Polyunsaturated fatty acid supplementation for drug-resistant epilepsy

Vasconcelos, Vivian Sarmento; Macedo, Cristiane R; Pedrosa, Alexsandra Souza; Morais, Edna Pereira Gomes de; Torloni, Maria Regina

doi:10.1002/14651858.cd011014

Cited by 4 publications

(5 citation statements)

References 31 publications

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“…Moreover, a search of the Cochrane library was also conducted to identify reviews regarding n -3 LCPUFA supplementation. The studies included in the Cochrane reviews were checked for inclusion in the current study [41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56]. Lastly, for all included articles, the “cited by” option of Web of Science was checked (this option gives all articles that cite that specific article).…”

Section: Methodsmentioning

confidence: 99%

A Review of Recruitment, Adherence and Drop-Out Rates in Omega-3 Polyunsaturated Fatty Acid Supplementation Trials in Children and Adolescents

2017

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Introduction: The influence of n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) supplementation on health outcomes has been studied extensively with randomized controlled trials (RCT). In many research fields, difficulties with recruitment, adherence and high drop-out rates have been reported. However, what is unknown is how common these problems are in n-3 LCPUFA supplementation studies in children and adolescents. Therefore, this paper will review n-3 LCPUFA supplementation studies in children and adolescents with regard to recruitment, adherence and drop-out rates. Methods: The Web of Science, PubMed and Ovid databases were searched for papers reporting on RCT supplementing children and adolescents (2–18 years) with a form of n-3 LCPUFA (or placebo) for at least four weeks. As a proxy for abiding to CONSORT guidelines, we noted whether manuscripts provided a flow-chart and provided dates defining the period of recruitment and follow-up. Results: Ninety manuscripts (reporting on 75 studies) met the inclusion criteria. The majority of the studies did not abide by the CONSORT guidelines: 55% did not provide a flow-chart, while 70% did not provide dates. The majority of studies provided minimal details about the recruitment process. Only 25 of the 75 studies reported an adherence rate which was on average 85%. Sixty-five of the 75 studies included drop-out rates which were on average 17%. Conclusion: Less than half of the included studies abided by the CONSORT guidelines (45% included a flow chart, while 30% reported dates). Problems with recruitment and drop-out seem to be common in n-3 LCPUFA supplementation trials in children and adolescents. However, reporting about recruitment, adherence and dropout rates was very heterogeneous and minimal in the included studies. Some techniques to improve recruitment, adherence and dropout rates were identified from the literature, however these techniques may need to be tailored to n-3 LCPUFA supplementation studies in children and adolescents.

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Section: Methodsmentioning

confidence: 99%

A Review of Recruitment, Adherence and Drop-Out Rates in Omega-3 Polyunsaturated Fatty Acid Supplementation Trials in Children and Adolescents

2017

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“…TNF-α may induce hyperexcitability of neuronal through changes in ion channels and production of glutamate, resulting in membrane depolarization and recurrent seizures. 13 The four studies conducted by Vasconcelos et al 15 in 2016, Pourmasoumi et al 14 in 2018, Ibrahim et al 16 in 2018, and Omrani et al 13 in 2019 exhibit strengths and limitations. In Vasconcelos et al 15 's study in 2016, limitations include the inclusion of only a few studies in the meta-analysis, small sample sizes, and insufficient evidence supporting the supplementation of omega-3 in individuals with refractory epilepsy.…”

Section: Discussionmentioning

confidence: 99%

“…13 The four studies conducted by Vasconcelos et al 15 in 2016, Pourmasoumi et al 14 in 2018, Ibrahim et al 16 in 2018, and Omrani et al 13 in 2019 exhibit strengths and limitations. In Vasconcelos et al 15 's study in 2016, limitations include the inclusion of only a few studies in the meta-analysis, small sample sizes, and insufficient evidence supporting the supplementation of omega-3 in individuals with refractory epilepsy. Further trials are necessary to assess the benefits of supplementation of omega-3 in the treatment of epilepsy with drug-resistant (referred to specific type of epilepsy).…”

Section: Discussionmentioning

confidence: 99%

“…This study need further trials with larger sample sizes to judge the benefits of omega-3 supplementation in the treatment of epilepsy with drug-resistant. 15 Pourmasoumi et al 14 conducted a systematic review and meta-analysis, identifying nine clinical trial articles published between 2002 and 2015, involving 205 epilepsy patients. DeGiorgio 14 in 2015 used low-dose fish oil (1080 mg/day) and high-dose fish oil (2160 mg/day) in epilepsy patients with an average age of 33 ± 10.33 years over 42 weeks.…”

Section: Discussionmentioning

confidence: 99%

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The impact of omega-3 on recurrent seizures in epileptic patients: A case study with evidence-based approaches

Wijayanthie,

Lestari

2024

World Nutr J

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Background: Epileptogenesis is also associated with increased production of excessive pro-inflammatory cytokines” which shows connection between pro-inflammatory cytokines as triggering factor with omega-3 which has anti-inflammatory effect. Omega-3, known for its neuroprotective and anticonvulsant properties, exhibits promising effects on epileptic seizure attacks. Objective: This study aimed to evaluate the effect of omega-3 supplementation on the incidence of seizures in epilepsy patients. Methods: This study used a literature search using advanced queries in the databases PubMed, Scopus, ProQuest, and Cochrane Library, and combined MeSH terms with Title/Abstract. The collected literature is discarded if there are duplicates, then literature is filtered that meets the eligibility criteria. We used the Oxford Center for Evidence-Based Medicine as a means of critical appraisal and determining the level of evidence of the selected literature. Results: Four chosen literatures were critically assessed. Two articles indicating no significant difference between omega-3 and placebo and two articles showed had a significantly higher number of seizure-free days than placebo. The first article, involving 78 adults, reported a 50% reduction in seizure risk with a frequency RR of 0.57, 95% CI 0.19 to 1.75 (IS = 0%) indicating no significant difference between omega-3 and placebo groups after 12 weeks of treatment. The second study, comprising mostly non-significant findings, demonstrated no significant correlation between omega-3 and epilepsy attacks in epilepsy patients. The third literature revealed seizure occurrences per month in the EPA group (9.7±1.2), DHA group (11.7±1.5), and placebo group (16.6±1.5). Incidence rate ratio (IRR) adjusted for seizure type in EPA and DHA groups compared to the placebo group were 0.61 (CI = 0.42–0.88, p = 0.008, a 42% reduction) and 0.67 (CI = 0.46–1.0, p = 0.04, a 39% reduction), respectively. Both treatment groups had a significantly higher number of seizure-free days compared to the placebo group (p < 0.05). The fourth study reported intervention group frequency (4.72 ± 1.6, p= 0.014) and placebo frequency (11.64 ± 1.63, p=0.014) with intervention group seizure duration (6.64 ± 1.39, p=0.009) compared to placebo group (14.36 ± 2.18, p=0.009). Conclusion: Omega-3 supplementation may be considered for management in patients with recurrent epileptic seizures, although its effect on reducing seizure frequency remains inconsistent.

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“…Dietary and healthy lifestyle measures have also been proposed to mitigate the occurrence of epilepsy and SUDEP; these include consumption of ω-3 fatty acid supplements, avoidance of alcohol, and engagement in physical activity [116]; however, the data on the effects of ω-3 fatty acids remain inconclusive and non-convincing [117,118].…”

Section: Preventionmentioning

confidence: 99%