Cited by 269Gut microbiota and healthDiet and metabolism studiesEpilepsy research and treatment

Altered gut microbiome composition in children with refractory epilepsy after ketogenic diet

Zhang, Yunjian, Zhou, Shuizhen, Zhou, Yuanfeng, Yu, Lifei, Zhang, Linmei, Wang, Yi·2018·Epilepsy Research

Abstract

Objective The aim of this study was to investigate the characteristics and composition of intestinal microbiota in children with refractory epilepsy after ketogenic diet (KD) therapy and to explore the bacterial biomarkers related to clinical efficacy.Methods We prospectively analyzed 20 patients (14 males, 6 females) treated with KD. Clinical efficacy, electroencephalogram (EEG) changes, and laboratory tests were evaluated, and fecal specimens were obtained prior to and 6 months after therapy. The composition of gut microbiota was analyzed by 16S rDNA sequencing, and we screened the possible flora associated with efficacy of the KD.Results After 6 months of treatment, 2 patients were seizure free, 3 had ≥ 90% seizure reduction, 5 had a reduction of 50-89%, and 10 had < 50% reduction. All 10 responders showed an improvement in EEG. Compared with baseline, fecal microbial profiles showed lower alpha diversity after KD therapy and revealed significantly decreased abundance of Firmicutes and increased levels of Bacteroidetes. We also observed that Clostridiales, Ruminococcaceae, Rikenellaceae, Lachnospiraceae, and Alistipes were enriched in the non-responsive group.Conclusions The results show that the KD can reduce the species richness and diversity of intestinal microbiota. The changes of gut microbiota may be associated with different efficacy after KD, and specific gut microbiota may serve as an efficacy biomarker and a potential therapeutic target in patients with refractory epilepsy.

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Crossref · 10.1016/j.eplepsyres.2018.06.015

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  • Fecal microbial profiles showed lower alpha diversity, decreased abundance of Firmicutes, and increased levels of Bacteroidetes after ketogenic diet.

    “Fecal microbial profiles showed lower alpha diversity, decreased abundance of Firmicutes and increased levels of Bacteroidetes after ketogenic diet.”
  • In another study of 20 children with drug-resistant epilepsy, after 6 months of ketogenic diet 2 patients were seizure free, 3 had ≥90% seizure reduction, 5 had 50-89% reduction, and 10 had <50% reduction.

    “In another study 20 children with drug-resistant epilepsy were enrolled.After 6 months of the ketogenic diet 2 patients were seizure free, 3 had ≥ 90% seizure reduction, 5 had a reduction of 50-89%, and 10 had < 50% reduction.”
  • Enrichment in Clostridiales, Ruminococcaceae, Rikenellaceae, Lachnospiraceae, and Alistipes was observed in the non-responsive group.

    “Furthermore, enrichment in Clostridiales, Ruminococcaceae, Rikenellaceae, Lachnospiraceae, and Alistipes was observed in the non-responsive group [364].”

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Authors
Zhang, Y., Zhou, S., Zhou, Y., Yu, L., Zhang, L., & Wang, Y.
Affiliations
Children's Hospital of Fudan University (CN)
Corresponding author
Wang, Yi
Venue
Epilepsy Research
Publisher
Elsevier BV
Published
2018-09
Volume
145
Pages
163-168
ISSN
0920-1211 (ISSN-L)
OpenAlex
W2809960745
Cited by
269
References
31
Citations by year
2026: 19 · 2025: 34 · 2024: 31 · 2023: 41 · 2022: 56 · 2021: 37 · 2020: 23 · 2019: 24 · 2018: 3
FWCI
7.73
Type
journal article
Language
en
Open access
closed
Locations
  • Epilepsy Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Research Project of Shanghai Municipal Commission of Health and Family Planning (201640065)
  • Key Research Project of the Ministry of Science and Technology of China (2016YFC0904400)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
Keywords
gut microbiota, drug-resistant epilepsy, ketogenic diet, children, bacterial biomarkers, treatment response, alpha diversity, Firmicutes, Bacteroidetes, Clostridiales, Ruminococcaceae, Lachnospiraceae, Alistipes, EEG improvement, seizure reduction
MeSH terms
Gastrointestinal Microbiome, Drug Resistant Epilepsy, Child, Child, Preschool, Electroencephalography, Female, Humans, Infant, Male, Retrospective Studies, RNA, Ribosomal, 16S, Diet, Ketogenic

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