The results, published online Dec. 3 in the journal Epilepsy Research, suggest the ketogenic diet and fasting can work in tandem to reduce seizures but appear do so through different mechanisms — a finding that challenges the longstanding assumption that the two share a common mechanism.
“Our findings suggest that fasting does not merely intensify the therapeutic effects of the ketogenic diet but may actually represent an entirely new way to change the metabolism of children with epilepsy,” says lead investigator Adam Hartman, M.D., a pediatric neurologist at the Johns Hopkins Children’s Center.
In the study, six children, ages 2 to 7, and all on the ketogenic diet, were asked to fast on alternate days. All six children had seizure disorders incompletely resolved by the diet alone. Four of the six children experienced between 50 percent and 99 percent fewer seizures after the fasts were added to the dietary regimen. Three of the six were able to continue the fasting regimen for two months or longer.
The Johns Hopkins investigators say while the results are preliminary, they do provide compelling evidence of the potential benefits of fasting. Periodic fasts, they add, may eventually prove to be an alternative standalone therapy in children with drug-resistant epilepsy.
The researchers caution that larger studies are needed to further elucidate the effects of fasting. They also warn that fasting should be done under the strict supervision of a pediatric neurologist.
Made up of high-fat foods and few carbohydrates, the ketogenic diet is believed to work by triggering biochemical changes that eliminate seizure-causing short circuits in the brain’s signaling system. The diet, popularized in the early 1900s, was designed to mimic the physiologic effects of fasting — a seizure-control method favored by ancient Greeks. Since then, physicians have believed that the two therapies share a common mechanism.
The new Johns Hopkins findings, however, suggest otherwise.
“We suspect that fasting affects nerve cells in a completely different manner from the ketogenic diet,” Hartman says.
This hypothesis stemmed from a 2010 study of mice conducted by the Johns Hopkins team.
Two groups of epileptic mice — one treated with the ketogenic diet and one treated with fasting — had strikingly different responses to different seizure triggers. Animals treated with the ketogenic diet experienced fewer seizures than fasting mice when exposed to low amounts of electricity, but fared worse when they were injected with kainic acid, a potent nervous system stimulant and a known seizure trigger. Fasting mice, on the other hand, did worse when exposed to electricity but tolerated kainic acid injections far better than their ketogenic diet counterparts. In other words, the researchers say, each therapy protected against one seizure trigger, while increasing sensitivity to the other.
“We don’t fully understand the reasons for these marked differences, but unraveling the mechanisms behind them will help pave the way toward new therapies for epilepsy, and is the focus of our ongoing work,” says Eric Kossoff, M.D., pediatric neurologist and director of the ketogenic diet clinic at the Johns Hopkins Children’s Center.
James Rubenstein, M.D., of Johns Hopkins was co-author on the research.
Founded in 1912 as the children's hospital at The Johns Hopkins Hospital, the Johns Hopkins Children's Center offers one of the most comprehensive pediatric medical programs in the country, with more than 92,000 patient visits and nearly 9,000 admissions each year. Hopkins Children’s is consistently ranked among the top children's hospitals in the nation. Hopkins Children’s Center is Maryland's largest children’s hospital and the only state-designated Trauma Service and Burn Unit for pediatric patients. It has recognized Centers of Excellence in dozens of pediatric subspecialties, including allergy, cardiology, cystic fibrosis, gastroenterology, nephrology, neurology, neurosurgery, oncology, pulmonary, and transplant. Hopkins Children's Center is celebrating its 100th anniversary in 2012. For more information, please visit www.hopkinschildrens.org
ekaterina pesheva | EurekAlert!
Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University
New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg
A newly developed laser technology has enabled physicists in the Laboratory for Attosecond Physics (jointly run by LMU Munich and the Max Planck Institute of Quantum Optics) to generate attosecond bursts of high-energy photons of unprecedented intensity. This has made it possible to observe the interaction of multiple photons in a single such pulse with electrons in the inner orbital shell of an atom.
In order to observe the ultrafast electron motion in the inner shells of atoms with short light pulses, the pulses must not only be ultrashort, but very...
A group of researchers led by Andrea Cavalleri at the Max Planck Institute for Structure and Dynamics of Matter (MPSD) in Hamburg has demonstrated a new method enabling precise measurements of the interatomic forces that hold crystalline solids together. The paper Probing the Interatomic Potential of Solids by Strong-Field Nonlinear Phononics, published online in Nature, explains how a terahertz-frequency laser pulse can drive very large deformations of the crystal.
By measuring the highly unusual atomic trajectories under extreme electromagnetic transients, the MPSD group could reconstruct how rigid the atomic bonds are...
Quantum computers may one day solve algorithmic problems which even the biggest supercomputers today can’t manage. But how do you test a quantum computer to...
For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.
In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...
Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale
Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...
15.02.2018 | Event News
13.02.2018 | Event News
12.02.2018 | Event News
23.02.2018 | Physics and Astronomy
23.02.2018 | Health and Medicine
23.02.2018 | Physics and Astronomy