Page 56 - BH-2-1

Brain & Heart

ORIGINAL RESEARCH ARTICLE
Efficacy and cognitive impact of modified Atkins

diet in adults with drug-resistant epilepsy

Huixin Liu , Hongjuan Lu , Yichen Ji , Wenjian Liu , Haoran Yang ,
1,2
1
1
1
1
1
Xuan Zhang , Jiayi Li , and Wei Sun *
1
1
1 Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
2 Department of Neurology, Emergency General Hospital, Beijing, China
Abstract
This study aims to explore the efficacy and cognitive impact of the modified
Atkins diet (MAD) in adults with drug-resistant epilepsy, as well as to analyze
changes in epileptiform activity during ketogenic diet (KD) intervention. We
performed a prospective, open-label study with patients aged 16 – 60 years who
met the International League Against Epilepsy (ILAE) criteria for drug-resistant
epilepsy. Sixteen patients were enrolled in this study, and baseline clinical and
electroencephalography (EEG) characteristics, along with neuropsychological tests,
were collected before and after 3 months of KD. Patients were divided into responders
(≥50% seizure reduction) and non-responders (<50% seizure reduction) according to
the clinical efficacy of the KD. Results indicate that 37.5% of patients reported a ≥50%
seizure reduction after 3 months. In terms of safety, 37.5% of patients reported adverse
effects, including constipation, abdominal pain, and nausea. In addition, a statistically
significant increase in the level of total cholesterol was observed (P = 0.037) after
*Corresponding author:
Wei Sun diet treatment. Regarding cognitive impact, there was a significant improvement in
(sunw@xwhosp.org) auditory verbal learning test (AVLT) instant recall scale scores (P = 0.017). In terms
of EEG characteristics, MAD significantly reduces interictal epileptic discharge (IED)
Citation: Liu H, Lu H, Ji Y, et al.
Efficacy and cognitive impact index in non-rapid eye movement 2 (NREM2) after 3 months. No clinical predictors or
of modified Atkins diet in adults EEG characteristics of MAD efficacy were identified. In conclusion, MAD can be safely
with drug-resistant epilepsy. and effectively practiced by adults with drug-resistant epilepsy. KD treatment has
Brain & Heart. 2024;2(1):1978.
https://doi.org/10.36922/bh.1978 a significant impact on AVLT instant recall and can reduce the IED index in NREM2.
Received: October 7, 2023
Accepted: January 5, 2024 Keywords: Modified Atkins diet; Drug-resistant epilepsy; Cognitive function;
Electroencephalography
Published Online: February 16,
2024
Copyright: © 2024 Author(s).
This is an Open-Access article 1. Introduction
distributed under the terms of the
Creative Commons Attribution Epilepsy affects almost 70 million people worldwide, with nearly 10 million cases
1
License, permitting distribution,
2
and reproduction in any medium, reported in China. Despite treatments with antiseizure medications (ASMs), only two-
provided the original work is thirds of patients achieve seizure freedom, leaving one-third classified as refractory
properly cited. to ASMs. The 2010 International League Against Epilepsy defines drug-resistant
Publisher’s Note: AccScience epilepsy as the lack of sustained seizure freedom despite the use of two tolerated,
Publishing remains neutral with appropriately chosen and used ASMs. Current treatment options for refractory
3
regard to jurisdictional claims in
published maps and institutional epilepsy include surgery, neurostimulation, ketogenic diet (KD), and other new
affiliations. treatment prospects. 4

Volume 2 Issue 1 (2024) 1 https://doi.org/10.36922/bh.1978