Brain-Gut-Epilepsy Link

This is exciting, folks! It has been well established that comorbidities such as anxiety, ADHD and fear-behavior are present for human and veterinary epileptics. Owners of dogs with epilepsy are frequently troubled by behavioral changes AND the seizures, especially when poorly controlled. Recently, the gut biome has been an area of focus as an area of possible therapeutics for these comorbidities in humans and animals. A group of colleagues from Europe and Asia recently published data looking into this question and... it’s pretty cool! Read on to learn what they learned. 

Material and Methods
Nine dogs with drug resistant epilepsy AND behavioral changes were included in the study. A fecal donor was a dog with epilepsy that did not have behavioral comorbidities and had responded well to phenobarbital. Fecal microbiota transplantation (FMT) was performed three times, two weeks apart. Questionnaires and behavioral tests were performed at 3 and 6 months after the FMT. This, along with urine testing of neurotransmitter concentrations and routine biochemistry and hematology. 

Results
There was a significant improvement in ADHD-like impulsivity, non-social fear and chasing behavior (questionnaire based), AND seizure severity and frequency. Not surprisingly, the care-giver anxiety concurrently decreased significantly. Even more interesting (to me), the excitatory neurotransmitters glutamate and aspartate decreased and GABA, an inhibitory neurotransmitter, increased. Only 1 dog had a partial seizure response (50% reduction in seizures), and several other dogs had a reduction in cluster days during the follow-up period. No dog was seizure-free after the FMT. 

Take Home Message
This was a pilot study, so it isn't clinically applicable yet. YET. But can you imagine having access to FMT to help manage comorbidities like these? I'm sure you can think of at least 1-2 patients right now that would benefit from a decrease in ADHD-like behavior, fear or anxiety behaviors! Although we cannot use this yet to change our patient's lives, keep your ears open for the future. However, as with all new treatments out there, there will be good and bad options as this comes out. Remember that there are a lot of factors that can affect FMT. Specifically, current or historic administration of medications (antibiotics, gastroprotection’s, NSAIDs, and possibly anticonvulsants). A donor with any of these medications in their past may have an altered gut biome that makes them an unfit donor for your specific patient. So, please don't just take any gut biome and assume it will work for another patient!

Thanks for reading. I hope you can feel my excitement oozing out as you read this week, and I hope you enjoyed reading this TidBit Tuesday as much as I enjoyed reading the article. If you wish to read more, please follow the link below. Have a great week!
Link: doi.org/10.3389/fvets.2024.1385469