title: Cognitive and behavioral impact of the ketogenic diet in children and adolescents with refractory epilepsy: A randomized controlled trial.
abstract: The ketogenic diet (KD) is increasingly used for the treatment of refractory epilepsy in childhood because of the beneficial effect on seizure reduction. The aim of the current study was to objectively assess cognition and aspects of behavior during the first 4months of a randomized controlled study in children and adolescents.
  
  
  
  Participants from a tertiary epilepsy center were randomized to a KD group (intervention) or a care-as-usual (CAU) group (control). Follow-up assessments on cognition and behavior were performed approximately 4months after initiation of the KD with a combination of parent report questionnaires and individually administered psychological tests for the children.
  
  
  
  A total of 50 patients were enrolled in this study, 28 patients from the KD group and 22 patients from the CAU group. The KD group showed lower levels of anxious and mood-disturbed behavior and was rated as more productive. Cognitive test results showed an improvement of activation in the KD group.
  
  
  
  This study showed a positive impact of the KD on behavioral and cognitive functioning in children and adolescents with refractory epilepsy. More specifically, an activated mood and cognitive activation were observed in patients treated with the KD.
authors.affiliation: Department of Behavioral Sciences, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; MHENS School of Mental Health & Neuroscience, Maastricht University, Maastricht, The Netherlands. Electronic address: IJffD@kempenhaeghe.nl.
authors.forename: Dominique M
authors.initials: DM
authors.lastname: IJff
authors.affiliation: Department of Research and Development, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands.
authors.forename: Debby
authors.initials: D
authors.lastname: Postulart
authors.affiliation: Department of Neurology, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands.
authors.forename: Danielle A J E
authors.initials: DAJE
authors.lastname: Lambrechts
authors.affiliation: Department of Research and Development, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; Department of Neurology, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; School of Health Professions Education, Maastricht University, The Netherlands.
authors.forename: Marian H J M
authors.initials: MHJM
authors.lastname: Majoie
authors.affiliation: CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors.forename: Reina J A
authors.initials: RJA
authors.lastname: de Kinderen
authors.affiliation: Department of Behavioral Sciences, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; Center of Neurological Disabilities, Kempenhaeghe, Heeze, The Netherlands.
authors.forename: Jos G M
authors.initials: JGM
authors.lastname: Hendriksen
authors.affiliation: CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands; Trimbos Institute, National Institute of Mental Health and Addiction, Utrecht, The Netherlands.
authors.forename: Silvia M A A
authors.initials: SMAA
authors.lastname: Evers
authors.affiliation: Department of Behavioral Sciences, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; MHENS School of Mental Health & Neuroscience, Maastricht University, Maastricht, The Netherlands; Department of Research and Development, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Neurology, Ghent University Hospital, Ghent, Belgium; Department of Electrical Engineering, University of Technology, Eindhoven, The Netherlands.
authors.forename: Albert P
authors.initials: AP
authors.lastname: Aldenkamp
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000339:Affect; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000178:diet therapy / Q000523:psychology; D002675:Child, Preschool; D003071:Cognition; D055423:Diet, Ketogenic / Q000379:methods*; D000069279:Drug Resistant Epilepsy / Q000175:diagnosis / Q000178:diet therapy* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000178:diet therapy / Q000523:psychology; D011581:Psychological Tests; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Behavior; Cognition; Epilepsy; Ketogenic diet