Association of node assortativity and internalizing symptoms with ketogenic diet effectiveness in pediatric patients with drug-resistant epilepsy

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition Pub Date : 2025-02-25 DOI:10.1016/j.nut.2025.112730

Yi-Fen Chen MD , Wei-Che Lin MD, PhD , Ting- Yu Su MD , Tzu-Yun Hsieh MD , Kai-Yin Hung MSc , Mei-Hsin Hsu MD , Ying-Jui Lin MD , Hsuan-Chang Kuo MD , Pi-Lien Hung MD, PhD

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引用次数: 0

Abstract

Background

The ketogenic diet (KD) is an effective alternative therapy for drug-resistant epilepsy (DRE). However, there are no established predictors for KD effectiveness. We aimed to investigate the impact of 12 months of KD therapy (KDT) on brain connectivity, as measured by functional magnetic resonance imaging (fMRI), and its correlation with seizure control, behavioral/mood alterations, and parental stress.

Methods

Children with DRE were enrolled in this single-center, prospective cohort study from February 2020 to October 2021. They were divided into a control group and a KDT group. The Child Behavior Checklist (CBCL) and Parental Stress Index (PSI) were administered to parents at the initiation of KDT (T0) and at 12 months (T1). Resting-state fMRI was performed at T0 and at 6 months of KDT. The primary outcome was the between-group difference in the change of CBCL/PSI scores, and brain connectivity metrics after KDT, and the secondary outcome involved measuring their correlation with seizure reduction rates.

Results

Twenty-two patients with DRE were enrolled. We had 13 patients in the control group and 9 in the KDT group. Our data revealed that 12 months of KDT can reduce monthly seizure frequency. Several subscales of CBCL T-scores were higher at T0 compared with the control group, then becoming comparable at T1. The PSI scores from ’mothers’ reports reduced after receiving KDT. The changes in node assortativity (ΔAssortativity) were positively correlated with behavioral problems and negatively with seizure reduction rates in the KD group.

Conclusions

Twelve months of KDT can reduce monthly seizure frequency and improve mood/behavioral disturbances in patients with DRE. Furthermore, KDT could relieve primary caregivers’ stress. A lower ΔAssortativity value was associated with better behavioral outcomes and greater seizure reduction. The ΔAssortativity value in fMRI may be a crucial predictor for the effectiveness of KDT.

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来源期刊

Nutrition 医学-营养学

CiteScore

7.80

自引率

2.30%

发文量

300

审稿时长

60 days

期刊介绍： Nutrition has an open access mirror journal Nutrition: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Founded by Michael M. Meguid in the early 1980''s, Nutrition presents advances in nutrition research and science, informs its readers on new and advancing technologies and data in clinical nutrition practice, encourages the application of outcomes research and meta-analyses to problems in patient-related nutrition; and seeks to help clarify and set the research, policy and practice agenda for nutrition science to enhance human well-being in the years ahead.