title: Neurobiochemical mechanisms of a ketogenic diet in refractory epilepsy.
abstract: A ketogenic diet is an important therapy used in the control of drug-refractory seizures. Many studies have shown that children and adolescents following ketogenic diets exhibit an over 50% reduction in seizure frequency, which is considered to be clinically relevant. These benefits are based on a diet containing high fat (approximately 90% fat) for 24 months. This dietary model was proposed in the 1920s and has produced variable clinical responses. Previous studies have shown that the mechanisms underlying seizure control involve ketone bodies, which are produced by fatty acid oxidation. Although the pathways involved in the ketogenic diet are not entirely clear, the main effects of the production of ketone bodies appear to be neurotransmitter modulation and antioxidant effects on the brain. This review highlights the impacts of the ketogenic diet on the modulation of neurotransmitters, levels of biogenic monoamines and protective antioxidant mechanisms of neurons. In addition, future perspectives are proposed.
authors.affiliation: Post-Graduate Program in Applied Human Nutrition, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Patricia Azevedo de
authors.initials: PA
authors.lastname: Lima
authors.affiliation: Children's Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Leticia Pereira de Brito
authors.initials: LP
authors.lastname: Sampaio
authors.affiliation: Department of Nutrition, School of Public Health, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Nágila Raquel Teixeira
authors.initials: NR
authors.lastname: Damasceno
mesh_terms: D000293:Adolescent; D015306:Biogenic Monoamines / Q000378:metabolism; D002648:Child; D055423:Diet, Ketogenic / Q000379:methods*; D004827:Epilepsy / Q000178:diet therapy* / Q000378:metabolism; D006801:Humans; D007657:Ketone Bodies / Q000378:metabolism; D008488:Medical Illustration; D018696:Neuroprotective Agents / Q000378:metabolism; D018377:Neurotransmitter Agents / Q000378:metabolism
chemical_list: D015306:Biogenic Monoamines; D007657:Ketone Bodies; D018696:Neuroprotective Agents; D018377:Neurotransmitter Agents