Can a Ketogenic Diet Reduce Concussion-Related Brain Damage?

A ketogenic diet (KD) appears to be a promising therapeutic strategy for treating the symptoms of mild traumatic brain injury (mTBI), suggest early research.

The results of a study in mice showed that a high-fat, low-carbohydrate diet, which induces fat metabolism and ketone production, was associated with a reduction in cognitive impairment, neuronal loss, and induced neuroinflammation. for TBI.

“Our results suggest that KD may be a vital treatment modality,” write Meirav Har-Even Kerzhner, a registered doctoral student in dietetics, Sackler School of Medicine, Tel Aviv University, Israel, and colleagues.

Researchers report that they plan to perform a similar study in humans with TBI.

The findings were published online December 7 a Scientific reports.

No proven treatment

Military injuries, traffic accidents, falls, assaults and sports injuries are the most common causes of TBI.

An estimated 2.8 million people in the United States receive medical care each year for a TBI, mostly as a result of traffic accidents, falls, assaults, and sports injuries. Mild TCEs account for between 80% and 95% of these cases. They are difficult to diagnose because routine tests, including imaging, show no changes in brain structure.

Patients with TBI may experience behavioral, emotional, and cognitive impairment that could include memory and concentration deficits, poor executive function, depression, and anxiety. Brain trauma is also a risk factor for diseases such as Alzheimer’s disease (AD) i Parkinson’s disease (PD). There is currently no proven effective treatment for TCE.

The ketogenic diet induces ketosis, a metabolic state in which the body uses ketone bodies as energy instead of glucose, and causes a state of fasting.

The diet has been used for years in patients with resistant epilepsy, but recent studies have explored its benefit in other neurological disorders, such as Parkinson’s and Alzheimer’s disease.

Previous research suggests that a ketogenic diet may induce anti-inflammatory effects, improve ischemic tolerance of the brain, and reduce activated microglial expression. There are also indications that the diet is neuroprotective, possibly due to altered SIRT1 expression.

Researchers point out that SIRT1 is involved in the development of the hippocampus and in various physiological processes, such as the response to oxidative stress, genetic silencing, genome stability, and the extension of cell life.

“SIRT1 is a very important protein throughout the body, but especially in the brain because it plays a very important role in cellular aging,” said Har-Even Kerzhner. Medscape medical news.

Improved symptoms

The researchers used four groups of adult male mice for the experiments. In two groups with mTBI, some mice were fed the keto diet and others a standard diet. Two injury-free simulated control groups were fed a keto diet or a standard diet.

The ketogenic diet consisted of 90.5% fat, 9.2% protein and 0.3% carbohydrate, while the standard diet consisted of 10.1% protein, a 77.4% carbohydrates and 12.5% ​​fats. All mice were tracked for up to 30 days.

To simulate an mTBI, mice were struck on the right temporal side of the head between the ear and the corner of the eye.

“This model has been chosen because it simulates traumatic head injuries such as traffic accidents or falls, as it imposes a diffuse and nonspecific injury,” the researchers write.

Compared with the lesion-free control mice, those with TBI had decreased visual and spatial memory and elevated levels of astrocytes and other markers of brain neuroinflammation.

The researchers also performed a series of cognitive and cellular tests to measure the effects of the keto diet. They found that diet improved cognitive deficits in spatial and visual memory, as well as cellular changes in neurons and injury-induced glial cells.

To better understand the molecular effects of diet and TBI, the researchers also evaluated SIRT1 levels in two regions of the brain that play a crucial role in memory formation: the cortex and the hippocampus.

TBI reduced SIRT1 levels in the cortex and hippocampus 30 days after the injury, which was improved with the keto diet. This, the researchers point out, suggests a potential mechanism that contributes to cognitive impairment and the improvement of cognitive symptoms when given this type of diet.

Researchers are now planning a clinical study in human patients with TBI. Because the diet is extremely restrictive, the study will include consultations with registered dietitians, Har-Even Kerzhner said.

The plan is to assess cognitive outcomes with standardized tests such as the Mini Mental State Exam and the Montreal Cognitive Assessment, as well as brain activity with EEG exams at 1 month and maybe 3 months after the start of the diet. , added.

The study was funded by the Ari and Regine Aprijaskis Fund, the Dr. Miriam and Sheldon G. Adelson for Addictive Disease Biology and the Sylvan Adams Sports Institute. Researchers have not reported any relevant financial reports.

Science Rep. Published online December 7, 2021. Full article

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https://www.medscape.com/viewarticle/967213

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