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Drug-Resistant Epilepsy and Gut-Brain Axis: an Overview of a New Strategy for Treatment

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Abstract

Drug-resistant epilepsy (DRE), also known as intractable epilepsy or refractory epilepsy, is a disease state with long-term poorly controlled seizures attack. Without effective treatment, patients are at an elevated risk of injury, premature death, mental disorders, and poor quality of life, increasing the need for a fresh perspective on the etiology and treatment of DRE. The gut is known to harbor a wide variety of microorganisms that can regulate the host’s response to exogenous signals and participate in various physiological and pathological processes in the human body. Interestingly, emerging evidence has uncovered the changes in gut microbiota in patients with epilepsy, particularly those with DRE. In addition, both dietary interventions and specific antibiotic therapy have been proven to be effective in restoring the microecological environment and, more importantly, reducing seizures. Here, we reviewed recent studies on DRE and the involvement of gut microbiota in it, describing changes in the gut microflora composition in patients with DRE and corresponding animal models. Furthermore, the influence of the ketogenic diet, probiotics, fecal microbiota transplantation (FMT), and antibiotics as microbiome-related factors on seizure control and its possible mechanisms are broadly discussed. Finally, we highlighted the significance of gut microbiome in DRE, in order to provide a new prospect for early identification and individualized treatment of patients with DRE.

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Funding

This work was supported by Liaoning Directed project for the planning of science and technology No.2021JH2/10300135 (to J.L.); Liaoning Province Excellent Talent Program Project No.xlyc1902031 (to J.L.); Dalian High-level Talent Team Project No.2022RG18 (to J.L.); National Health and Family Planning Commission and Food and Drug Administration No.CMR-20161129-1003 (to J.L.); Dalian Medical Science Research Project, No.2112006 (to Y.J.); and Dalian high-level talent innovation support plan, No. 2021RQ028 (to C.H.).

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  1. Shuna Chen and Yang Jiao contributed equally to this work.

Authors and Affiliations

  1. Stem Cell Clinical Research Center, National Joint Engineering Laboratory, Regenerative Medicine Center, The First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China

    Shuna Chen, Chao Han, Ying Li & Jing Liu

  2. Dalian Innovation Institute of Stem Cell and Precision Medicine, Dalian, People’s Republic of China

    Shuna Chen, Yang Jiao, Chao Han, Ying Li, Wei Zou & Jing Liu

  3. Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China

    Yang Jiao

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All authors contributed to the manuscript. Conceptualization: Jing Liu and Wei Zou; writing—original draft preparation: Shuna Chen and Yang Jiao; writing—review and editing: Shuna Chen and Yang Jiao; visualization: Chao Han and Ying Li; supervision: Jing Liu and Wei Zou. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Chen, S., Jiao, Y., Han, C. et al. Drug-Resistant Epilepsy and Gut-Brain Axis: an Overview of a New Strategy for Treatment. Mol Neurobiol (2023). https://doi.org/10.1007/s12035-023-03757-2

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