Connecting the Dots Between Fasting and Seizures

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Highlights:

• Fasting can reduce seizure occurrence-A novel research by Boston Children's Hospital
• Restricting calories has traditionally been associated with fewer epileptic episodes
• Signaling by DEPDC5 in the brain reduces seizures by using an mTOR inhibitor A length of time without eating or, in some situations, drinking only fluids is referred to as fasting. There are numerous justifications for people to choose to fast

What Motivates People to Fast?

There are several possible justifications for people's desire to fast. These include:

• Religious motivations
• As a component of a diet for weight loss or health reasons
• Prior to anesthesia

There are numerous diets that call for specific period fasting (called intermittent fasting).

These consist of:

• Eating regular food the first day and then fasting the next is known as alternate-day fasting.
• Eating normally for five days in a week and fasting for two days is called 5:2 diet.
• Eating regularly but only during a set period of time each day using the time-restricted eating method (1^✔).

The neurological condition epilepsy is characterized by aberrant brain activity that results in seizures or episodes of strange behaviour, sensations, and occasionally loss of consciousness.

‘Researchers from Boston Children's Hospital found that employing a mTOR inhibitor could lower seizures in an animal model that specifically knocks off DEPDC5 in the brain.’

Some people utilize a ketogenic diet, a specialized medical diet, as a form of epilepsy therapy. Even though it doesn't require fasting, it tricks the body into believing that it is starving or fasting.

The initial line of treatment for epilepsy is an anticonvulsant drug, however one of the first two drugs are effective for two thirds of patients only. There are still a sizable proportion of individuals who require extra care. The ketogenic diet is a treatment option that is underutilized for people who do not have a lesion that can be surgically removed (2^✔).

Restricting calories has long been linked to fewer seizures in people with epilepsy. The effects of fasting on brain neurons are now better understood according to new research from Boston Children's Hospital, which may also pave the way for innovative methods that do not require fasting or restrictive diets. The journal Cell Reports published the findings.

According to first author Christopher J. Yuskaitis, MD, PhD, a neurologist from the Epilepsy Center and Epilepsy Genetics Program at Boston Children's Hospital, "this study represents the first step in understanding how dietary therapies for epilepsy work (3^✔)".

Details of the Study:

First Step is Sensing of Amino Acids

In recent work, it was demonstrated using a mouse seizure model that mTOR signaling was decreased in the brain after fasting. Additional research on rat neurons grown in culture suggests that the absence of three amino acids such as leucine, arginine, and glutamine is what causes this fasting effect.

DEPDC5 (or DEP domain-containing 5) is a human protein of poorly understood function. DEPDC5-related epilepsy are characterized by focal seizures, with seizure onset in a discrete area of the brain. The group showed that the DEPDC5 protein can detect the presence of these nutrients. When DEPDC5 was removed from the brain, mTOR activity was unaffected, and fasting no longer prevented seizures in the mice.

According to Yuskaitis, amino acid sensing appears to be essential for the positive benefits of fasting on seizures. This shows that patients with DEPDC5 mutations may not benefit from dietary modification because they are unable to perceive the loss of amino acids. However, patients without DEPDC5 mutations might profit from a focused nutritional approach.

This may be accomplished by consuming meals that are lower in the three amino acids or by using drugs or supplements that prevent the absorption of those amino acids.

Next step is a ketogenic diet

Yuskaitis and associates are currently interested in testing specific amino acid-free diets on animal models to see how they affect seizure frequency. They also aim to investigate how the ketogenic diet, a well-known method of treating epilepsy, reduces seizure frequency. Nobody currently understands why this high-fat, low-carb diet is effective(3^✔,4^✔ ).

Hoping that this will lead to the discovery of new dietary-based treatments, in addition to the ketogenic diet, " which can be challenging to follow for long periods of time due to its side effects," adds Yuskaitis.

Findings from these unusual conditions may open possibilities for better therapies for epilepsy generally. This type of research may also offer a new perspective on neurologic disorders in general(3^✔,4^✔ ).

References:

1. Fasting and epilepsy - (https:www.epilepsy.org.uk/info/daily-life/fasting-ramadan)
2. Intermittent fasting: A "new" historical strategy for controlling seizures? - (https:www.ncbi.nlm.nih.gov/pmc/articles/PMC3740951/)
3. How fasting affects neurons in brain: Research - (https:www.hindustantimes.com/lifestyle/health/how-fasting-affects-neurons-in-brain-research-101662699354076-amp.html)
4. Why does fasting reduce seizures? - (https:www.eurekalert.org/news-releases/964159)

Source: Medindia

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