The Impact of Synbiotics on Drug-Resistant Epilepsy Treatment and Parental Burden of Caregivers

The gut microbiota of patients with drug-resistant epilepsy (DRE) differs from that of drug-sensitive patients and healthy individuals. It has been observed that synbiotics, a combination of probiotics and prebiotics can enhance the gut microbiome's bacterial equilibrium. The purpose of this study was to evaluate the impact of synbiotics on DRE therapy and the burden on caregivers.

This quasi-experimental study involved thirty children with DRE who were diagnosed by a pediatric neurologist and met the inclusion criteria during 2021-22. In addition to their anticonvulsant medications, infants received PediLact (5-15 drops per day) and children aged 2-15 years received KidiLact (one sachet per day) for eight weeks; both are synbiotics. The study assessed caregiver burden using the Zarit Caregiver Burden Interview, and it evaluated the frequency of epileptic seizures reported by mothers before and immediately after the one-month intervention.

The study's participants had a mean age of 8.6 years (SD: 3.4), with 60% being boys and 40% girls and the outcome of the study revealed the following:

• A statistically remarkable reduction was seen in caregiver burden, with the mean score decreasing from 34.20 (SD: 14.4) before the intervention to 30.26 (SD: 15.8) afterward. 
• Additionally, the mean frequency of seizures significantly decreased from 15.83 (SD: 12.9) prior to the intervention to 12.73 (SD: 12.8) afterward.
• Post-intervention results showed that seizure frequency ceased in two patients, decreased by 50% in six patients, increased only in one patient, and remained unaltered in 21 patients.

The findings concluded that synbiotics in patients with DRE are linked to reduced parental burden of caregivers and decreased seizure frequency.  However, there is a need for well-designed randomized clinical trial studies to obtain robust causal evidence and conclusions.

Source: Shariatmadari F, Motaghi A, Arjmand Shabestari A, Hashemi SM, Almasi-Hashiani A. The effect of synbiotics in the treatment of drug-resistant epilepsy and the parental burden of caregivers: a single-arm pretest-posttest trial. BMC Pediatr. 2024 Oct 17;24(1):666. doi: 10.1186/s12887-024-05134-x. PMID: 39415135; PMCID: PMC11483994.