Emerging roles for the intestinal microbiome in epilepsy

• Published in: Neurobiology of disease Vol. 135; p. 104576
• Main Authors: Lum, Gregory R., Olson, Christine A., Hsiao, Elaine Y.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2020; Elsevier
• Subjects: Animals; Diet, Ketogenic; Drug Resistant Epilepsy - etiology; Drug Resistant Epilepsy - microbiology; Epilepsy - etiology; Epilepsy - microbiology; Gastrointestinal Microbiome - physiology; Humans; Role; Seizures - complications
• ISSN: 0969-9961; 1095-953X
• DOI: 10.1016/j.nbd.2019.104576

The gut microbiome is emerging as a key regulator of brain function and behavior and is associated with symptoms of several neurological disorders. There is emerging evidence that alterations in the gut microbiota are seen in epilepsy and in response to seizure interventions. In this review, we highlight recent studies reporting that individuals with refractory epilepsy exhibit altered composition of the gut microbiota. We further discuss antibiotic treatment and infection as microbiome-related factors that influence seizure susceptibility in humans and animal models. In addition, we evaluate how the microbiome may mediate effects of the ketogenic diet, probiotic treatment, and anti-epileptic drugs on reducing both seizure frequency and severity. Finally, we assess the open questions in interrogating roles for the microbiome in epilepsy and address the prospect that continued research may uncover fundamental insights for understanding risk factors for epilepsy, as well as novel approaches for treating refractory epilepsy.