be made available at the RPFC, Faculty of Medicine, University of Colombo. Participants may physically attend this venue and attend the online sessions through the computers provided at the venue. Site -Onsite training will be conducted at a hall at the Clinical Medicine Academic Research Centre (CLINMARC) at the National Hospital of Sri Lanka (NHSL).

Randomization and Controls: Simple random sampling would be the method of randomization in this study. Controls will continue with their usual prescribed medicines during the 8-week period of intervention. The controls would be wait listed for the intervention at the end of 8 weeks.

Inclusion criteria for Parkinson’s disease group

1) Diagnosis of PD according to Movement Disorder Society clinical diagnostic criteria for Parkinson Disease 2) Patients in Hoehn and Yahr stages I–III 3) Optimally treated with PD medication and unlikely to require anti-PD medication adjustments in the next one month 4) Stable dose of all medications for 30 days prior to inclusion 5) Lack of cognitive dysfunction as evidenced by the Montreal Cognitive Assessment Test (MoCA) (score greater than or equal to 26) 6) No known unstable or life-threatening concomitant disease 7) No previous meditation training and or regular practice 8) Commitment to attend meditation training sessions both onsite and online and to perform the prescribed daily homework of meditation.

Inclusion criteria for Epilepsy group

1) Patients aged 18 years or older 2) Having a clinical diagnosis of medication-resistant epilepsy 3) Seizure frequency of 4 or more seizures per month 4) On a stable antiepileptic drug regimen for the prior ?30 days 5) No history of status epilepticus within the previous 6 months 6) Not pregnant or planning pregnancy 7) Able to maintain a seizure diary independently 8) No known unstable or life-threatening concomitant disease 9) No previous meditation training or regular practice 10) Commitment to attend meditation training sessions both onsite and online and to perform the prescribed daily homework of meditation

Exclusion criteria for Parkinson disease group

1) Usage of neuroleptics or other drugs that induce parkinsonism within 60 days prior to inclusion 2) Patients with psychotic symptoms 3) Atypical parkinsonian syndromes

Exclusion criteria for Epilepsy group

1.) Patients with coexisting psychiatric diagnosis 2.) Patients with intellectual impairment
3.) Alcohol or substance dependence