A Study on the Age-Dependent Antiepileptic Effects of the Ketogenic Diet in the Pentylenetetrazole-Seizure Animal Model / 대한소아신경학회지

ABSTRACT

PURPOSE: The ketogenic diet(KD) has been felt to be clinically more efficacious at younger ages, presumably because of the enhanced ability of the immature brain to extract and utilize ketone bodies. The present study was designed to investigate age-dependent effects of the KD on pentylenetetrazole(PTZ)-seizure severity in rats. METHODS: A KD([fat][protein+carbohydrate] ratio of 4.31) was administered to male Sprague-Dawley rats for 3 weeks, while control animals were fed a standard rodent chow. Dietary treatment was initiated at either postnatal 9 or 12 weeks. Seizures were chemically induced by intraperitoneal injection of PTZ(60 mg/kg) and blood beta-hydroxybutyrate (BHB) levels were assayed on treatment day 21. Seizure severity was evaluated by using a scoring system of seizure behaviors0, no seizure; 0.5, abnormal behavior; 1, myoclonic jerk; 2, myoclonic jerk with jumping; 3, forelimb clonus with preserving righting reflex; 4, generalized clonic seizure with brief loss of righting reflex; 5, generalized tonic clonic seizure; 6, expire. A greater score represents a more severe seizure. RESULTS: In 9 weeks old rats, the mean(+/-SEM) seizure behavior scores were 3.5+/-1.2 [n=19] and 4.4+/-0.9[n=17] for the KD-treated and control groups, respectively(P<0.05), whereas in 12 weeks old animals, no significant differences in seizure behavior scores between the two groups(3.9+/-0.3[n=17] vs. 4.1+/-0.3[n=16], respectively). Blood BHB levels in the KD-treated group were significantly higher than those of the control group in 9 (1.21+/-0.14[n=19] vs. 0.14+/-0.12[n=17] mM, respectively; P<0.001) and 12(0.64+/-0.08[n=17] vs. 0.18+/-0.02[n=16] mM, respectively; P<0.001) weeks old animals. CONCLUSION: The KD was previously reported to decrease PTZ-seizure severity in 3 weeks old rats. In this study, the KD decreases PTZ-seizure severity in 9 weeks old rats, but is ineffective in 12 weeks old rats. These results parallel clinical experience, where the beneficial effects of the KD are felt to be age-dependent.