Can the Gut Microbiota Serve as a Guide to the Diagnosis and Treatment of Childhood Epilepsy?

Türay, Sevim; Cangür, Şengül; Kahraman, Gozde; Kayabasi, Eda; Cetiner, Omer Faruk; Aydın, Burak; Öztürk, Cihadiye Elif

doi:10.1016/j.pediatrneurol.2023.04.006

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…Some of those studies showed an enrichment of various gut microbes in patients with DRE in comparison with drug-sensitive patients and healthy controls, such as Clostridium XVIII, Dorea, Coprobacillus, Ruminococcus, Akkermansia, Neisseria, and Coprococcus 24 or Actinobacteria, Verrucomicrobia, Nitrospirae, Blautia, Bifidobacterium, Subdoligranulum, Dialister and Anaerostipes. [25][26][27][28] In fact, various microbe-based or microbiota-altering interventions have shown promising efficacy in reducing seizure frequency in patients with DRE. Fecal microbiota transplantation (FMT), initially used to treat symptoms of Crohn's disease (CD), had a positive effect on the frequency of seizures in a young woman who had also suffered from epilepsy for 17 years.…”

Section: Role Of the Microbiota In Drug-resistant Epilepsy: Microbial...mentioning

confidence: 99%

The impact of microbiota and ketogenic diet interventions in the management of drug‐resistant epilepsy

Diaz‐Marugan,

Rutsch,

Kaindl

et al. 2024

Acta Physiologica

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AimDrug‐resistant epilepsy (DRE) is a neurological disorder characterized by uncontrolled seizures. It affects between 10%–40% of the patients with epilepsy worldwide. Drug‐resistant patients have been reported to have a different microbiota composition compared to drug‐sensitive patients and healthy controls. Importantly, fecal microbiota transplantations (FMTs), probiotic and dietary interventions have been shown to be able to reduce seizure frequency and improve the quality of life in drug‐resistant patients. The classic ketogenic diet (KD) and its modifications may reduce seizures in DRE in some patients, whereas in others they do not. The mechanisms mediating the dietary effects remain elusive, although it is known that gut microbes play an important role in transmitting dietary effects to the host. Indeed, specific commensal microbes differ even between responders and non‐responders to KD treatment.MethodsIn this narrative mini‐review, we summarize what is known about the gut microbiota changes and ketogenic diets with special focus on patients with DRE.Results and ConclusionsBy highlighting unanswered questions and by suggesting future research directions, we map the route towards future improvement of successful DRE therapy.

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Section: Role Of the Microbiota In Drug-resistant Epilepsy: Microbial...mentioning

confidence: 99%

The impact of microbiota and ketogenic diet interventions in the management of drug‐resistant epilepsy

Diaz‐Marugan,

Rutsch,

Kaindl

et al. 2024

Acta Physiologica

View full text Add to dashboard Cite

show abstract

“…Therefore, additional and more effective antiseizure medications are urgently needed. Many studies have shown that the gut microbiota is associated with epilepsy ( Xie et al, 2017 ; Peng et al, 2018 , 2023 ; Zhang et al, 2018 ; Huang et al, 2019 , 2022 ; Lindefeldt et al, 2019 ; Gong et al, 2020 , 2022 ; Lee et al, 2020 , 2021 ; Safak et al, 2020 ; Cui et al, 2021 ; Xu et al, 2021 ; Bertuccioli et al, 2022 ; Dahlin et al, 2022 ; Dai et al, 2022 ; Ouyang et al, 2022 ; Zhou et al, 2022 , 2023 ; Turay et al, 2023 ; Wan et al, 2024 ); however, it is difficult to determine whether the gut microbiota is the cause of epilepsy or whether changes in the microbiota are only a result of epilepsy. Therefore, a long journey lies ahead in discovering drugs that target the gut microbiota for epilepsy treatment.…”

Section: Introductionmentioning

confidence: 99%

A long journey to treat epilepsy with the gut microbiota

Li,

Gu,

Liang

et al. 2024

Front. Cell. Neurosci.

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Epilepsy is a common neurological disorder that affects approximately 10.5 million children worldwide. Approximately 33% of affected patients exhibit resistance to all available antiseizure medications, but the underlying mechanisms are unknown and there is no effective treatment. Increasing evidence has shown that an abnormal gut microbiota may be associated with epilepsy. The gut microbiota can influence the function of the brain through multiple pathways, including the neuroendocrine, neuroimmune, and autonomic nervous systems. This review discusses the interactions between the central nervous system and the gastrointestinal tract (the brain–gut axis) and the role of the gut microbiota in the pathogenesis of epilepsy. However, the exact gut microbiota involved in epileptogenesis is unknown, and no consistent results have been obtained based on current research. Moreover, the target that should be further explored to identify a novel antiseizure drug is unclear. The role of the gut microbiota in epilepsy will most likely be uncovered with the development of genomics technology.

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The interplay between microbiota and brain-gut axis in epilepsy treatment

Zhu,

Wang,

2024

Front. Pharmacol.

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The brain-gut axis plays a vital role in connecting the cognitive and emotional centers of the brain with the intricate workings of the intestines. An imbalance in the microbiota-mediated brain-gut axis extends far beyond conditions like Irritable Bowel Syndrome (IBS) and obesity, playing a critical role in the development and progression of various neurological disorders, including epilepsy, depression, Alzheimer’s disease (AD), and Parkinson’s disease (PD). Epilepsy, a brain disorder characterized by unprovoked seizures, affects approximately 50 million people worldwide. Accumulating evidence suggests that rebuilding the gut microbiota through interventions such as fecal microbiota transplantation, probiotics, and ketogenic diets (KD) can benefit drug-resistant epilepsy. The disturbances in the gut microbiota could contribute to the toxic side effects of antiepileptic drugs and the development of drug resistance in epilepsy patients. These findings imply the potential impact of the gut microbiota on epilepsy and suggest that interventions targeting the microbiota, such as the KD, hold promise for managing and treating epilepsy. However, the full extent of the importance of microbiota in epilepsy treatment is not yet fully understood, and many aspects of this field remain unclear. Therefore, this article aims to provide an overview of the clinical and animal evidence supporting the regulatory role of gut microbiota in epilepsy, and of potential pathways within the brain-gut axis that may be influenced by the gut microbiota in epilepsy. Furthermore, we will discuss the recent advancements in epilepsy treatment, including the KD, fecal microbiota transplantation, and antiseizure drugs, all from the perspective of the gut microbiota.

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Can the Gut Microbiota Serve as a Guide to the Diagnosis and Treatment of Childhood Epilepsy?

Cited by 3 publications

References 42 publications

The impact of microbiota and ketogenic diet interventions in the management of drug‐resistant epilepsy

The impact of microbiota and ketogenic diet interventions in the management of drug‐resistant epilepsy

A long journey to treat epilepsy with the gut microbiota

The interplay between microbiota and brain-gut axis in epilepsy treatment

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