Feasibility of and patient satisfaction with Readiness Brain Operation Optimization Training, a manualized cognitive prehabilitation program for epilepsy surgery.

Objective: Readiness Brain Operation Optimization Training (ReBOOT) is a manualized cognitive prehabilitation program for patients considering epilepsy surgery designed to improve presurgical preparedness through education and reduce the impact of postsurgical cognitive changes with preemptive cognitive compensatory training. The purpose of this study was to understand the feasibility of cognitive prehabilitation, examine patient satisfaction with ReBOOT, and assess changes in compensatory strategy use following ReBOOT.

Methods: Seventeen participants (65% female, mean age = 41 years) considering epilepsy surgery were enrolled in ReBOOT, which includes two one-on-one psychoeducation sessions, four group sessions on cognitive compensatory strategies, and weekly goal setting to facilitate implementation of strategies. Patient retention, attendance, and goal completion were tracked. Participants also completed the Everyday Compensation Questionnaire pre- and postintervention along with a satisfaction survey postintervention. Aggregate ratings were examined, and paired samples t-test was used to assess change in compensatory strategy use postintervention.

Results: Five participants withdrew shortly after consent, prior to starting ReBOOT, because of a change in surgical status/date or lack of desire to complete relevant study activities. Of the 12 remaining participants, only two missed one session. Participants indicated that they found ReBOOT to be quite beneficial, reported satisfaction with the information and support provided by ReBOOT, and felt that ReBOOT was effective at preparing them for epilepsy surgery and potential postsurgical cognitive changes. Most participants made some (i.e., little to moderate) progress on their goals each week and demonstrated increased compensatory strategy use by the end of ReBOOT.

Significance: Findings indicate that cognitive prehabilitation is feasible. Participants reported high satisfaction with ReBOOT, reporting multiple benefits, and demonstrated increased compensatory strategy use following program completion. These results highlight cognitive prehabilitation for epilepsy surgery as a worthwhile pursuit and demonstrate that ReBOOT may serve as a useful clinical resource in the future following further validation of its efficacy.