Epilepsy & Behavior 17 (2010) 304
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Epilepsy & Behavior
journal homepage: www.elsevier.com/locate/yebeh
Letter to the Editor
Did Vincent van Gogh eat fish?
In our experience, it is very common for lecturers on epilepsy to
begin their talks with a slide that lists a large number of famous
individuals who are said to have had epilepsy [1]. Curiously, this
information often shocks the audience and does get their attention
because so many famous people are mentioned [1]. One example is
the ‘‘tragic life” of Vincent van Gogh. An interesting study, recently
published, clearly demonstrated that Vincent van Gogh never had
a generalized tonic–clonic seizure [2]. Furthermore, as epilepsy is a
diagnosis that requires spontaneous seizures, it was also con-
cluded that van Gogh did not have epilepsy of any type [2]. Before
he began to drink heavily, when he was near starvation, he had
‘‘fainting fits,” and after drinking, especially absinthe (a convulsant
drug), he continued to have ‘‘seizure-like” episodes [2]. Thus, his
episodes of unconsciousness can be well explained by chronic mal-
nutrition and alcohol abuse, possibly exacerbated by drinking large
quantities of absinthe.
We believe that van Gogh’s tendencies toward extremely poor
nutrition can help us explain the facts of his life. Some of these
points became obvious from his countless letters to his brother,
Theo van Gogh, an art dealer in Paris. The majority of Vincent’s let-
ters to Theo catalog his illnesses and also his hunger. For example,
Vincent told Theo in 1883: ‘‘The day passed like a dream, I had
been so immersed in that heart-rending music all day that I had lit-
erally forgotten to eat and drink—I had had a slice of black bread
and a cup of coffee in the little inn” [3]. Many of van Gogh’s letters
suggest that his near-chronic state of starvation affected him more
than has been recognized, and to our surprise, in his letters no
comments can be found about regular consumption of fish, a very
common type of food in that period.
This raises an interesting question: How could a fish-containing
diet have helped Vincent van Gogh? As we know, omega-3 fatty
acids (from fatty fish in the human diet) appear to have significant
effects on the structure, biochemistry, physiology and thus func-
tion of the brain [4,5]. In fact, the brain is one of the organs with
the highest levels of lipids (fats). Brain lipids, composed of fatty
acids, participate in the structure of membranes. For example,
50% of fatty acids are polyunsaturated in the gray matter; one-
third are of the omega-3 family and are, thus, of dietary origin
[6]. In humans, intake of omega-3 fatty acids, commonly found
in fish and fish oil, not only contributes to central nervous system
(CNS) development, but also plays a role in achieving optimal
health and in protecting against certain adult-onset CNS diseases
[6]. With respect to CNS disorders, especially epilepsy, omega-3
supplementation has an important role. The results of a random-
ized trial of omega-3 supplementation in patients with chronic
epilepsy were encouraging, demonstrating a transient effect on
seizure control that was not confirmed by other research groups,
but additional trials are required [7,8]. Although these results did
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doi:10.1016/j.yebeh.2009.11.009
not completely confirm that omega-3 fatty acid supplementation
reduces the frequency of epileptic seizures in patients with refrac-
tory epilepsy, they did establish the safety of omega-3 supplemen-
tation in people with epilepsy [8]. Using the pilocarpine model of
epilepsy, a valuable tool to study the pathogenesis of temporal
lobe epilepsy in humans, our research group was the first to dem-
onstrate that chronic treatment with omega-3 fatty acids promotes
neuroprotection and positive plastic changes in the brains of rats
with epilepsy [9]. Van Gogh’s nutrition stimulated us to describe
here the positive health effects of fish consumption by people with
refractory epilepsy. Most of all, we are quite convinced that ome-
ga-3 fatty acids are useful in the prevention and treatment of
epilepsy.
References
[1] Hughes JR. Did all those famous people really have epilepsy? Epilepsy Behav
2005;6:115–39.
[2] Hughes JR. A reappraisal of the possible seizures of Vincent van Gogh. Epilepsy
Behav 2005;6:504–10.
[3] Letter from Vincent van Gogh to Theo van Gogh, 02 November 1883. Available
from: http://webexhibits.org/vangogh [accessed November 2009].
[4] Bourre JM. Effects of nutrients (in food) on the structure and function of the
nervous system: update on dietary requirements for brain. Part 2.
Macronutrients. J Nutr Health Aging 2006;10:386–99.
[5] Bourre JM. Dietary omega-3 Fatty acids and psychiatry: mood, behaviour,
stress, depression, dementia and aging. J Nutr Health Aging 2005;9:31–8.
[6] Bourre JM. Omega-3 fatty acids in psychiatry. Med Sci 2005;21:216–21.
[7] Yuen AW, Sander JW, Fluegel D, et al. Omega-3 fatty acid supplementation in
patients with chronic epilepsy: a randomized trial. Epilepsy Behav
2005;7:253–8.
[8] DeGiorgio CM, Miller P. n-3 fatty acids (eicosapentanoic and docosahexanoic
acids) in epilepsy and for the prevention of sudden unexpected death in
epilepsy. Epilepsy Behav 2008;13:712–3.
[9] Ferrari D, Cysneiros RM, Scorza CA, et al. Neuroprotective activity of omega-3
fatty acids against epilepsy-induced hippocampal damage: quantification with
immunohistochemical for calcium-binding proteins. Epilepsy Behav
2008;13:36–42.
Fulvio A. Scorza *
Esper A. Cavalheiro
Disciplina de Neurologia Experimental,
Universidade Federal de São Paulo/Escola Paulista de Medicina
(UNIFESP/EPM), São Paulo, Brazil
*
Fax: +55 11 55739304 (F.A. Scorza).
E-mail address: scorza.nexp@epm.br (F.A. Scorza)
Ricardo M. Arida
Departamento de Fisiologia, UNIFESP/EPM, São Paulo, Brazil
John R. Hughes
Department of Neurology, University of Illinois Medical Center,
Chicago, IL, USA
Available online 29 December 2009