Factors associated with seizure response in adults with epilepsy on a modified Atkins diet.

Autor: Huerta N; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Electronic address: nhuerta1@jh.edu., Lu M; Institute for Clinical and Translational Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Electronic address: mlu33@jhu.edu., Henry-Barron BJ; Institute for Clinical and Translational Research, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Electronic address: bjhenry@jhu.edu., Cervenka MC; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Electronic address: mcerven1@jhmi.edu., McDonald TJW; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Electronic address: twill145@jhmi.edu.
Jazyk: angličtina
Zdroj: Seizure [Seizure] 2024 Oct; Vol. 121, pp. 147-151. Date of Electronic Publication: 2024 Aug 22.
DOI: 10.1016/j.seizure.2024.08.014
Abstrakt: Purpose: This study investigated factors associated with improved seizure control in adults with epilepsy following a modified Atkins diet (MAD).
Methods: Follow-up data collected from participants enrolled in a prospective study between March 2016 and November 2023 was analyzed. Demographic and clinical differences between diet responders and non-responders were evaluated. MAD response was defined as ≥ 50 % reduction in seizure frequency from baseline.
Results: MAD use led to clinical response in 48 % of study participants with 2-3 month follow-up and in 56 % of study participants with 6 month follow-up. No significant differences were found for gender, age at diet initiation, age at epilepsy diagnosis, or for number of current or past medications tried. However, a significant relationship emerged between epilepsy type and diet response at 6 months with a response of 100 % seen in adults with generalized epilepsy and a response of only 42 % in adults with focal epilepsy (p = 0.004). Those who responded to the diet showed non-significant increases in many of the measured lipid biomarkers. Levels of apolipoprotein-B and small low-density lipoprotein particles showed significant increases from baseline after 3 months in responders compared to non-responders (p = 0.004 and 0.049, respectively).
Conclusions: These findings support the continued use of MAD particularly for seizure management in adults with generalized epilepsy and highlight potential mechanisms of clinical response involving lipoprotein and energy metabolism.
Competing Interests: Declaration of competing interest Dr. Huerta has no conflicts of interest to disclose. Ms. Lu and Ms. Henry-Barron work within the Johns Hopkins Institute for Clinical and Translational Research (ICTR), which is funded in part by Grant Number UL1 TR003098 from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Ms. Henry-Barron has received support from Nutricia, Vitaflo, and The Carson Harris Foundation and personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Nutricia, BioMarin, and Therachon, and has received royalties from Demos/Springer Publishing Company. Dr. Cervenka receives or has received support from The Epilepsy Foundation, The Johns Hopkins University School of Medicine Clinician Scientist Award, Nutricia, Vitaflo, The Glut1 Deficiency Foundation, The Carson Harris Foundation, Owens Family Foundation, Elaine Freeman and Johns Hopkins University Department of Neurosurgery, NIH (NINDS R01NS075020), and Army Research Laboratory. Dr. Cervenka has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Nutricia/Danone, Vitaflo/Nestlé Health Science, and The Neurology Center in Rockville, Maryland. Dr. Cervenka has received royalties from Demos/Springer Publishing Company. Dr. McDonald has received support from the Johns Hopkins KL2 Mentored Career Development Award (1 KL2 TR 3099–1), a grant from the American Heart Association, and a grant from the American Epilepsy Society.
(Copyright © 2024 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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