Lysine Restriction Therapy for PDE Outcomes

October 12, 2023

This article is based on a recent publication titled: Association Between Lysine Reduction Therapies and Cognitive Outcomes in Patients With Pyridoxine-Dependent Epilepsy. Please find the original article here:

While pyridoxine (a form of vitamin B6) has been the go-to treatment for controlling seizures in PDE, it often falls short in helping with overall cognitive development. Lysine restriction therapy (LRT) has long been suggested as a possible aid to B6, but no definitive information has been gathered. A recent study has shed light on how combining LRTs with pyridoxine can make a significant difference, especially if started early in life.

What the Study Says:

The study looked at 60 patients with PDE and examined how their cognitive abilities—things like learning, memory, and problem-solving—were affected by different treatments. The researchers compared the effects of pyridoxine alone to a combination of pyridoxine and LRTs.

The Good News:

The exciting part? For those who started the combined treatment of pyridoxine and LRTs in the first six months of life, there was a significant improvement in cognitive abilities. In simpler terms, starting this dual treatment early in life can make a big difference in mental development.

But What About Older Patients?

For those who started the treatment later, the study found a mild improvement in cognitive abilities when LRTs were added to pyridoxine. While the improvement wasn’t as dramatic as in younger patients, it’s still a step in the right direction.

What Are Lysine Reduction Therapies (LRTs)?

You might be wondering what LRTs are. In essence, LRTs are treatments aimed at reducing the levels of certain harmful substances in the brain that are believed to interfere with mental development. “These treatment strategies include a lysine-restricted diet, pharmacologic doses of arginine, which acts as a competitive inhibitor of lysine transport, and a combination of these 2 therapeutic strategies and pyridoxine referred to as triple therapy.”

Why This Matters

Until now, controlling seizures with pyridoxine was the main focus of treating PDE. However, many patients still faced challenges with cognitive development. This study shows that adding LRTs to the treatment plan can offer a more comprehensive approach to managing PDE, improving not just seizure control but also cognitive outcomes.

Final Thoughts

If you’re dealing with PDE, this study brings encouraging news. While more research is needed, the findings suggest that a combined treatment approach could offer a brighter future for patients, especially when started early in life. As always, consult with your healthcare provider for a treatment plan tailored to your needs.

If you would like to read more, “To date, 13 observational studies have reported the benefit of LRT” which are listed as reference 8, 19, 20, and 22-31 in the cited article.

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