Posted on October 11, 2022 by Amanda Cerreto

October 12, 2022 – Focused on driving San Antonio's knowledge economy, The UTSA Office for Research, Economic Development, and Knowledge Enterprise (REDKE) awards annual seed grants to spark innovation on campus. A total of $240,000 was awarded among 14 recipients—money that will fund new research projects or new lines of inquiry to advance their research portfolio through the discovery process.

Denver Brown Assistant Professor of Psychology Denver Brown earned an Internal Research Award of $5,000 for his research project, Investigating the influence of 24-hour movement behaviors on indicators of mental health among youth with epilepsy.

Brown and his team will measure physical activity, sedentary behavior and sleep that youth with epilepsy engage in on an average day, and see how these behaviors relate to their mental health.

Brown has been interested in this topic since his Ph.D. training. While working on a longitudinal randomized controlled trial that examined whether behavior change coaching could increase physical activity among children with epilepsy, he realized there was not much research being conducted in this particular area.

"That gap sparked me to go back to stage one, and I have use some of the nationally representative population health data from the National Survey of Children’s Health to show that children with epilepsy are meeting the physical activity guidelines at lower rates," Brown said. "This work also showed that this population have poor sleep patterns, and generally spend more time using screens compared to children without chronic health conditions. We know that this is a bad thing, because this relates to a number of mental health outcomes."

At the same time, research indicates that children with epilepsy have much higher rates of mental health disorders – between 30%-60%, where the rates among population norms are from 5%-15%.

“One of the shortcomings of this population level data is that it was self-reported by the parents,” Brown added. “By using physical activity tracking devices known as accelerometers, we can get an unbiased view of how much time these youth spend engaging in physical activity, sedentary behavior and sleep.”

That in-depth insight allows Brown to look into the composition of their day at a much more micro level, and remove any biases from self-reporting. It also allows for the application of more advanced statistical analysis techniques that consider how these behaviors are co-dependent across the course of a full day and interact to influence a range of health outcomes.

Measuring physical activity is important not only as an indicator for mental health, but also for the seizure-related symptomology as well. “For a long time, there’s been this myth that physical activity is related to increased seizure frequency and severity,” Brown said. “But some self-reported data among adults has shown that it’s actually the opposite - physical activity is linked with reduces seizure frequency and severity. So we need to start getting some of this data with children and youth in this pediatric population, because if we can get them more active and improve their sleep patterns early in life, it can help shape trajectories of these behaviors in a positive manner as they transition into adulthood.”

Brown and his team will enroll 100 youth with epilepsy in Southwest Central Texas. Co-PI Linda Leary, medical director for pediatric epilepsy services at UT Health, will recruit through her clinic. The Epilepsy Foundation Central & South Texas will also partner with the researchers and help to advertise the study.

Brown hopes the research can shed light on potential reasons for mental health disorders among youth with epilepsy and as such, improve mental health among youth as a whole.

“One of the reasons why we’re looking into this from a behavioral medicine standpoint is because we know that someone who has epilepsy is probably taking one or more medications to combat their seizures,” he said. “At the same time, given the mental health disorders they experience, they are likely also taking medications to alleviate these problems, which can potentially lead to adverse side effects due to interactions between different types of medications.”

With their data, the researchers will look for different non-pharmacological approaches that can be implemented that are low cost and provide other health benefits.

“I’m hoping we get a good understanding of which movement behavior has the strongest relationship with depressive symptoms and anxiety so that we can identify interventions,” Brown said.

The findings of the study will be shared at the annual meeting of the American Epilepsy Society and with the Epilepsy Foundation. Each participant will also receive a personalized report of what their day-to-day behavioral composition looks like. Ultimately, Brown and his team aim for this to provide preliminary evidence to support a longitudinal study.

“What we're doing now is cross-sectional - we can't really understand the causal nature of the mental health disorders,” Brown said. “We want this to support a longitudinal study that we can get a better understanding the causal nature of the relationships between mental health and 24-hour movement behaviors.”

This research, while aiming to affect a population of youth with epilepsy, could have a blossoming affect among all populations that have been diagnosed with chronic health conditions.

“The peak onset of a lot of mental health disorders, particularly affective disorders like depression and anxiety, is in adolescence,” Brown said. “If we can better understand what’s going on with a population that’s at even greater risk of experiencing these disorders, we can implement some interventions that can combat it.”

— Amanda Cerreto