Observational studyEBioMedicine2022
Higher levels of Bifidobacteria and tumor necrosis factor in children with drug-resistant epilepsy are associated with anti-seizure response to the ketogenic diet.
Observational study in EBioMedicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Does the ketogenic diet improve neurological disorders by influencing gut microbiota? A systematic review.Nutrition journal · 2023Pooled it
- Effects of ketogenic diet on health outcomes: an umbrella review of meta-analyses of randomized clinical trials.BMC medicine · 2023Pooled it
- Akkermansia muciniphila enhances washed microbiota transplantation in the treatment of epilepsy.Chinese medical journal · 2026Trial
- The Gut Microbiota-Epilepsy Axis: Bibliometric Trends, Mechanistic Insights, and Microbiota-Targeted Next-Generation Therapeutic Opportunities.Molecular neurobiology · 2026Review
- Review
- The gut microbiome and drug-resistant epilepsy: Microbiome-antiseizure medication interactions and implications for pharmacoresistance.Epilepsia open · 2026Review
- Nonlinear Association Between the C-Reactive Protein-To-Albumin Ratio and Post-Stroke Epilepsy Risk.CNS neuroscience & therapeutics · 2026Article
- The ketogenic diet alters microbiome-metabolome profiles to improve West syndrome therapy.Pediatric investigation · 2026Article
- Modulation of Gut Microbiome and Metabolome as One of the Potential Mechanisms of Ketogenic Diet Effect in the Treatment of Epilepsy.Nutrients · 2025Review
- The Influence of the Probiotics, Ketogenic Diets, and Gut Microbiota on Epilepsy and Epileptic Models: A Comprehensive Review.Molecular neurobiology · 2025Review
- The Interplay between the Gut and Ketogenic Diets in Health and Disease.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Review
- Multi-omics: a bridge connecting genotype and phenotype for epilepsy?Biomarker research · 2025Review
- Effects ofNutrients · 2025Article
- Review
- Characterizing the fecal microbiome in patients on the ketogenic diet for drug resistant epilepsy.Heliyon · 2025Article
- Microbiota-gut-brain Axis: Novel Potential Pathways for Developing Antiepileptogenic Drugs.Current neuropharmacology · 2025Review
- Association between dietary inflammatory index and epilepsy: findings from NHANES.Frontiers in neurology · 2025Article
- Genetic aetiologies in relation to response to the ketogenic diet in 226 children with epilepsy.Brain communications · 2025Article
- Association between seizure reduction during ketogenic diet treatment of epilepsy and changes in circulatory metabolites and gut microbiota composition.EBioMedicine · 2024Observational
- Effects of dietary intervention on human diseases: molecular mechanisms and therapeutic potential.Signal transduction and targeted therapy · 2024Review
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecently, studies have suggested a role for the gut microbiota in epilepsy. Gut microbial changes during ketogenic diet (KD) treatment of drug-resistant epilepsy have been described. Inflammation is associated with certain types of epilepsy and specific inflammation markers decrease during KD. The gut microbiota plays an important role in the regulation of the immune system and inflammation.
methods28 children with drug-resistant epilepsy treated with the ketogenic diet were followed in this observational study. Fecal and serum samples were collected at baseline and three months after dietary intervention.
findingsWe identified both gut microbial and inflammatory changes during treatment. KD had a general anti-inflammatory effect. Novel bioinformatics and machine learning approaches identified signatures of specific Bifidobacteria and TNF (tumor necrosis factor) associated with responders before starting KD. During KD, taxonomic and inflammatory profiles between responders and non-responders were more similar than at baseline.
interpretationOur results suggest that children with drug-resistant epilepsy are more likely to benefit from KD treatment when specific Bifidobacteria and TNF are elevated. We here present a novel signature of interaction of the gut microbiota and the immune system associated with anti-epileptic response to KD treatment. This signature could be used as a prognostic biomarker to identify potential responders to KD before starting treatment. Our findings may also contribute to the development of new anti-seizure therapies by targeting specific components of the gut microbiota.
fundingThis study was supported by the Swedish Brain Foundation, Margarethahemmet Society, Stiftelsen Sunnerdahls Handikappfond, Linnea & Josef Carlssons Foundation, and The McCormick Genomic & Proteomic Center.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.