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ORIGINAL RESEARCH ARTICLE

Efficacy and cognitive impact of modified Atkins diet in adults with drug-resistant epilepsy

Huixin Liu1,2 ,  Hongjuan Lu1 ,  Yichen Ji1 ,  Wenjian Liu1 ,  Haoran Yang1 ,  Xuan Zhang1 ,  Jiayi Li1 ,  Wei Sun1*
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1 Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
2 Department of Neurology, Emergency General Hospital, Beijing, China
Brain & Heart 2024, 2(1), 1978 https://doi.org/10.36922/bh.1978
Submitted: 7 October 2023 | Accepted: 5 January 2024 | Published: 16 February 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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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 diet treatment. Regarding cognitive impact, there was a significant improvement in auditory verbal learning test (AVLT) instant recall scale scores (P = 0.017). In terms of EEG characteristics, MAD significantly reduces interictal epileptic discharge (IED) index in non-rapid eye movement 2 (NREM2) after 3 months. No clinical predictors or EEG characteristics of MAD efficacy were identified. In conclusion, MAD can be safely and effectively practiced by adults with drug-resistant epilepsy. KD treatment has a significant impact on AVLT instant recall and can reduce the IED index in NREM2.

Keywords
Modified Atkins diet
Drug-resistant epilepsy
Cognitive function
Electroencephalography
Funding
Beijing Hospitals Authority Clinical Medicine Development of special funding
Conflict of interest
There are no conflicts of interest to declare.
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Brain & Heart, Electronic ISSN: 2972-4139 Published by AccScience Publishing
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