Dietary medium chain triglycerides for management of epilepsy: New data from human, dog, and rodent studies
| Autor: | Galena Rybachuk, Karin Borges, Lisa Conboy-Schmidt, Holger A. Volk, Yuanlong Pan, Felicity Y. Han, Brian M. Zanghi |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
nonketogenic diets medicine.medical_treatment seizure Central nervous system Rodentia ketogenic diets Ketone Bodies Mitochondrion Carbohydrate metabolism Bioinformatics 03 medical and health sciences Epilepsy chemistry.chemical_compound 0302 clinical medicine Dogs medium chain triglycerides Seizures energy metabolism medicine Animals Humans Critical Review–Invited Commentary Neurotransmitter Triglycerides business.industry energy storage Decanoic acid medicine.disease mitochondria 030104 developmental biology Anticonvulsant medicine.anatomical_structure Glucose Neurology chemistry Ketone bodies Anticonvulsants Neurology (clinical) business Diet Ketogenic Decanoic Acids 030217 neurology & neurosurgery |
| Zdroj: | Epilepsia |
| ISSN: | 1528-1167 |
| Popis: | Many studies show that glucose metabolism in epileptic brain areas can be impaired. Energy is crucial to maintain normal brain function, including ion and neurotransmitter balances. Energy deficits can lead to disruption of ion gradients, which can trigger neuronal depolarization and generation of seizures. Thus, perturbed metabolic processing of glucose in epileptogenic brain areas indicates a specific nutritional need for people and animals with epilepsy, as they are likely to benefit from auxiliary brain fuels other than glucose. Ketogenic diets provide the ketone bodies acetoacetate and β‐hydroxybutyrate, which can be used as auxiliary fuel by the brain. In approximately 50% children and adults with certain types of epilepsy, who can tolerate and maintain these dietary regimens, seizure frequency can be effectively reduced. More recent data demonstrate that addition of medium chain triglycerides (MCTs), which provide the medium chain fatty acids octanoic and decanoic acid, as well as ketone bodies as auxiliary brain energy, can be beneficial in rodent seizure models, and dogs and humans with epilepsy. Here, this evidence is reviewed, including tolerance in 65% of humans, efficacy studies in dogs, possible anticonvulsant mechanisms of actions of MCTs, and specifically decanoic acid as well as metabolic and antioxidant mechanisms. In conclusion, MCTs are a promising adjunct to standard pharmacological treatment for both humans and dogs with epilepsy, as they lack central nervous system side effects found with current antiepileptic drugs. There is now a need for larger clinical trials in children, adults, and dogs to find the ideal composition and doses of MCTs and the types of epilepsy that respond best. |
| Databáze: | OpenAIRE |
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