1. MECANISMOS DE ACCIÓN Y CAUSALIDAD DE LA DIETA CETOGÉNICA EN LA EPILEPSIA Y CRITERIOS BASADOS EN LA EVIDENCIA (MEACEVI)
- Author
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Barrera Mora, Antonio
- Abstract
Epilepsy is a neurological ultra-prevalent disease of aetiology not fully known that is hypothetically caused by a wide variety of cellular and molecular modifications at multiple levels at the brain (Badawy, Harvey, & Macdonell, 2009, p. 2-9;Scheffer et al., 2017); characterized by an enduring predisposition to generate epileptic seizures and by the neurobiological, cognitive, psychological, and social impairments as a result of this condition. Epileptic seizures are a transient behaviour occurrence of subjective symptoms and/or objective signs due to abnormal excessive or synchronous neuronal activity from a focal onset -arise from one brain region or hemisphere and widespread to another hemispheres or brain regions-, from generalized onset -arises from both hemispheres- and from unknown onset -unidentified brain area or hemisphere epileptogénesis- (Fisher et al., 2017, p.476). The onset determination is based on the clinical features, electroencephalography (EEG) and by the neuroimaging findings. The epileptogénesis describes how a normal neural network changes to the point of becoming a hyperexcitable neural network (Bartolomei et al., 2017, p.1131), capable of causing and spreading seizure as a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms and the “status epilepticus” (SE) - a first level medical emergency-, a prolonged or repeated seizures in a period with a risk of causing serious injuries (Trinka et al., 2015, p. 1516) and it’s. The first-choice treatment for epilepsy is pharmacologic, the antiepileptic drugs (AED), that don’t lack of side effects and in some types of epilepsy -refractory epilepsy (RE), refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE) 1-, have also have an remarkable lack of effectivity (Armeno et al., 2014, p.213). For those cases, surgery would be the next step, but sometimes the epilepsy is a drug-resistant epilepsy, not suitable for resective surgery. Then, the emerging options are two: Neurostimulation (NS) and dietary therapies (DT) -Ketogenic diet (KD) and derivates 2-. The mechanisms by which the KD operates are unclear, although the research indicates the existence of a positive correlation between a RE, KD and SE (Giner, 2009, p.83) talking about a percentage of around 15-20% SE free and other benefits 3. In the KD field, this project aims towards: 1. the creation of a common framework protocol for the investigation of the effects of the KD in different patients, pathologies and a unified body of knowledge. 2. Using different techniques -PET and EEGG-, elucidate the mechanisms of action of the KD. Being able to describe the molar and molecular changes that the KD origins, its mechanisms of action, the changings areas, etc., will allow us to get a nomothetic knowledge of the epilepsy disease (ED) that can facilitate the acquisition of new therapeutic targets, helping us to guide future researches and empowering us to design treatment based in the evidence and in terms of causality backed by the scientific method.
- Published
- 2023
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