Ketogenic diet effects on neurobehavioral development of children with intractable epilepsy: A prospective study

Abstract Objective This study aimed to determine the impact of a ketogenic diet (KD) on neurobehavioral development when used to treat children with intractable epilepsy, confirming the efficacy of the KD, as well as the correlation between early electroencephalography (EEG) changes in the early sta...

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Veröffentlicht in:Epilepsy & behavior 2016-02, Vol.55, p.87-91
Hauptverfasser: Zhu, Dengna, Wang, Mingmei, Wang, Jun, Yuan, Junying, Niu, Guohui, Zhang, Guangyu, Sun, Li, Xiong, Huachun, Xie, Mengmeng, Zhao, Yunxia
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container_end_page 91
container_issue
container_start_page 87
container_title Epilepsy & behavior
container_volume 55
creator Zhu, Dengna
Wang, Mingmei
Wang, Jun
Yuan, Junying
Niu, Guohui
Zhang, Guangyu
Sun, Li
Xiong, Huachun
Xie, Mengmeng
Zhao, Yunxia
description Abstract Objective This study aimed to determine the impact of a ketogenic diet (KD) on neurobehavioral development when used to treat children with intractable epilepsy, confirming the efficacy of the KD, as well as the correlation between early electroencephalography (EEG) changes in the early stage with treatment efficacy. Methods We enrolled 42 children who were starting treatment for intractable epilepsy with the classic KD protocol. The total development quotient as well as the development quotients for adaptability, gross motor movements, fine motor movements, language, and individual–social interaction on the Gesell developmental scales were assessed before and after 3, 6, 12, and 18 months of KD treatment. The efficacy assessment was based on changes in seizure frequency after KD as recorded by the parents. We conducted 24-h video-EEG before and after 1 month of KD treatment. Results Developmental quotients of five energy regions in the Gesell developmental scales assessment were used to compare adaptability ( P1 = 0.000), gross motor movements ( P2 = 0.010), and fine motor movements ( P3 = 0.000); the results showed significant differences. After KD treatment at different time points, 69.0%, 54.8%, 40.5%, and 33.3% patients, respectively, achieved a ≥ 50% reduction in seizure frequency. The reduction of epileptiform discharges in the awake state after 1 month of KD treatment correlated with the efficacy after 3 months of KD treatment. Conclusions Ketogenic diet treatment tends to be associated with improved neurobehavioral development, and more significant improvement can be obtained with prolonged treatment. The KD is safe and effective in treating children with intractable epilepsy. Early EEG changes correlate with clinical efficacy, to a certain degree.
doi_str_mv 10.1016/j.yebeh.2015.12.011
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Methods We enrolled 42 children who were starting treatment for intractable epilepsy with the classic KD protocol. The total development quotient as well as the development quotients for adaptability, gross motor movements, fine motor movements, language, and individual–social interaction on the Gesell developmental scales were assessed before and after 3, 6, 12, and 18 months of KD treatment. The efficacy assessment was based on changes in seizure frequency after KD as recorded by the parents. We conducted 24-h video-EEG before and after 1 month of KD treatment. Results Developmental quotients of five energy regions in the Gesell developmental scales assessment were used to compare adaptability ( P1 = 0.000), gross motor movements ( P2 = 0.010), and fine motor movements ( P3 = 0.000); the results showed significant differences. After KD treatment at different time points, 69.0%, 54.8%, 40.5%, and 33.3% patients, respectively, achieved a ≥ 50% reduction in seizure frequency. The reduction of epileptiform discharges in the awake state after 1 month of KD treatment correlated with the efficacy after 3 months of KD treatment. Conclusions Ketogenic diet treatment tends to be associated with improved neurobehavioral development, and more significant improvement can be obtained with prolonged treatment. The KD is safe and effective in treating children with intractable epilepsy. Early EEG changes correlate with clinical efficacy, to a certain degree.</description><identifier>ISSN: 1525-5050</identifier><identifier>EISSN: 1525-5069</identifier><identifier>DOI: 10.1016/j.yebeh.2015.12.011</identifier><identifier>PMID: 26773676</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Child ; Child Development ; Child, Preschool ; Diet, Ketogenic - methods ; Drug Resistant Epilepsy - diagnosis ; Drug Resistant Epilepsy - diet therapy ; Drug Resistant Epilepsy - psychology ; Electroencephalography - trends ; Female ; Follow-Up Studies ; Humans ; Infant ; Intractable epilepsy ; Ketogenic diet ; Male ; Neurobehavioral development ; Neurology ; Prospective Studies ; Treatment Outcome ; Video-electroencephalography</subject><ispartof>Epilepsy &amp; behavior, 2016-02, Vol.55, p.87-91</ispartof><rights>The Authors</rights><rights>2015 The Authors</rights><rights>Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c492t-9de88bbe88cddd21f80ed8630aab365dac0b59c0d999bc86a61b2c4e766432b23</citedby><cites>FETCH-LOGICAL-c492t-9de88bbe88cddd21f80ed8630aab365dac0b59c0d999bc86a61b2c4e766432b23</cites><orcidid>0000-0003-1399-5812</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.yebeh.2015.12.011$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26773676$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhu, Dengna</creatorcontrib><creatorcontrib>Wang, Mingmei</creatorcontrib><creatorcontrib>Wang, Jun</creatorcontrib><creatorcontrib>Yuan, Junying</creatorcontrib><creatorcontrib>Niu, Guohui</creatorcontrib><creatorcontrib>Zhang, Guangyu</creatorcontrib><creatorcontrib>Sun, Li</creatorcontrib><creatorcontrib>Xiong, Huachun</creatorcontrib><creatorcontrib>Xie, Mengmeng</creatorcontrib><creatorcontrib>Zhao, Yunxia</creatorcontrib><title>Ketogenic diet effects on neurobehavioral development of children with intractable epilepsy: A prospective study</title><title>Epilepsy &amp; behavior</title><addtitle>Epilepsy Behav</addtitle><description>Abstract Objective This study aimed to determine the impact of a ketogenic diet (KD) on neurobehavioral development when used to treat children with intractable epilepsy, confirming the efficacy of the KD, as well as the correlation between early electroencephalography (EEG) changes in the early stage with treatment efficacy. Methods We enrolled 42 children who were starting treatment for intractable epilepsy with the classic KD protocol. The total development quotient as well as the development quotients for adaptability, gross motor movements, fine motor movements, language, and individual–social interaction on the Gesell developmental scales were assessed before and after 3, 6, 12, and 18 months of KD treatment. The efficacy assessment was based on changes in seizure frequency after KD as recorded by the parents. We conducted 24-h video-EEG before and after 1 month of KD treatment. Results Developmental quotients of five energy regions in the Gesell developmental scales assessment were used to compare adaptability ( P1 = 0.000), gross motor movements ( P2 = 0.010), and fine motor movements ( P3 = 0.000); the results showed significant differences. After KD treatment at different time points, 69.0%, 54.8%, 40.5%, and 33.3% patients, respectively, achieved a ≥ 50% reduction in seizure frequency. The reduction of epileptiform discharges in the awake state after 1 month of KD treatment correlated with the efficacy after 3 months of KD treatment. Conclusions Ketogenic diet treatment tends to be associated with improved neurobehavioral development, and more significant improvement can be obtained with prolonged treatment. The KD is safe and effective in treating children with intractable epilepsy. 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Wang, Mingmei ; Wang, Jun ; Yuan, Junying ; Niu, Guohui ; Zhang, Guangyu ; Sun, Li ; Xiong, Huachun ; Xie, Mengmeng ; Zhao, Yunxia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c492t-9de88bbe88cddd21f80ed8630aab365dac0b59c0d999bc86a61b2c4e766432b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Child</topic><topic>Child Development</topic><topic>Child, Preschool</topic><topic>Diet, Ketogenic - methods</topic><topic>Drug Resistant Epilepsy - diagnosis</topic><topic>Drug Resistant Epilepsy - diet therapy</topic><topic>Drug Resistant Epilepsy - psychology</topic><topic>Electroencephalography - trends</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Infant</topic><topic>Intractable epilepsy</topic><topic>Ketogenic diet</topic><topic>Male</topic><topic>Neurobehavioral development</topic><topic>Neurology</topic><topic>Prospective Studies</topic><topic>Treatment Outcome</topic><topic>Video-electroencephalography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhu, Dengna</creatorcontrib><creatorcontrib>Wang, Mingmei</creatorcontrib><creatorcontrib>Wang, Jun</creatorcontrib><creatorcontrib>Yuan, Junying</creatorcontrib><creatorcontrib>Niu, Guohui</creatorcontrib><creatorcontrib>Zhang, Guangyu</creatorcontrib><creatorcontrib>Sun, Li</creatorcontrib><creatorcontrib>Xiong, Huachun</creatorcontrib><creatorcontrib>Xie, Mengmeng</creatorcontrib><creatorcontrib>Zhao, Yunxia</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>Epilepsy &amp; behavior</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhu, Dengna</au><au>Wang, Mingmei</au><au>Wang, Jun</au><au>Yuan, Junying</au><au>Niu, Guohui</au><au>Zhang, Guangyu</au><au>Sun, Li</au><au>Xiong, Huachun</au><au>Xie, Mengmeng</au><au>Zhao, Yunxia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ketogenic diet effects on neurobehavioral development of children with intractable epilepsy: A prospective study</atitle><jtitle>Epilepsy &amp; behavior</jtitle><addtitle>Epilepsy Behav</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>55</volume><spage>87</spage><epage>91</epage><pages>87-91</pages><issn>1525-5050</issn><eissn>1525-5069</eissn><abstract>Abstract Objective This study aimed to determine the impact of a ketogenic diet (KD) on neurobehavioral development when used to treat children with intractable epilepsy, confirming the efficacy of the KD, as well as the correlation between early electroencephalography (EEG) changes in the early stage with treatment efficacy. Methods We enrolled 42 children who were starting treatment for intractable epilepsy with the classic KD protocol. The total development quotient as well as the development quotients for adaptability, gross motor movements, fine motor movements, language, and individual–social interaction on the Gesell developmental scales were assessed before and after 3, 6, 12, and 18 months of KD treatment. The efficacy assessment was based on changes in seizure frequency after KD as recorded by the parents. We conducted 24-h video-EEG before and after 1 month of KD treatment. Results Developmental quotients of five energy regions in the Gesell developmental scales assessment were used to compare adaptability ( P1 = 0.000), gross motor movements ( P2 = 0.010), and fine motor movements ( P3 = 0.000); the results showed significant differences. After KD treatment at different time points, 69.0%, 54.8%, 40.5%, and 33.3% patients, respectively, achieved a ≥ 50% reduction in seizure frequency. The reduction of epileptiform discharges in the awake state after 1 month of KD treatment correlated with the efficacy after 3 months of KD treatment. Conclusions Ketogenic diet treatment tends to be associated with improved neurobehavioral development, and more significant improvement can be obtained with prolonged treatment. The KD is safe and effective in treating children with intractable epilepsy. Early EEG changes correlate with clinical efficacy, to a certain degree.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26773676</pmid><doi>10.1016/j.yebeh.2015.12.011</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-1399-5812</orcidid><oa>free_for_read</oa></addata></record>
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subjects Child
Child Development
Child, Preschool
Diet, Ketogenic - methods
Drug Resistant Epilepsy - diagnosis
Drug Resistant Epilepsy - diet therapy
Drug Resistant Epilepsy - psychology
Electroencephalography - trends
Female
Follow-Up Studies
Humans
Infant
Intractable epilepsy
Ketogenic diet
Male
Neurobehavioral development
Neurology
Prospective Studies
Treatment Outcome
Video-electroencephalography
title Ketogenic diet effects on neurobehavioral development of children with intractable epilepsy: A prospective study
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