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Effects of a ketogenic diet on ADHD-like behavior in dogs with idiopathic epilepsy

Published:January 07, 2016DOI:https://doi.org/10.1016/j.yebeh.2015.11.014

      Highlights

      • Attention-deficit/hyperactivity disorder is a common comorbidity of epilepsy.
      • We observed ADHD-like behaviors in dogs with naturally occurring epilepsy.
      • Hyperactivity, excitability, and distractibility were high in these dogs.
      • A medium chain triglyceride diet (MCTD) reduced some ADHD-like behaviors.
      • Stranger-directed fear lowered on the MCTD, a potential anxiolytic effect.

      Abstract

      Objectives

      Epilepsy in humans and rodent models of epilepsy can be associated with behavioral comorbidities including an increased prevalence of attention-deficit/hyperactivity disorder (ADHD). Attention-deficit/hyperactivity disorder symptoms and seizure frequency have been successfully reduced in humans and rodents using a ketogenic diet (KD). The aims of this study were (i) to describe the behavioral profile of dogs with idiopathic epilepsy (IE) while on a standardized nonketogenic placebo diet, to determine whether ADHD-like behaviors are present, and (ii) to examine the effect of a ketogenic medium chain triglyceride diet (MCTD) on the behavioral profile of dogs with idiopathic epilepsy (IE) compared with the standardized placebo control diet, including ADHD-like behaviors.

      Methods

      A 6-month prospective, randomized, double-blinded, placebo-controlled, crossover dietary trial comparing the effects of the MCTD with a standardized placebo diet on canine behavior was carried out. Dogs diagnosed with IE, with a seizure frequency of at least 3 seizures in the past 3 months (n = 21), were fed the MCTD or placebo diet for 3 months and were then switched to the alternative diet for 3 months. Owners completed a validated behavioral questionnaire to measure 11 defined behavioral factors at the end of each diet period to report their dogs' behavior, with three specific behaviors hypothesized to be related to ADHD: excitability, chasing, and trainability.

      Results

      The highest scoring behavioral factors in the placebo and MCTD periods were excitability (mean ± SE: 1.910 ± 0.127) and chasing (mean ± SE: 1.824 ± 0.210). A markedly lower trainability score (mean ± SE: 0.437 ± 0.125) than that of previously studied canine populations was observed. The MCTD resulted in a significant improvement in the ADHD-related behavioral factor chasing and a reduction in stranger-directed fear (p < 0.05) compared with the placebo diet. The latter effect may be attributed to previously described anxiolytic effects of a KD.

      Conclusions

      These data support the supposition that dogs with IE may exhibit behaviors that resemble ADHD symptoms seen in humans and rodent models of epilepsy and that a MCTD may be able to improve some of these behaviors, along with potentially anxiolytic effects.

      Abbreviations:

      ADHD (attention-deficit/hyperactivity disorder), AED (antiepileptic drug), AKC (American Kennel Club), BHB (β-hydroxybutyrate), C-BARQ (Canine Behavioral Assessment and Research Questionnaire), CPRS-R (Conners' Parent Rating Scale — Revised), IE (idiopathic epilepsy), KD (ketogenic diet), MCTD (medium chain triglyceride diet), MRI (magnetic resonance imaging), QoL (quality of life)

      Keywords

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