Efficacy of the ketogenic diet in the 6-Hz seizure test

Authors

  • Adam L. Hartman,

    1. Epilepsy Research Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, U.S.A.
    2. The John M. Freeman Pediatric Epilepsy Center, Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland, U.S.A.
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  • Megan Lyle,

    1. Epilepsy Research Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, U.S.A.
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  • Michael A. Rogawski,

    1. Epilepsy Research Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, U.S.A.
    2. Department of Neurology, University of California, Davis School of Medicine, Sacramento, California, U.S.A.
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  • Maciej Gasior

    1. Epilepsy Research Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, U.S.A.
    2. Cephalon, Inc., West Chester, Pennsylvania, U.S.A.
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Address correspondence to Adam L. Hartman, M.D., The John M. Freeman Pediatric Epilepsy Center; Department of Neurology, Johns Hopkins Hospital, 600 N. Wolfe, St., Meyer 2-147, Baltimore, MD 21287, U.S.A. E-mail: ahartma2@jhmi.edu

Summary

Purpose: Since the ketogenic diet is effective in drug-resistant epilepsies, we sought to determine whether it is active in the 6-Hz seizure test, which identifies agents with a broader spectrum of activity than conventional antiepileptic screening tests.

Methods: Male (3–4 week old) NIH Swiss mice were fed a normal or ketogenic diet ad libitum for 2–21 days. The intensity of the corneal stimulation current required to elicit seizures in the 6-Hz test was measured. Blood glucose and β-hydroxybutyrate were measured on the day of seizure testing.

Results: CC50 (current intensity producing seizures in 50% of mice tested) was 50.6 mA and 15 mA in mice fed for 12 days with a ketogenic or normal diet, respectively (p < 0.001). CC50 was elevated in separate experiments after 16, but not 2, 5, and 21 days of ketogenic diet exposure. CC50 values of growing mice fed the normal diet does not differ, indicating CC50 does not vary with mouse weight during a rapid growth phase. β-Hydroxybutyrate was significantly higher, and glucose was significantly lower in mice fed the ketogenic diet than those fed the normal diet. Blood glucose and β-hydroxybutyrate levels did not correlate with CC50.

Discussion: The ketogenic diet significantly elevates the seizure threshold in the 6-Hz test in a time-specific manner. Protection from seizures in this model was not related to level of ketosis. CC50 was insensitive to body weight in mice fed the normal diet, demonstrating that the 6-Hz model can assess anticonvulsant regimens where weight is a confounding factor.

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