Dados do Trabalho

Título

PILOT PROJECT: QUANTITATIVE ANALYSIS OF ELECTROENCEPHALOGRAMS PERFORMED IN PATIENTS SUBMITTED TO A KETOGENIC DIET: ARE THERE CHANGES IN BRAIN ELECTRICAL ACTIVITY?

Resumo

INTRODUCTION The ketogenic diet (CD) is a medical treatment indicated, from childhood to adulthood, for the control of epileptic seizures, being a therapeutic option in patients diagnosed with Drug-Resistant Epilepsy. Several cohort series reported the effectiveness of the diet. In a bibliographic review in PUBMED on electroencephalographic analysis as proof of the anti-seizure effect of CD, it was observed that in most studies, visual counts were performed with no systematic quantitative analysis using certified mathematical programs. OBJECTIVE To develop a pilot project to investigate the brain electrophysiological transformations through specific mathematical/computational programs aimed at the quantitative analysis of the electroencephalograms (EEGS) performed. METHODOLOGY Prospective, comparative and quantitative longitudinal analysis, EEGS were performed in a female patient diagnosed with Drug-Resistant Epilepsy at 3 years of age due to Neonatal Hypoxic Encephalopathy, with indication of a ketogenic diet. Three EEGS were performed: the first when the ketogenic diet was indicated, the second thirty days after starting the diet and the third 3 months after starting the diet. They were performed according to homogeneous protocols, with the same EEG technician, 10-20 electrode placement system, the same EEG machinery, duration of approximately 30 minutes, with the patient in spontaneous sleep, performed at the same time shift. The patient had her blood ketosis levels measured daily. Data from the first day were used as baseline. The artifact subspace rejection (ASR) and the Common Average Reference (CAR) were first applied on EEG data to remove or reduce the undesirable effect of artifacts and interferences. The fast Fourier transform was employed and the relative power with respect to the baseline was obtained. Wilcoxon rank sum test was used to compare. RESULTS The relative power decreased significantly in the frontal lobe for delta and beta bands. Furthermore, the relative teta power increased significantly on the frontal lobe mainly, also more emphasized the last day of acquisition. Similarly, significant alfa power increases were observed in both motor cortex and occipital lobe. CONCLUSION The findings found in this analysis may corroborate the positive cognitive effects due to an improvement in baseline sleep activity, even perceived by the parents during the patient's therapy, as well as the benefits of CD reported in the literature.