Ketogenic Dietary Therapies in Neurological Disorders

Dear Collegues,

Ketogenic dietary therapies (KDT) are established, effective nonpharmacologic treatments for intractable childhood epilepsy and some neurometabolic disorders. Today there are several ketogenic dietary therapies (KDTs) used in neurology: the classic ketogenic diet, the medium-chain triglyceride diet (MCT), the modified Atkins diet (MAD), and the low glycemic index treatment (LGIT).  In a few studies a very low calorie ketogenic diet (VLCKD)  has also been used. These dietary protocols differ greatly in their ketogenic potential and blood levels of ketosis. The mechanisms by which KDTs exert their antiseizure effects are likely multiple, may be different for various epilepsy conditions. There is a growing interest in using KDTs for several conditions other than epilepsy. KDTs may be efficacious in improving brain cancer survival and slowing progression. Ketogenesis may be a useful therapeutic strategy for migraines. In Alzheimer’s disease medium-chain triglyceride supplements have been shown to improve short-term cognitive performance in clinical studies. In autism, metabolic or mitochondrial dysfunction has been implicated as an underlying pathophysiology, with KDTs being used to target this dysfunction. Preclinical data suggest that KDTs may modulate immunity, reduce disease severity and promote remyelination in the mouse model of Multiple Sclerosis. Although KDTs use in several neurological conditions is promising, understanding mechanisms underlying its efficacy and larger studies are needed for these diverse disorders. While ketosis remain a feasible indicator of dietary compliance, its relationship with clinical efficacy has not been completely clarified.  This issue is aimed at collecting studies on a) emerging applications of KDTs in neurology and b) definition of the best dietary protocol and level of ketosis to implement in the different clinical conditions.

Prof. Dr. Anna Tagliabue
Dr. Cinzia Ferraris
Guest Editors

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