Ketosis and epilepsy: 31P spectroscopic imaging at 4.1 T.
OBJECTIVE
To determine whether changes in the high-energy phosphates occur with use of the ketogenic diet in patients with intractable epilepsy.


METHODS
31P magnetic resonance spectroscopic imaging studies were performed at 4.1 T in seven patients with intractable epilepsy (four Lennox-Gastaut syndrome, one absence, one primary generalized tonic-clonic, and one partial complex) before and after institution of the ketogenic diet. Coronal 1H anatomic imaging also was performed to provide correlation to the 31P data.


RESULTS
Taking the patients as a group, the ratio of phosphocreatine (PC)/gamma-adenosine triphosphate (ATP) measured at baseline (regular diet) compared with that measured after the ketogenic diet showed a small but significant increase from 0.61+/-0.08 to 0.69+/-0.08 (p < 0.05). Comparing the ratio of PCr inorganic phosphorus (Pi) measured at baseline with the postketogenic diet, there was a significant increase from 2.45+/-0.27 to 2.99+/-0.44 (p < 0.05).


CONCLUSIONS
As a group, improvement of energy metabolism occurs with use of the ketogenic diet. This is in agreement with the chronic ketosis studies performed earlier in rodents.
Pan
J W
JW
Medical Department, Brookhaven National Laboratory, Upton, New York 11793, USA.
Bebin
E M
EM
Chu
W J
WJ
Hetherington
H P
HP
D000255:Adenosine Triphosphate / Q000378:metabolism; D000293:Adolescent; D001921:Brain / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000175:diagnosis / Q000178:diet therapy* / Q000378:metabolism*; D005526:Food, Formulated; D006801:Humans; D007662:Ketosis / Q000139:chemically induced* / Q000175:diagnosis / Q000378:metabolism*; D009682:Magnetic Resonance Spectroscopy; D010725:Phosphocreatine / Q000378:metabolism; D010758:Phosphorus / Q000378:metabolism; D010759:Phosphorus Isotopes
D010759:Phosphorus Isotopes; D010725:Phosphocreatine; D010758:Phosphorus; D000255:Adenosine Triphosphate