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New insights into the mechanisms of the ketogenic diet.

Abstract High-fat, low-carbohydrate ketogenic diets have been used for almost a century for the treatment of epilepsy. Used traditionally for the treatment of refractory pediatric epilepsies, in recent years the use of ketogenic diets has experienced a revival to include the treatment of adulthood epilepsies as well as conditions ranging from autism to chronic pain and cancer. Despite the ability of ketogenic diet therapy to suppress seizures refractory to antiepileptic drugs and reports of lasting seizure freedom, the underlying mechanisms are poorly understood. This review explores new insights into mechanisms mobilized by ketogenic diet therapies.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title current opinion in neurology
Publication Year Start




PMID- 28141738
OWN - NLM
STAT- In-Process
LR  - 20171212
IS  - 1473-6551 (Electronic)
IS  - 1350-7540 (Linking)
VI  - 30
IP  - 2
DP  - 2017 Apr
TI  - New insights into the mechanisms of the ketogenic diet.
PG  - 187-192
LID - 10.1097/WCO.0000000000000432 [doi]
AB  - PURPOSE OF REVIEW: High-fat, low-carbohydrate ketogenic diets have been used for 
      almost a century for the treatment of epilepsy. Used traditionally for the
      treatment of refractory pediatric epilepsies, in recent years the use of
      ketogenic diets has experienced a revival to include the treatment of adulthood
      epilepsies as well as conditions ranging from autism to chronic pain and cancer. 
      Despite the ability of ketogenic diet therapy to suppress seizures refractory to 
      antiepileptic drugs and reports of lasting seizure freedom, the underlying
      mechanisms are poorly understood. This review explores new insights into
      mechanisms mobilized by ketogenic diet therapies. RECENT FINDINGS: Ketogenic
      diets act through a combination of mechanisms, which are linked to the effects of
      ketones and glucose restriction, and to interactions with receptors, channels,
      and metabolic enzymes. Decanoic acid, a component of medium-chain triclycerides, 
      contributes to seizure control through direct
      alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor
      inhibition, whereas drugs targeting lactate dehydrogenase reduce seizures through
      inhibition of a metabolic pathway. Ketogenic diet therapy also affects DNA
      methylation, a novel epigenetic mechanism of the diet. SUMMARY: Ketogenic diet
      therapy combines several beneficial mechanisms that provide broad benefits for
      the treatment of epilepsy with the potential to not only suppress seizures but
      also to modify the course of the epilepsy.
FAU - Boison, Detlev
AU  - Boison D
AD  - Robert Stone Dow Neurobiology Laboratories, Legacy Research Institute, Portland, 
      Oregon, USA.
LA  - eng
GR  - R01 NS065957/NS/NINDS NIH HHS/United States
GR  - R01 NS084920/NS/NINDS NIH HHS/United States
GR  - R21 NS088024/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, N.I.H., Extramural
PL  - England
TA  - Curr Opin Neurol
JT  - Current opinion in neurology
JID - 9319162
PMC - PMC5409832
MID - NIHMS856759
EDAT- 2017/02/01 06:00
MHDA- 2017/02/01 06:00
CRDT- 2017/02/01 06:00
PMCR- 2018/04/01 00:00
PHST- 2018/04/01 00:00 [pmc-release]
PHST- 2017/02/01 06:00 [pubmed]
PHST- 2017/02/01 06:00 [medline]
PHST- 2017/02/01 06:00 [entrez]
AID - 10.1097/WCO.0000000000000432 [doi]
PST - ppublish
SO  - Curr Opin Neurol. 2017 Apr;30(2):187-192. doi: 10.1097/WCO.0000000000000432.