1
|
Qiao Q, Tian S, Zhang Y, Che L, Li Q, Qu Z, Wang W. A Ketogenic Diet may Improve Cognitive Function in Rats with Temporal Lobe Epilepsy by Regulating Endoplasmic Reticulum Stress and Synaptic Plasticity. Mol Neurobiol 2024; 61:2249-2264. [PMID: 37870676 DOI: 10.1007/s12035-023-03659-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/15/2023] [Indexed: 10/24/2023]
Abstract
A ketogenic diet (KD) is often used in the treatment of refractory epilepsy. Many studies have found that it also has a positive impact on cognitive comorbidities, but the specific mechanism remains unclear. In many disease models, endoplasmic reticulum stress (ERS) and synaptic plasticity is considered a new therapeutic target for improving cognitive impairment, and it has become a research focus in recent years. Recently, studies have found that a KD has a certain regulatory effect on both ERS and synaptic plasticity, but this result has not been confirmed in epilepsy. To investigate the effect of a KD on ERS and synaptic plasticity. In this study, a rat model of temporal lobe epilepsy (TLE) induced by lithium chloride-pilocarpine was used. After the model was successfully established, the rats in each group were fed a normal diet or a KD for 28 days, and the effect of a KD on the latency and seizure frequency of spontaneous recurrent seizures (SRSs) was observed via video monitoring. Subsequently, a Morris water maze was used to evaluate the spatial learning and memory abilities of the rats in each group; the ultrastructure of the ER and the synapses of the hippocampus were observed by transmission electron microscopy, and the dendritic spine density of the hippocampus was analysed by Golgi staining. Long-term potentiation (LTP) was used to detect the synaptic plasticity of the rats' hippocampi, and the expression of ERS-related proteins and synapse-related proteins was detected by Western blotting. A KD effectively reduced the frequency of SRSs in rats with TLE and improved their learning and memory impairment. Further investigations found that a KD inhibited the up-regulation of glucose-regulated protein 78, phospho-protein kinase-like ER kinase, phosphorylated α subunit of eukaryotic initiation factor 2, activating transcription factor 4 and C/EBP homologous protein expression in the hippocampi of rats with TLE and protected the ultrastructure of the neuronal ER, suggesting that a KD suppressed excessive ERS induced by epilepsy. Concurrently, we also found that a KD not only improved the synaptic ultrastructure and increased the density of dendritic spines in rats with TLE but also reversed the epilepsy-induced LTP deficit to some extent. More importantly, the expression of postsynaptic density protein 95, synaptotagmin-1 and synaptosomal-associated protein 25 in the hippocampi of rats with epilepsy was significantly increased after KD intervention. The study findings indicate that a KD improves learning and memory impairment in rats with epilepsy, possibly by regulating ERS and synaptic plasticity.
Collapse
Affiliation(s)
- Qi Qiao
- Key Laboratory of Neurology of Hebei Province, Department of Neurology, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, 050000, China
| | - Shuang Tian
- Department of Neurology, Shijiazhuang People's Hospital, Shijiazhuang, 050000, China
| | - Yuan Zhang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, 050000, China
| | - Liqin Che
- Key Laboratory of Neurology of Hebei Province, Department of Neurology, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, 050000, China
| | - Qing Li
- Key Laboratory of Neurology of Hebei Province, Department of Neurology, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, 050000, China
| | - Zhenzhen Qu
- Key Laboratory of Neurology of Hebei Province, Department of Neurology, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, 050000, China.
| | - Weiping Wang
- Key Laboratory of Neurology of Hebei Province, Department of Neurology, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, 050000, China.
| |
Collapse
|
2
|
Díez-Arroyo C, García-García M, Soto-Méndez MJ, Molina-Montes E, Gil-Campos M, Gil Á, Gutiérrez-Jimeno M, Hernández-Ruiz Á. Effect of the ketogenic diet as a treatment for refractory epilepsy in children and adolescents: a systematic review of reviews. Nutr Rev 2024; 82:487-502. [PMID: 37400987 DOI: 10.1093/nutrit/nuad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023] Open
Abstract
CONTEXT Epilepsy is one of the most prevalent neurological disorders in childhood. Antiepileptic drugs are the preferred treatment. However, 30% of children continue suffering seizures. A ketogenic diet (KD) is one of the emerging alternative treatments. OBJECTIVE This review aims to analyze the current evidence regarding the use of a KD for the treatment of refractory epilepsy (RE) in childhood. DATA SOURCES A systematic review of reviews was performed, based on MEDLINE (PubMed) as at January 2021. DATA EXTRACTION The data extracted included the first author's last name; the year of publication; the country; the study design; the population; the diagnosis, concept, and description of KD types; and major outcome. RESULTS Twenty-one reviews were included, 8 with systematic methodology (2 of them included a meta-analysis) and 13 with unsystematic methodology. The main difference between the 2 types of reviews is the reproducibility of their methodology. Therefore, the results of each type of review were analyzed separately. Each type of review described 4 categories of KD: classic KD, modified Atkins diet (MAD), use of medium-chain triglycerides (MCTs), and low glycemic index treatment (LGIT). In terms of effectiveness, the considered systematic reviews reported reductions in the frequency of seizures greater than 50% in about half of the patients. Reviews without systematic methodology reported that 30%-60% of the children showed a 50% or greater reduction in seizures. The most frequently described adverse effects in the 8 systematic reviews were: vomiting (6/8), constipation (6/8), and diarrhea (6/8); and in the unsystematic reviews: vomiting and nausea (10/13), constipation (10/13), and acidosis (9/13). CONCLUSION KD can be an effective treatment for RE, with a more than 50% reduction in the frequency of seizures and cognitive improvement being achieved in half of the pediatric patients. The effectiveness of the various types of KD is comparable, and the KD can be adapted to the needs of the patient. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021244142.
Collapse
Affiliation(s)
- Cristina Díez-Arroyo
- Nursing Department, Faculty of Nursing, University of Valladolid, Valladolid, Spain
- Unidad de Hospitalización de Medicina Interna, Hospital Tres Mares, Reinosa, Cantabria, Spain
| | - Mónica García-García
- Nursing Department, Faculty of Nursing, University of Valladolid, Valladolid, Spain
- Servicio de Emergencias Sanitarias de SACYL, Valladolid, Spain
| | | | - Esther Molina-Montes
- Department of Nutrition and Food Science, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technology "José Mataix," Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Armilla, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
- CIBERESP (Epidemiology and Publich Health), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Mercedes Gil-Campos
- CIBEROBN, (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Armilla, Granada, Spain
- Institute of Nutrition and Food Technology "José Mataix," Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Armilla, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
- CIBEROBN, (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), Madrid, Spain
- Department of Biochemistry and Molecular Biology, II University of Granada, University of Granada, Granada, Spain
| | - Miriam Gutiérrez-Jimeno
- Departamento de Pediatría del Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Ángela Hernández-Ruiz
- Nursing Department, Faculty of Nursing, University of Valladolid, Valladolid, Spain
- Iberoamerican Nutrition Foundation (FINUT), Armilla, Granada, Spain
| |
Collapse
|
3
|
Iyer SH, Yeh MY, Netzel L, Lindsey MG, Wallace M, Simeone KA, Simeone TA. Dietary and Metabolic Approaches for Treating Autism Spectrum Disorders, Affective Disorders and Cognitive Impairment Comorbid with Epilepsy: A Review of Clinical and Preclinical Evidence. Nutrients 2024; 16:553. [PMID: 38398876 PMCID: PMC10893388 DOI: 10.3390/nu16040553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
Epilepsy often occurs with other neurological disorders, such as autism, affective disorders, and cognitive impairment. Research indicates that many neurological disorders share a common pathophysiology of dysfunctional energy metabolism, neuroinflammation, oxidative stress, and gut dysbiosis. The past decade has witnessed a growing interest in the use of metabolic therapies for these disorders with or without the context of epilepsy. Over one hundred years ago, the high-fat, low-carbohydrate ketogenic diet (KD) was formulated as a treatment for epilepsy. For those who cannot tolerate the KD, other diets have been developed to provide similar seizure control, presumably through similar mechanisms. These include, but are not limited to, the medium-chain triglyceride diet, low glycemic index diet, and calorie restriction. In addition, dietary supplementation with ketone bodies, polyunsaturated fatty acids, or triheptanoin may also be beneficial. The proposed mechanisms through which these diets and supplements work to reduce neuronal hyperexcitability involve normalization of aberrant energy metabolism, dampening of inflammation, promotion of endogenous antioxidants, and reduction of gut dysbiosis. This raises the possibility that these dietary and metabolic therapies may not only exert anti-seizure effects, but also reduce comorbid disorders in people with epilepsy. Here, we explore this possibility and review the clinical and preclinical evidence where available.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Timothy A. Simeone
- Department of Pharmacology & Neuroscience, Creighton University School of Medicine, Omaha, NE 68178, USA; (S.H.I.); (K.A.S.)
| |
Collapse
|
4
|
Grabowska K, Grabowski M, Przybyła M, Pondel N, Barski JJ, Nowacka-Chmielewska M, Liśkiewicz D. Ketogenic diet and behavior: insights from experimental studies. Front Nutr 2024; 11:1322509. [PMID: 38389795 PMCID: PMC10881757 DOI: 10.3389/fnut.2024.1322509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
As a journal page for full details. The ketogenic diet (KD) has been established as a treatment for epilepsy, but more recently it has been explored as an alternative or add-on therapy for many other diseases ranging from weight loss to neurological disorders. Animal models are widely used in studies investigating the therapeutic effects of the KD as well as underlying mechanisms. Especially in the context of neurological, psychiatric, and neurodevelopmental disorders essential endpoints are assessed by behavioral and motor tests. Here we summarized research evaluating the influence of the KD on cognition, depressive and anxiety-related behaviors, and social and nutritional behaviors of laboratory rodents. Each section contains a brief description of commonly used behavioral tests highlighting their limitations. Ninety original research articles, written in English, performed on mice or rats, providing measurement of blood beta-hydroxybutyrate (BHB) levels and behavioral evaluation were selected for the review. The majority of research performed in various disease models shows that the KD positively impacts cognition. Almost an equal number of studies report a reduction or no effect of the KD on depressive-related behaviors. For anxiety-related behaviors, the majority of studies show no effect. Despite the increasing use of the KD in weight loss and its appetite-reducing properties the behavioral evaluation of appetite regulation has not been addressed in preclinical studies. This review provides an overview of the behavioral effects of nutritional ketosis addressed to a broad audience of scientists interested in the KD field but not necessarily specializing in behavioral tests.
Collapse
Affiliation(s)
- Konstancja Grabowska
- Laboratory of Molecular Biology, Institute of Physiotherapy and Health Sciences, Academy of Physical Education, Katowice, Poland
- Department for Experimental Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Mateusz Grabowski
- Laboratory of Molecular Biology, Institute of Physiotherapy and Health Sciences, Academy of Physical Education, Katowice, Poland
- Department for Experimental Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Marta Przybyła
- Laboratory of Molecular Biology, Institute of Physiotherapy and Health Sciences, Academy of Physical Education, Katowice, Poland
- Department for Experimental Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Natalia Pondel
- Laboratory of Molecular Biology, Institute of Physiotherapy and Health Sciences, Academy of Physical Education, Katowice, Poland
| | - Jarosław J Barski
- Department for Experimental Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
- Department of Physiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Marta Nowacka-Chmielewska
- Laboratory of Molecular Biology, Institute of Physiotherapy and Health Sciences, Academy of Physical Education, Katowice, Poland
| | - Daniela Liśkiewicz
- Laboratory of Molecular Biology, Institute of Physiotherapy and Health Sciences, Academy of Physical Education, Katowice, Poland
- Institute of Diabetes and Obesity, Helmholtz Center Munich, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| |
Collapse
|
5
|
Oliveira TPD, Morais ALB, dos Reis PLB, Palotás A, Vieira LB. A Potential Role for the Ketogenic Diet in Alzheimer's Disease Treatment: Exploring Pre-Clinical and Clinical Evidence. Metabolites 2023; 14:25. [PMID: 38248828 PMCID: PMC10818526 DOI: 10.3390/metabo14010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Given the remarkable progress in global health and overall quality of life, the significant rise in life expectancy has become intertwined with the surging occurrence of neurodegenerative disorders (NDs). This emerging trend is poised to pose a substantial challenge to the fields of medicine and public health in the years ahead. In this context, Alzheimer's disease (AD) is regarded as an ND that causes recent memory loss, motor impairment and cognitive deficits. AD is the most common cause of dementia in the elderly and its development is linked to multifactorial interactions between the environment, genetics, aging and lifestyle. The pathological hallmarks in AD are the accumulation of β-amyloid peptide (Aβ), the hyperphosphorylation of tau protein, neurotoxic events and impaired glucose metabolism. Due to pharmacological limitations and in view of the prevailing glycemic hypometabolism, the ketogenic diet (KD) emerges as a promising non-pharmacological possibility for managing AD, an approach that has already demonstrated efficacy in addressing other disorders, notably epilepsy. The KD consists of a food regimen in which carbohydrate intake is discouraged at the expense of increased lipid consumption, inducing metabolic ketosis whereby the main source of energy becomes ketone bodies instead of glucose. Thus, under these dietary conditions, neuronal death via lack of energy would be decreased, inasmuch as the metabolism of lipids is not impaired in AD. In this way, the clinical picture of patients with AD would potentially improve via the slowing down of symptoms and delaying of the progression of the disease. Hence, this review aims to explore the rationale behind utilizing the KD in AD treatment while emphasizing the metabolic interplay between the KD and the improvement of AD indicators, drawing insights from both preclinical and clinical investigations. Via a comprehensive examination of the studies detailed in this review, it is evident that the KD emerges as a promising alternative for managing AD. Moreover, its efficacy is notably enhanced when dietary composition is modified, thereby opening up innovative avenues for decreasing the progression of AD.
Collapse
Affiliation(s)
- Tadeu P. D. Oliveira
- Departamento de Fisiologia e Centro de Investigação em Medicina Molecular (CIMUS), Universidad De Santiago de Compostela, 15782 Santiago de Compostela, Spain;
| | - Ana L. B. Morais
- Departamento de Farmacologia, Instituto de Ciências Biológicas (ICB), Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (A.L.B.M.); (P.L.B.d.R.)
| | - Pedro L. B. dos Reis
- Departamento de Farmacologia, Instituto de Ciências Biológicas (ICB), Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (A.L.B.M.); (P.L.B.d.R.)
| | - András Palotás
- Asklepios-Med (Private Medical Practice and Research Center), H-6722 Szeged, Hungary;
- Kazan Federal University, Kazan R-420012, Russia
- Tokaj-Hegyalja University, H-3910 Tokaj, Hungary
| | - Luciene B. Vieira
- Departamento de Farmacologia, Instituto de Ciências Biológicas (ICB), Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (A.L.B.M.); (P.L.B.d.R.)
| |
Collapse
|
6
|
Chinna-Meyyappan A, Gomes FA, Koning E, Fabe J, Breda V, Brietzke E. Effects of the ketogenic diet on cognition: a systematic review. Nutr Neurosci 2023; 26:1258-1278. [PMID: 36354157 DOI: 10.1080/1028415x.2022.2143609] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Ketogenic diet (KD) therapy has been used as a dietary intervention in drug-resistant epilepsy for several years. Research currently suggests that KD therapy may carry neuroprotective and cognition enhancing effects for individuals with non-epileptic conditions as well as for healthy individuals. Therefore, KD may have potential as a non-invasive, nutritional treatment approach for difficult to manage conditions such as neurodegenerative illnesses or mood disorders. The aim of this review is to summarize the available evidence on ketogenic interventions and the resulting cognitive outcomes. MATERIALS AND METHODS The paper was based on PRISMA 2020 guidelines. The search was conducted in June 2021 on the following databases: CENTRAL, PubMed, EMBASE, PsycInfo, Web of Science. The search yielded 2014 studies, of which 49 were included. RESULTS There were 22 animal studies assessing murine models and 27 studies on humans. The primary indications in these studies were epileptic conditions, neurodegenerative disorders, cognitive impairment, and healthy populations. DISCUSSION Administration of KD seems to confer cognitive-enhancing effects in areas such as working memory, reference memory and attention. Studies found that KD treatment in animals has the potential to alleviate age-related cognitive decline. Over 80% of the 27 human studies reported a favourable effect of intervention, and none reported a detrimental effect of KD. While these findings suggest that KD may improve the functioning of certain cognitive domains, definitive conclusions were limited by studies with small sample sizes, the absence of controls and randomization, and the lack of objective measures of cognition.
Collapse
Affiliation(s)
| | - Fabiano Alves Gomes
- Department of Psychiatry, Queen's University School of Medicine, Kingston, Canada
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, Canada
| | - Elena Koning
- Department of Psychiatry, Queen's University School of Medicine, Kingston, Canada
| | | | - Vitor Breda
- Department of Psychiatry, Queen's University School of Medicine, Kingston, Canada
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, Canada
| | - Elisa Brietzke
- Department of Psychiatry, Queen's University School of Medicine, Kingston, Canada
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, Canada
| |
Collapse
|
7
|
Danduga RCSR, Shaik HB, Polopalli S, Kola PK, Kanakaraju VK, Kandaswamy S. Tetramethylpyrazine contributes to the neuroprotection in a rodent epileptic model of pentylenetetrazole-induced kindling. J Pharm Pharmacol 2023; 75:1163-1176. [PMID: 37100619 DOI: 10.1093/jpp/rgad022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 03/01/2023] [Indexed: 04/28/2023]
Abstract
OBJECTIVES In this study, tetramethylpyrazine (TMP) was evaluated for its therapeutic potential as an alternative therapy for epileptogenesis and its associated comorbidities in rats. METHODS The sub-convulsant dose of pentylenetetrazole (PTZ) (35 mg/kg, intraperitoneally) was injected on alternative days to produce kindling for 32 days and observed for seizure score percent of kindled animals in each group. After kindling, the animals were evaluated in models of anxiety, memory and predictive of depression. The neuroprotective effect of TMP was assessed by estimating the biochemical parameters in the cortex and hippocampus of the brain. Histopathological alterations were also observed in the cortex and hippocampus (CA1, CA3 and DG). KEY FINDINGS The administration of TMP reduced the seizure score and percentage of kindled animals dose-dependently. Furthermore, TMP significantly improved the behavioural parameters measured in the predictive models of depression but not in the anxiety and cognitive performances of the animals. The oxidative-nitrosative stress, excitotoxicity, neuroinflammation and histological alterations in the brain induced by PTZ were significantly mitigated by administering the TMP high dose of 60 mg/kg. CONCLUSION In conclusion, the TMP attenuated the depression behaviour in the PTZ-induced kindled rats, and reduced the oxidative-nitrosative stress, excitotoxicity, neuroinflammation and histological alterations of the brain.
Collapse
Affiliation(s)
- Ravi Chandra Sekhara Reddy Danduga
- Department of Pharmacology, Acharya Nagarjuna University College of Pharmaceutical Sciences, Acharya Nagarjuna University, Guntur, Andhra Pradesh, India
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai, 400056, India
| | - Habbeb Banu Shaik
- Department of Pharmacology, Acharya Nagarjuna University College of Pharmaceutical Sciences, Acharya Nagarjuna University, Guntur, Andhra Pradesh, India
| | - Subramanyam Polopalli
- Department of Pharmacology, Acharya Nagarjuna University College of Pharmaceutical Sciences, Acharya Nagarjuna University, Guntur, Andhra Pradesh, India
| | - Phani Kumar Kola
- Department of Pharmacology, Acharya Nagarjuna University College of Pharmaceutical Sciences, Acharya Nagarjuna University, Guntur, Andhra Pradesh, India
| | - Vijaya Kishore Kanakaraju
- Department of Pharmaceutical Chemistry, Acharya Nagarjuna University College of Pharmaceutical Sciences, Acharya Nagarjuna University, Guntur, Andhra Pradesh, India
| | - Surabhi Kandaswamy
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire, United Kingdom
| |
Collapse
|
8
|
Sahin H, Yucel O, Emik S, Senturk GE. Protective Effects of Intranasally Administrated Oxytocin-Loaded Nanoparticles on Pentylenetetrazole-Kindling Epilepsy in Terms of Seizure Severity, Memory, Neurogenesis, and Neuronal Damage. ACS Chem Neurosci 2022; 13:1923-1937. [PMID: 35713692 PMCID: PMC9264347 DOI: 10.1021/acschemneuro.2c00124] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Pentylenetetrazole (PTZ)-induced kindling is an animal model for studying human temporal lobe epilepsy (TLE), which is characterized by alterations of hippocampal neurons and memory. Although the intranasal (IN) administration of oxytocin (OT) has limited efficiency, nanoparticles (NPs) are a promising candidate to deliver OT to the brain. However, there are very limited data on epilepsy research about oxytocin-loaded nanoparticles (NP-OTs). The aim of this study is to investigate the effects of IN administration of chronic NP-OTs on the hippocampus of PTZ-induced male epileptic rats in terms of seizure severity, memory, neurogenesis, and neuronal damage. Saline/OT/NP-OTs were administrated to both control (Ctrl) and PTZ groups intranasally. Consequently, saline and PTZ were injected, respectively, 25 times every 48 h. Then, seizure severity (score and latency) was calculated for the PTZ groups. A spatial working memory evaluation test (SWMET) was performed after the last injection. Hippocampus histopathology, neurogenesis, and apoptosis were demonstrated. Serum total antioxidant status (TAS) and total oxidant status (TOS) levels and the oxidative stress index (OSI) were measured. We showed that OTs and NP-OTs prevented the kindling development and had positive effects on seizure severity. SWMET-related behaviors were also recovered in the PTZ + NP-OT group. A significant increase of neurogenesis and decrease of apoptosis in the hippocampus of the PTZ + NP-OT group were observed, while OTs and NP-OTs had protective effects against PTZ-induced damage to hippocampal neurons. Our results indicate that the chronic administration of NP-OTs may have positive effects on hippocampal damage via increasing neurogenesis and decreasing apoptosis and seizure severity.
Collapse
Affiliation(s)
- Hakan Sahin
- Department
of Histology and Embryology, Cerrahpasa Faculty of Medicine, Istanbul University—Cerrahpasa, Istanbul 34098, Turkey
| | - Oguz Yucel
- Department
of Chemical Engineering, Faculty of Engineering, Istanbul University—Cerrahpasa, Istanbul 34320, Turkey
| | - Serkan Emik
- Department
of Chemical Engineering, Faculty of Engineering, Istanbul University—Cerrahpasa, Istanbul 34320, Turkey
| | - Gozde Erkanli Senturk
- Department
of Histology and Embryology, Cerrahpasa Faculty of Medicine, Istanbul University—Cerrahpasa, Istanbul 34098, Turkey
| |
Collapse
|
9
|
Pavón S, Lázaro E, Martínez O, Amayra I, López-Paz JF, Caballero P, Al-Rashaida M, Luna PM, García M, Pérez M, Berrocoso S, Rodríguez AA, Pérez-Núñez P. Ketogenic diet and cognition in neurological diseases: a systematic review. Nutr Rev 2020; 79:802-813. [PMID: 33354711 DOI: 10.1093/nutrit/nuaa113] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
CONTEXT In recent years, the ketogenic diet has gained special relevance as a possible therapeutic alternative to some neurological and chronic diseases. OBJECTIVE The aim of this systematic review was to answer the following question: Does a ketogenic diet improve cognitive skills in patients with Alzheimer's disease, Parkinson's disease, refractory epilepsy, and type 1 glucose deficiency syndrome? To define the research question, the PICOS criteria were used, following the guidelines of the PRISMA method. DATA SOURCES Medline/PubMed, Elsevier Science Direct, Dialnet, EBSCOhost, Mediagraphic, Sage Journals, ProQuest, and Wiley Online Library databases were used. DATA EXTRACTION After applying inclusion and exclusion criteria in accordance with the PRISMA method, a total of 63 entries published between 2004 and 2019 were used. DATA ANALYSIS The records extracted were analyzed from a qualitative approach, so no statistical analysis was carried out. CONCLUSION Although scientific literature on the subject is scarce and there has tended to be a lack of scientific rigor, the studies reviewed confirmed the effectiveness of this diet in improving the cognitive symptomatology of the aforementioned diseases.
Collapse
Affiliation(s)
- S Pavón
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| | - E Lázaro
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| | - O Martínez
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| | - I Amayra
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| | - J F López-Paz
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| | - P Caballero
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| | - M Al-Rashaida
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| | - P M Luna
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| | - M García
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| | - M Pérez
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| | - S Berrocoso
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| | - A A Rodríguez
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| | - P Pérez-Núñez
- Neuromuscular and Neurodevelopment Disorders Research Group (Neuro-e-Motion), Faculty of Psychology and Education, University of Deusto, Spain
| |
Collapse
|
10
|
Effects of ketogenic diet on cognitive function in pentylenetetrazol-kindled rats. Epilepsy Res 2020; 170:106534. [PMID: 33385944 DOI: 10.1016/j.eplepsyres.2020.106534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
Although the ketogenic diet (KD) is known to control seizures and improve cognition function in patients with drug-refractory epilepsy, the underlying mechanism remains unknown. In the present study, using pentylenetetrazol (PTZ)-induced and kindled rats, we found that KD significantly improved the impaired spatial reference memory of PTZ-kindled rats in the Morris water maze. To explore the mechanism underlying the action of KD in PTZ-kindled rats, quantitative real-time PCR (qRT-PCR) and immunohistochemical analysis were used to detect the expression of GluR1 and NR2B. The results showed that both the mRNA and protein expression of GluR1 and NR2B were significantly downregulated in the hippocampus of PTZ-kindled rats, while KD could observably improve both the mRNA and protein expression of GluR1 and NR2B in the hippocampus of PTZ-kindled rats. Additionally, KD improved the over-activated MAPK in PTZ-kindled rats, but not CAMKII, as detected by enzyme-linked immuno sorbent assay (ELISA), suggesting that the MAPK signaling pathway might be involved in the memory improvement of KD in PTZ-kindled rats. In conclusion, these results demonstrate that KD can indeed improve impaired spatial reference memory in PTZ-kindled rats, and KD can improve the expression of NR2B and GluR1.
Collapse
|
11
|
Alachkar A, Ojha SK, Sadeq A, Adem A, Frank A, Stark H, Sadek B. Experimental Models for the Discovery of Novel Anticonvulsant Drugs: Focus on Pentylenetetrazole-Induced Seizures and Associated Memory Deficits. Curr Pharm Des 2020; 26:1693-1711. [PMID: 32003682 DOI: 10.2174/1381612826666200131105324] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 12/30/2019] [Indexed: 02/07/2023]
Abstract
Epilepsy is a chronic neurological disorder characterized by irregular, excessive neuronal excitability, and recurrent seizures that affect millions of patients worldwide. Currently, accessible antiepileptic drugs (AEDs) do not adequately support all epilepsy patients, with around 30% patients not responding to the existing therapies. As lifelong epilepsy treatment is essential, the search for new and more effective AEDs with an enhanced safety profile is a significant therapeutic goal. Seizures are a combination of electrical and behavioral events that can induce biochemical, molecular, and anatomic changes. Therefore, appropriate animal models are required to evaluate novel potential AEDs. Among the large number of available animal models of seizures, the acute pentylenetetrazole (PTZ)-induced myoclonic seizure model is the most widely used model assessing the anticonvulsant effect of prospective AEDs, whereas chronic PTZ-kindled seizure models represent chronic models in which the repeated administration of PTZ at subconvulsive doses leads to the intensification of seizure activity or enhanced seizure susceptibility similar to that in human epilepsy. In this review, we summarized the memory deficits accompanying acute or chronic PTZ seizure models and how these deficits were evaluated applying several behavioral animal models. Furthermore, major advantages and limitations of the PTZ seizure models in the discovery of new AEDs were highlighted. With a focus on PTZ seizures, the major biochemicals, as well as morphological alterations and the modulated brain neurotransmitter levels associated with memory deficits have been illustrated. Moreover, numerous medicinal compounds with concurrent anticonvulsant, procognitive, antioxidant effects, modulating effects on several brain neurotransmitters in rodents, and several newly developed classes of compounds applying computer-aided drug design (CADD) have been under development as potential AEDs. The article details the in-silico approach following CADD, which can be utilized for generating libraries of novel compounds for AED discovery. Additionally, in vivo studies could be useful in demonstrating efficacy, safety, and novel mode of action of AEDs for further clinical development.
Collapse
Affiliation(s)
- Alaa Alachkar
- Department of Pharmacology & Therapeutics, College of Medicine & Health Sciences, United Arab Emirates University, P.O. Box 17666 Al Ain, United States.,Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United States
| | - Shreesh K Ojha
- Department of Pharmacology & Therapeutics, College of Medicine & Health Sciences, United Arab Emirates University, P.O. Box 17666 Al Ain, United States.,Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United States
| | - Adel Sadeq
- College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
| | - Abdu Adem
- Department of Pharmacology & Therapeutics, College of Medicine & Health Sciences, United Arab Emirates University, P.O. Box 17666 Al Ain, United States.,Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United States
| | - Annika Frank
- Institute of Pharmaceutical and Medicinal Chemistry, Heinrich Heine University Düsseldorf, Universitaetsstr. 1, 40225 Düsseldorf, Germany
| | - Holger Stark
- Institute of Pharmaceutical and Medicinal Chemistry, Heinrich Heine University Düsseldorf, Universitaetsstr. 1, 40225 Düsseldorf, Germany
| | - Bassem Sadek
- Department of Pharmacology & Therapeutics, College of Medicine & Health Sciences, United Arab Emirates University, P.O. Box 17666 Al Ain, United States.,Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United States
| |
Collapse
|
12
|
Alachkar A, Azimullah S, Lotfy M, Adeghate E, Ojha SK, Beiram R, Łażewska D, Kieć-Kononowicz K, Sadek B. Antagonism of Histamine H3 receptors Alleviates Pentylenetetrazole-Induced Kindling and Associated Memory Deficits by Mitigating Oxidative Stress, Central Neurotransmitters, and c-Fos Protein Expression in Rats. Molecules 2020; 25:molecules25071575. [PMID: 32235506 PMCID: PMC7181068 DOI: 10.3390/molecules25071575] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 12/19/2022] Open
Abstract
Histamine H3 receptors (H3Rs) are involved in several neuropsychiatric diseases including epilepsy. Therefore, the effects of H3R antagonist E177 (5 and 10 mg/kg, intraperitoneal (i.p.)) were evaluated on the course of kindling development, kindling-induced memory deficit, oxidative stress levels (glutathione (GSH), malondialdehyde (MDA), catalase (CAT), and superoxide dismutase (SOD)), various brain neurotransmitters (histamine (HA), acetylcholine (ACh), γ-aminobutyric acid (GABA)), and glutamate (GLU), acetylcholine esterase (AChE) activity, and c-Fos protein expression in pentylenetetrazole (PTZ, 40 mg/kg) kindled rats. E177 (5 and 10 mg/kg, i.p.) significantly decreased seizure score, increased step-through latency (STL) time in inhibitory avoidance paradigm, and decreased transfer latency time (TLT) in elevated plus maze (all P < 0.05). Moreover, E177 mitigated oxidative stress by significantly increasing GSH, CAT, and SOD, and decreasing the abnormal level of MDA (all P < 0.05). Furthermore, E177 attenuated elevated levels of hippocampal AChE, GLU, and c-Fos protein expression, whereas the decreased hippocampal levels of HA and ACh were modulated in PTZ-kindled animals (all P < 0.05). The findings suggest the potential of H3R antagonist E177 as adjuvant to antiepileptic drugs with an added advantage of preventing cognitive impairment, highlighting the H3Rs as a potential target for the therapeutic management of epilepsy with accompanied memory deficits.
Collapse
Affiliation(s)
- Alaa Alachkar
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, UAE; (A.A.); (S.A.); (S.K.O.); (R.B.)
| | - Sheikh Azimullah
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, UAE; (A.A.); (S.A.); (S.K.O.); (R.B.)
| | - Mohamed Lotfy
- Department of Biology, College of Science, United Arab Emirates University, Al Ain 17666, UAE;
| | - Ernest Adeghate
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, UAE;
| | - Shreesh K. Ojha
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, UAE; (A.A.); (S.A.); (S.K.O.); (R.B.)
| | - Rami Beiram
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, UAE; (A.A.); (S.A.); (S.K.O.); (R.B.)
| | - Dorota Łażewska
- Jagiellonian University Medical College, Faculty of Pharmacy, Department of Technology and Biotechnology of Drugs, Medyczna 9 St., 30-688 Kraków, Poland; (D.Ł.); (K.K.-K.)
| | - Katarzyna Kieć-Kononowicz
- Jagiellonian University Medical College, Faculty of Pharmacy, Department of Technology and Biotechnology of Drugs, Medyczna 9 St., 30-688 Kraków, Poland; (D.Ł.); (K.K.-K.)
| | - Bassem Sadek
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, UAE; (A.A.); (S.A.); (S.K.O.); (R.B.)
- Correspondence: ; Tel.: +971-3-7137-512; Fax: +971-3-7672-033
| |
Collapse
|
13
|
Chen F, He X, Luan G, Li T. Role of DNA Methylation and Adenosine in Ketogenic Diet for Pharmacoresistant Epilepsy: Focus on Epileptogenesis and Associated Comorbidities. Front Neurol 2019; 10:119. [PMID: 30863356 PMCID: PMC6399128 DOI: 10.3389/fneur.2019.00119] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 01/29/2019] [Indexed: 01/02/2023] Open
Abstract
Epilepsy is a neurological disorder characterized by a long term propensity to produce unprovoked seizures and by the associated comorbidities including neurological, cognitive, psychiatric, and impairment the quality of life. Despite the clinic availability of several novel antiepileptic drugs (AEDs) with different mechanisms of action, more than one-third of patients with epilepsy suffer with pharmacoresistant epilepsy. Until now, no AEDs have been proven to confer the efficacy in alteration of disease progression or inhibition of the development of epilepsy. The ketogenic diet, the high-fat, low-carbohydrate composition is an alternative metabolic therapy for epilepsy, especially for children with drug-resistant epilepsy. Recently clinical and experimental results demonstrate its efficacy in ameliorating both seizures and comorbidities associated with epilepsy, such as cognitive/psychiatric concerns for the patients with refractory epilepsy. Of importance, ketogenic diet demonstrates to be a promising disease-modifying or partial antiepileptogenesis therapy for epilepsy. The mechanisms of action of ketogenic diet in epilepsy have been revealed recently, such as epigenetic mechanism for increase the adenosine level in the brain and inhibition of DNA methylation. In the present review, we will focus on the mechanisms of ketogenic diet therapies underlying adenosine system in the prevention of epileptogenesis and disease modification. In addition, we will review the role of ketogenic diet therapy in comorbidities associated epilepsy and the underlying mechanisms of adenosine.
Collapse
Affiliation(s)
- Fan Chen
- Beijing Key Laboratory of Epilepsy Research, Department of Neurology, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Xinghui He
- Beijing Key Laboratory of Epilepsy Research, Department of Neurosurgery, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Guoming Luan
- Beijing Key Laboratory of Epilepsy Research, Department of Neurosurgery, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Tianfu Li
- Beijing Key Laboratory of Epilepsy Research, Department of Neurology, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
14
|
Jiang Y, Han CL, Liu HG, Wang X, Zhang X, Meng FG, Zhang JG. Abnormal hippocampal functional network and related memory impairment in pilocarpine-treated rats. Epilepsia 2018; 59:1785-1795. [PMID: 30073661 DOI: 10.1111/epi.14523] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 07/09/2018] [Indexed: 01/14/2023]
Affiliation(s)
- Yin Jiang
- Department of Functional Neurosurgery; Beijing Neurosurgical Institute; Capital Medical University; Beijing China
- Beijing Key Laboratory of Neurostimulation; Beijing China
| | - Chun-Lei Han
- Department of Functional Neurosurgery; Beijing Neurosurgical Institute; Capital Medical University; Beijing China
| | - Huan-Guang Liu
- Beijing Key Laboratory of Neurostimulation; Beijing China
- Department of Functional Neurosurgery; Beijing Tiantan Hospital; Capital Medical University; Beijing China
| | - Xiu Wang
- Department of Functional Neurosurgery; Beijing Tiantan Hospital; Capital Medical University; Beijing China
| | - Xin Zhang
- Department of Functional Neurosurgery; Beijing Neurosurgical Institute; Capital Medical University; Beijing China
- Beijing Key Laboratory of Neurostimulation; Beijing China
| | - Fan-Gang Meng
- Department of Functional Neurosurgery; Beijing Neurosurgical Institute; Capital Medical University; Beijing China
- Beijing Key Laboratory of Neurostimulation; Beijing China
| | - Jian-Guo Zhang
- Department of Functional Neurosurgery; Beijing Neurosurgical Institute; Capital Medical University; Beijing China
- Beijing Key Laboratory of Neurostimulation; Beijing China
- Department of Functional Neurosurgery; Beijing Tiantan Hospital; Capital Medical University; Beijing China
| |
Collapse
|
15
|
Wu Q, Wang H, Fan YY, Zhang JM, Liu XY, Fang XY, Yang FH, Cao QJ, Qi Y. Ketogenic diet effects on 52 children with pharmacoresistant epileptic encephalopathy: A clinical prospective study. Brain Behav 2018; 8:e00973. [PMID: 29761022 PMCID: PMC5943818 DOI: 10.1002/brb3.973] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/04/2018] [Accepted: 03/11/2018] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To evaluate the clinical impact of ketogenic diet (KD) on children with pharmacoresistant epileptic encephalopathy. METHODS In all, 52 children with pharmacoresistant epileptic encephalopathy that diagnosed in our hospital from July 2012 to June 2015 were selected, including West syndrome 38 cases, Lennox-Gastaut Syndrome 7 cases, Doose Syndrome 1 case, and Dravet syndrome 6 cases, and the effect, compliance, adverse reactions, electroencephalogram (EEG), and cognitive function were analyzed. Modified Johns Hopkins protocol was used to initiate KD, and Engel scale was used to evaluate the effect, and evaluated the effect of KD on the cognition, language, and motor function. RESULTS At 12 weeks of KD treatment, the patients achieved I, II, III, and IV grade effect were accounted for 26.9% (14/52 cases), 17.3% (9/52 cases), 11.5% (6/52 cases), and 44.2% (23/52 cases), respectively, according to Engel scale. KD has different effect on different epileptic syndromes, best effect on Doose syndromes of 100%, and better effect on West syndrome with the effect rate of 57.9%, and the total effect number was 22 cases. The reduction of epileptiform discharges in the awake state before KD treatment was correlated with the seizure time after 3 months of KD treatment (r = .330, p = .017). The cognitive function of 23 patients was improved, 12 patients had language improvement, and the motor function was improved in 10 patients. In all, 23 patients had adverse reactions, and all patients were tolerated and improved. CONCLUSION KD has certain effect on children with pharmacoresistant epileptic encephalopathy, and it can reduce interictal epileptic discharge frequency, and improve the background rhythm of EEG. The reduction of epileptiform discharges in awake state is in favor of the reduction of seizures frequency, thus increasing the efficacy, and improve the cognitive function, language, and motor function to varying degrees, combined with less adverse reaction, which is worthy of clinical application.
Collapse
Affiliation(s)
- Qiong Wu
- Department of Pediatric Neurology Shengjing Hospital of China Medical University Shenyang China
| | - Hua Wang
- Department of Pediatric Neurology Shengjing Hospital of China Medical University Shenyang China
| | - Yu Ying Fan
- Department of Pediatric Neurology Shengjing Hospital of China Medical University Shenyang China
| | - Jun Mei Zhang
- Department of Pediatric Neurology Shengjing Hospital of China Medical University Shenyang China
| | - Xue Yan Liu
- Department of Pediatric Neurology Shengjing Hospital of China Medical University Shenyang China
| | - Xiu Ying Fang
- Department of Functional Neurology Office Shengjing Hospital of China Medical University Shenyang China
| | - Feng Hua Yang
- Department of Pediatric Neurology Shengjing Hospital of China Medical University Shenyang China
| | - Qing Jun Cao
- Department of Pediatric Neurology Shengjing Hospital of China Medical University Shenyang China
| | - Ying Qi
- Department of Radiology Shengjing Hospital of China Medical University Shenyang China
| |
Collapse
|
16
|
Hernandez AR, Hernandez CM, Campos KT, Truckenbrod LM, Sakarya Y, McQuail JA, Carter CS, Bizon JL, Maurer AP, Burke SN. The Antiepileptic Ketogenic Diet Alters Hippocampal Transporter Levels and Reduces Adiposity in Aged Rats. J Gerontol A Biol Sci Med Sci 2018; 73:450-458. [PMID: 29040389 PMCID: PMC5861916 DOI: 10.1093/gerona/glx193] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/07/2017] [Indexed: 01/21/2023] Open
Abstract
Nutritional ketosis is induced by high fat/low carbohydrate dietary regimens, which produce high levels of circulating ketone bodies, shifting metabolism away from glucose utilization. While ketogenic diets (KD) were initially introduced to suppress seizures, they are garnering attention for their potential to treat a myriad of neurodegenerative and metabolic disorders that are associated with advanced age. The feasibility and physiological impact of implementing a long-term KD in old animals, however, has not been systematically examined. In this study, young and aged rats consumed a calorically- and nutritionally-matched KD or control diet for 12 weeks. All KD-fed rats maintained higher levels of BHB and lower levels of glucose relative to controls. However, it took the aged rats longer to reach asymptotic levels of BHB compared to young animals. Moreover, KD-fed rats had significantly less visceral white and brown adipose tissue than controls without a loss of lean mass. Interestingly, the KD led to significant alterations in protein levels of hippocampal transporters for monocarboxylates, glucose, and vesicular glutamate and gamma-aminobutyric acid. Most notably, the age-related decline in vesicular glutamate transporter expression was reversed by the KD. These data demonstrate the feasibility and potential benefits of KDs for treating age-associated neural dysfunction.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Andrew P Maurer
- Department of Neuroscience, McKnight Brain Institute
- Department of Biomedical Engineering, University of Florida, Gainesville
| | - Sara N Burke
- Department of Neuroscience, McKnight Brain Institute
- Institute on Aging, University of Florida, Gainesville
| |
Collapse
|
17
|
Ketogenic diet attenuates neuronal injury via autophagy and mitochondrial pathways in pentylenetetrazol-kindled seizures. Brain Res 2018; 1678:106-115. [DOI: 10.1016/j.brainres.2017.10.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 09/20/2017] [Accepted: 10/07/2017] [Indexed: 11/24/2022]
|
18
|
Clossen BL, Reddy DS. Novel therapeutic approaches for disease-modification of epileptogenesis for curing epilepsy. Biochim Biophys Acta Mol Basis Dis 2017; 1863:1519-1538. [PMID: 28179120 PMCID: PMC5474195 DOI: 10.1016/j.bbadis.2017.02.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/31/2017] [Accepted: 02/03/2017] [Indexed: 11/16/2022]
Abstract
This article describes the recent advances in epileptogenesis and novel therapeutic approaches for the prevention of epilepsy, with a special emphasis on the pharmacological basis of disease-modification of epileptogenesis for curing epilepsy. Here we assess animal studies and human clinical trials of epilepsy spanning 1982-2016. Epilepsy arises from a number of neuronal factors that trigger epileptogenesis, which is the process by which a brain shifts from a normal physiologic state to an epileptic condition. The events precipitating these changes can be of diverse origin, including traumatic brain injury, cerebrovascular damage, infections, chemical neurotoxicity, and emergency seizure conditions such as status epilepticus. Expectedly, the molecular and system mechanisms responsible for epileptogenesis are not well defined or understood. To date, there is no approved therapy for the prevention of epilepsy. Epigenetic dysregulation, neuroinflammation, and neurodegeneration appear to trigger epileptogenesis. Targeted drugs are being identified that can truly prevent the development of epilepsy in at-risk people. The promising agents include rapamycin, COX-2 inhibitors, TRK inhibitors, epigenetic modulators, JAK-STAT inhibitors, and neurosteroids. Recent evidence suggests that neurosteroids may play a role in modulating epileptogenesis. A number of promising drugs are under investigation for the prevention or modification of epileptogenesis to halt the development of epilepsy. Some drugs in development appear rational for preventing epilepsy because they target the initial trigger or related signaling pathways as the brain becomes progressively more prone to seizures. Additional research into the target validity and clinical investigation is essential to make new frontiers in curing epilepsy.
Collapse
Affiliation(s)
- Bryan L Clossen
- Department of Neuroscience and Experimental Therapeutics, College of Medicine, Texas A&M University Health Science Center, Bryan, TX 77807, USA
| | - Doodipala Samba Reddy
- Department of Neuroscience and Experimental Therapeutics, College of Medicine, Texas A&M University Health Science Center, Bryan, TX 77807, USA.
| |
Collapse
|
19
|
Ketogenic diet improves the spatial memory impairment caused by exposure to hypobaric hypoxia through increased acetylation of histones in rats. PLoS One 2017; 12:e0174477. [PMID: 28355243 PMCID: PMC5371359 DOI: 10.1371/journal.pone.0174477] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/09/2017] [Indexed: 12/28/2022] Open
Abstract
Exposure to hypobaric hypoxia causes neuron cell damage, resulting in impaired cognitive function. Effective interventions to antagonize hypobaric hypoxia-induced memory impairment are in urgent need. Ketogenic diet (KD) has been successfully used to treat drug-resistant epilepsy and improves cognitive behaviors in epilepsy patients and other pathophysiological animal models. In the present study, we aimed to explore the potential beneficial effects of a KD on memory impairment caused by hypobaric hypoxia and the underlying possible mechanisms. We showed that the KD recipe used was ketogenic and increased plasma levels of ketone bodies, especially β-hydroxybutyrate. The results of the behavior tests showed that the KD did not affect general locomotor activity but obviously promoted spatial learning. Moreover, the KD significantly improved the spatial memory impairment caused by hypobaric hypoxia (simulated altitude of 6000 m, 24 h). In addition, the improving-effect of KD was mimicked by intraperitoneal injection of BHB. The western blot and immunohistochemistry results showed that KD treatment not only increased the acetylated levels of histone H3 and histone H4 compared to that of the control group but also antagonized the decrease in the acetylated histone H3 and H4 when exposed to hypobaric hypoxia. Furthermore, KD-hypoxia treatment also promoted PKA/CREB activation and BDNF protein expression compared to the effects of hypoxia alone. These results demonstrated that KD is a promising strategy to improve spatial memory impairment caused by hypobaric hypoxia, in which increased modification of histone acetylation plays an important role.
Collapse
|