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!
Physics of bubbles could explain language patterns
25.07.2017 | University of Portsmouth
Obstructing the ‘inner eye’
07.07.2017 | Friedrich-Schiller-Universität Jena
Strong light-matter coupling in these semiconducting tubes may hold the key to electrically pumped lasers
Light-matter quasi-particles can be generated electrically in semiconducting carbon nanotubes. Material scientists and physicists from Heidelberg University...
Fraunhofer IPA has developed a proximity sensor made from silicone and carbon nanotubes (CNT) which detects objects and determines their position. The materials and printing process used mean that the sensor is extremely flexible, economical and can be used for large surfaces. Industry and research partners can use and further develop this innovation straight away.
At first glance, the proximity sensor appears to be nothing special: a thin, elastic layer of silicone onto which black square surfaces are printed, but these...
3-D shape acquisition using water displacement as the shape sensor for the reconstruction of complex objects
A global team of computer scientists and engineers have developed an innovative technique that more completely reconstructs challenging 3D objects. An ancient...
Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.
For several years, researchers have been trying to use the spin of an electron to store and transmit information. The spin of each electron is always coupled...
What is the mass of a proton? Scientists from Germany and Japan successfully did an important step towards the most exact knowledge of this fundamental constant. By means of precision measurements on a single proton, they could improve the precision by a factor of three and also correct the existing value.
To determine the mass of a single proton still more accurate – a group of physicists led by Klaus Blaum and Sven Sturm of the Max Planck Institute for Nuclear...
21.07.2017 | Event News
19.07.2017 | Event News
12.07.2017 | Event News
25.07.2017 | Physics and Astronomy
25.07.2017 | Earth Sciences
25.07.2017 | Life Sciences