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Review
. 2021 Aug;8(8):1730-1737.
doi: 10.1002/acn3.51423. Epub 2021 Jul 11.

Metabolism-based therapies for epilepsy: new directions for future cures

Mackenzie Cervenka  1 , Juan M Pascual  2 , Jong M Rho  3 , Elizabeth Thiele  4 , Gary Yellen  5 , Vicky Whittemore  6 , Adam L Hartman  6
Affiliations
Review

Metabolism-based therapies for epilepsy: new directions for future cures

Mackenzie Cervenka et al. Ann Clin Transl Neurol. 2021 Aug.

Abstract

Objective: Thousands of years after dietary therapy was proposed to treat seizures, how alterations in metabolism relates to epilepsy remains unclear, and metabolism-based therapies are not always effective.

Methods: We consider the state of the science in metabolism-based therapies for epilepsy across the research lifecycle from basic to translational to clinical studies.

Results: This analysis creates a conceptual framework for creative, rigorous, and transparent research to benefit people with epilepsy through the understanding and modification of metabolism.

Interpretation: Despite intensive past efforts to evaluate metabolism-based therapies for epilepsy, distinct ways of framing a problem offer the chance to engage different mindsets and new (or newly applied) technologies. A comprehensive, creative, and inclusive problem-directed research agenda is needed, with a renewed and stringent adherence to rigor and transparency across all levels of investigation.

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Conflict of interest statement

Drs Pascual, Yellen, Thiele, Whittemore, and Hartman report no conflicts of interest. Dr Rho serves as a consultant for Aquestive Therapeutics, Cerecin Ltd., Biocodex, and Cypralis Ltd. Dr. Cervenka has received grants from Vitaflo International Ltd, honoraria from Nutricia and Vitaflo International Ltd, royalties from Demos Health/Springer Publishing Company, and consulting fees for Nutricia.

References

    1. This article reflects presentations and discussion during and after the November 9–10, 2020 Metabolism‐based Therapies for Epilepsy Workshop hosted by the National Institutes of Health in Bethesda, Maryland. The contents of the workshop are available at https://www.ninds.nih.gov/News‐Events/Events‐Proceedings/Events/Metaboli....
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