Format

Send to

Choose Destination
BMC Neurol. 2019 Jun 22;19(1):136. doi: 10.1186/s12883-019-1351-1.

A ketogenic diet normalizes interictal cortical but not subcortical responsivity in migraineurs.

Author information

1
IRCCS - Fondazione Don Carlo Gnocchi, Milan, Italy. cherub@inwind.it.
2
Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University Rof Rome Polo Pontino, Latina, Italy.
3
Dietary Section, Associazione Eupraxia, Rome, Italy.
4
INI, Headache Clinic, Grottaferrata (RM), Italy.
5
Laboratory of Psychophysiology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
6
Research Unit of Neurophysiology of Vision and Neurophthalmology, IRCCS - Fondazione Bietti, Rome, Italy.
7
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, USA.
8
IRCCS - Neuromed, Pozzilli, IS, Italy.

Abstract

BACKGROUND:

A short ketogenic diet (KD) treatment can prevent migraine attacks and correct excessive cortical response. Here, we aim to prove if the KD-related changes of cortical excitability are primarily due to cerebral cortex activity or are modulated by the brainstem.

METHODS:

Through the stimulation of the right supraorbital division of the trigeminal nerve, we concurrently interictally recorded the nociceptive blink reflex (nBR) and the pain-related evoked potentials (PREP) in 18 migraineurs patients without aura before and after 1-month on KD, while in metabolic ketosis. nBR and PREP reflect distinct brain structures activation: the brainstem and the cerebral cortex respectively. We estimated nBR R2 component area-under-the-curve as well as PREP amplitude habituation as the slope pof the linear regression between the 1st and the 2nd block of 5 averaged responses.

RESULTS:

Following 1-month on KD, the mean number of attacks and headache duration reduced significantly. Moreover, KD significantly normalized the interictal PREP habituation (pre: +ā€‰1.8, post: -ā€‰9.1, pā€‰=ā€‰0.012), while nBR deficit of habituation did not change.

CONCLUSIONS:

The positive clinical effects we observed in a population of migraineurs by a 1-month KD treatment coexists with a normalization at the cortical level, not in the brainstem, of the typical interictal deficit of habituation. These findings suggest that the cerebral cortex may be the primary site of KD-related modulation.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT03775252 (retrospectively registered, December 09, 2018).

KEYWORDS:

Habituation; Ketogenesis; Ketogenic diet; Migraine; Nociceptive blink reflex; Pain-related evoked potentials

PMID:
31228957
PMCID:
PMC6588932
DOI:
10.1186/s12883-019-1351-1
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center