Efeito de dieta cetogênica à base de óleo de coco sobre as crises convulsivas de ratos portadores de epilepsia induzida por pilocarpina

Abstract

Epilepsy is a chronic disturbance of brain function characterized by the presence of recurrent and spontaneous seizures, making one of the most frequent and severe neurological diseases, affecting approximately 50 million people worldwide, mainly children. Among these, 40% had antiepileptic drug refractory seizures. Non-drug options as surgery, vagus nerve stimulation and the ketogenic diet are timely. This diet, used since 1921 in treatment of drug-resistant epilepsy is characterized by a high concentration of lipids and often by low concentration of carbohydrates and proteins. Traditionally, the ketogenic diet use long chain triacylglycerols (LCT), however, the medium chain triacylglycerols (MCT) are considered an alternative substrate for promoting faster ketonemia-ketonuria. The oil from coconut (Cocos nucifera L.) is a natural source of MCT, and is used for several purposes, including therapeutic. This dissertation aims to investigate the effects of the ketogenic diet based on coconut oil and soybean oil on epileptic seizures in rats, consists of a review chapter, entitled Drug-resistant epilepsies: an emphasis on treatment ketogenic, and an article from the results, entitled Effects of ketogenic diet based on coconut oil on the seizures of rats with epilepsy induced by pilocarpine. The article deals an experimental study conducted in Wistar rats, divided into three groups (n=10), named according to the diet received, in Control (standard diet AIN-93G), CetoTAGcoco (ketogenic diet based in coconut oil; AIN-93G diet modified to contain 7% soybean oil, 22.79% of extra virgin coconut oil and 40% margarine) and CetoTAGsoja (ketogenic diet based in soybean oil; AIN-93G diet modified to contain 29.79% of soybean oil and 40% margarine). The ratio lipid:carbohydrate+protein of ketogenic diets was 3.5:1 (control diet, 1:11.8). The experimental period lasted 19 days. The animals fed ketogenic diets showed food intake (g) below, however, dispend energetic and weight gain similar to Control group. The behavioral analysis showed that the experimental groups did not differ in frequency and duration of seizures, however, the animals in group CetoTAGcoco had shorter duration of seizures in the 19th day, that the Control group (0.00±0.00 against 22.78±2.95, respectively, P<0.05). Additionally, the CetoTAGcoco group presented lower variation of frequency and duration of seizures between the 19th and 1st day of treatment than the Control group (9.00±1.73 against 11.00±1.00, for frequency, and 20.80±12.61 against 49.14±21.15, for duration, respectively, P<0.05). The results of this study suggest a possible protective effect of ketogenic diet based on extra virgin coconut oil on seizures. That result, coupled with studies attesting to confidence and tolerance of the coconut oil, particularly in ketogenic ratios, indicating a potential benefit of this oil for control the seizures, especially for individuals with medically refractory epilepsy.