Graduation Date

Spring 5-8-2021

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Medical Sciences Interdepartmental Area

First Advisor

Dr. Corrine Hanson

Second Advisor

Dr. Jiri Adamec

Third Advisor

Dr. Arun Swaminathan

Fourth Advisor

Dr. Ann Anderson-Berry

Abstract

Ketogenic diet therapies (KDTs) have been used to treat epilepsy for nearly 100 years. Although effective, restrictive diet patterns and unknown impacts on long-term health outcomes often prevent their use as first-line therapy. To date, a distinct mechanism of action for KDTs has not been determined and evidence suggests fatty acids (FAs) may play a role in eliciting anti-seizure effects. This dissertation aimed to provide insights into the effect of polyunsaturated fatty acids (PUFAs) and saturated fatty acids (SFAs) on seizure presence and severity through the analysis of dietary intake in a cohort of patients admitted to an epilepsy monitoring unit at Nebraska Medicine. Seizure activity was monitored throughout the inpatient stay via continuous video electrocephalogram monitoring (EEG) and dietary intake was determined by administering a food frequency questionnaire. PUFAs were evaluated separately while SFAs were analyzed by carbon length groupings: short chain (SCFA), medium chain (MCFA) and long chain (LCFA). EEG reports were reviewed and assessed for seizure presence (yes/no) and seizure severity (score of 1-4). Differences in median FA intakes across seizure presence and severity groups were evaluated and regression models assessed the ability of PUFAs and SFAs to act as predictors of seizure presence and severity, respectively. Seizure presence was observed in 31 of 82 (37.8%) subjects included in the final analysis. While no statistically significant (p p = 0.16). Results from this dissertation suggest specific dietary FAs have potential anti-seizure properties that warrant exploration as epilepsy treatment. A minimally invasive, targeted dietary treatment could decrease the devastating side effects of epilepsy, reduce the staggering cost of treatment and improve quality of life for patients and their families.

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