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Background Functional Seizures (FS) are common, costly and harmful. There is a need to develop mechanistically based treatments that reduce seizure frequency and severity.Recent research suggests that interoception – how the nervous system senses, interprets, and integrates information from inside the body – is altered in FS.1 Individuals with FS have an interoceptive mismatch that correlates with seizure frequency. They have both reduced sensitivity to bodily signals, and limited insight into their perceptual accuracy.Objectives Primary To demonstrate the feasibility of an intervention based on Aligning Dimensions of Interoceptive Experience (ADIE), in individuals with FS. This intervention is based on its successful application in individuals with autism and anxiety. 2 Secondary To explore the potential of ADIE-FS to improve the interoceptive sensitivity/insight in participants with FS and reduce seizure frequency/severity.Methods ADIE targets the mismatch between subjective and objective behavioural measures of an individual’s interoceptive sensitivity to their heartbeat. It combines two modified heartbeat detection tasks with performance feedback before and after brief physical activity. The exercise temporarily increases cardiac arousal and therefore makes it easier to appraise cardiac bodily signals.Participants with documented FS were randomly assigned to receive either six sessions of ADIE, or treatment as usual. All participants completed baseline measures at three timepoints: initial T0, one-week follow-up T1, and 3-month follow-up T2.Interim Results Nineteen participants have been enrolled. Thirteen participants have completed all aspects of the study. Three participants are awaiting 3-month follow-up in April. Three participants stopped attending due to an unrelated health condition (N=1 intervention) and an increase in seizure frequency unrelated to the interoceptive training (N=1 intervention, N=1 waiting list).Initial impressions in terms of feasibility are promising with 84% of participants expected to complete all aspects of the trial, and almost half (N=9) travelling for over two hours to attend appointments despite minimal financial reimbursement being available. Responses on the client satisfaction questionnaire for intervention participants have been overwhelmingly positive with one participant reporting that ADIE helped them to become aware of, hitherto unrecognized, seizure warnings signs leading to a decrease in seizure frequency.Discussion Based on initial data results ADIE-FS is a feasible intervention for FS. It is acceptable to participants, and there has been no participant drop out as a direct result of this intervention. We envisage completion of the study and publication of the data and results in 2025.References Koreki, et al. Trait and state interoceptive abnormalities are associated with dissociation and seizure frequency in patients with functional seizures, Epilepsia 2020.Quadt et al. Interoceptive training to target anxiety in autistic adults (ADIE): A single-center, superiority randomized controlled trial, eClinical Medicine 2021.