A ketogenic diet normalizes interictal cortical but not subcortical responsivity in migraineurs.
Adult
Blinking
/ physiology
Brain Stem
/ physiopathology
Case-Control Studies
Cerebral Cortex
/ physiopathology
Diet, Ketogenic
Evoked Potentials
/ physiology
Female
Habituation, Psychophysiologic
/ physiology
Humans
Male
Migraine Disorders
/ physiopathology
Pain
/ physiopathology
Retrospective Studies
Trigeminal Nerve
Habituation
Ketogenesis
Ketogenic diet
Migraine
Nociceptive blink reflex
Pain-related evoked potentials
Journal
BMC neurology
ISSN: 1471-2377
Titre abrégé: BMC Neurol
Pays: England
ID NLM: 100968555
Informations de publication
Date de publication:
22 Jun 2019
22 Jun 2019
Historique:
received:
20
11
2018
accepted:
31
05
2019
entrez:
24
6
2019
pubmed:
24
6
2019
medline:
3
8
2019
Statut:
epublish
Résumé
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. 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. Following 1-month on KD, the mean number of attacks and headache duration reduced significantly. Moreover, KD significantly normalized the interictal PREP habituation (pre: + 1.8, post: - 9.1, p = 0.012), while nBR deficit of habituation did not change. 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. ClinicalTrials.gov NCT03775252 (retrospectively registered, December 09, 2018).
Sections du résumé
BACKGROUND
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
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
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: + 1.8, post: - 9.1, p = 0.012), while nBR deficit of habituation did not change.
CONCLUSIONS
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
BACKGROUND
ClinicalTrials.gov NCT03775252 (retrospectively registered, December 09, 2018).
Identifiants
pubmed: 31228957
doi: 10.1186/s12883-019-1351-1
pii: 10.1186/s12883-019-1351-1
pmc: PMC6588932
doi:
Banques de données
ClinicalTrials.gov
['NCT03775252']
Types de publication
Journal Article
Langues
eng
Pagination
136Références
Neurophysiol Clin. 1999 Feb;29(1):7-38
pubmed: 10093816
Headache. 2000 Jan;40(1):30-5
pubmed: 10759900
Cephalalgia. 2000 Jul;20(6):525-32
pubmed: 11075834
J Biol Chem. 2002 Aug 23;277(34):30409-12
pubmed: 12087111
Magn Reson Med. 2003 Apr;49(4):615-9
pubmed: 12652530
Cephalalgia. 2005 Jul;25(7):493-506
pubmed: 15955036
Cephalalgia. 2005 Jul;25(7):507-18
pubmed: 15955037
Cephalalgia. 2005 Aug;25(8):593-7
pubmed: 16033384
Neurology. 1992 Jun;42(6):1209-14
pubmed: 1603349
J Headache Pain. 2005 Sep;6(4):195-8
pubmed: 16362662
Headache. 2006 Jan;46(1):182
pubmed: 16412174
Neurochem Int. 2006 May-Jun;48(6-7):498-507
pubmed: 16542760
Ann Neurol. 2006 Aug;60(2):223-35
pubmed: 16807920
Neurology. 2006 Jul 25;67(2):252-7
pubmed: 16864817
Cephalalgia. 2006 Sep;26(9):1106-14
pubmed: 16919061
Neuroscience. 2007 Mar 2;145(1):256-64
pubmed: 17240074
Brain. 2007 Mar;130(Pt 3):765-70
pubmed: 17251239
Epilepsia. 2007 Sep;48(9):1756-1763
pubmed: 17561954
Anesth Analg. 2007 Sep;105(3):673-9
pubmed: 17717222
Neurology. 2007 Aug 28;69(9):835-41
pubmed: 17724285
Headache. 2007 Nov-Dec;47(10):1436-42
pubmed: 18052953
Exp Neurol. 2008 Apr;210(2):449-57
pubmed: 18199435
Neurosci Lett. 2008 Sep 12;442(2):81-5
pubmed: 18620023
Complement Ther Med. 2008 Aug;16(4):220-7
pubmed: 18638713
Int J Neuropsychopharmacol. 2009 Apr;12(3):357-70
pubmed: 18771605
Epilepsia. 2008 Nov;49 Suppl 8:91-3
pubmed: 19049599
Brain Res. 2009 May 1;1268:17-23
pubmed: 19285044
Neurology. 2009 May 5;72(18):1588-94
pubmed: 19414726
Neuroimage. 2009 May 15;46(1):193-200
pubmed: 19457385
J Neurochem. 2010 Jul;114(1):130-41
pubmed: 20374433
J Headache Pain. 2010 Dec;11(6):505-12
pubmed: 20714776
Clin Neurophysiol. 2011 Dec;122(12):2482-7
pubmed: 21641860
Curr Opin Neurol. 2012 Apr;25(2):173-8
pubmed: 22322415
Neurophysiol Clin. 2012 Jun;42(4):199-206
pubmed: 22632868
J Pain. 2012 Sep;13(9):866-73
pubmed: 22901763
Cephalalgia. 2012 Dec;32(16):1189-97
pubmed: 23053304
J Headache Pain. 2013 Mar 12;14:25
pubmed: 23566208
Biol Psychol. 2013 Jul;93(3):373-6
pubmed: 23607998
Cephalalgia. 2013 Nov;33(15):1272-6
pubmed: 23709498
Continuum (Minneap Minn). 2013 Jun;19(3 Epilepsy):756-66
pubmed: 23739109
Neurochem Int. 2013 Oct;63(4):244-58
pubmed: 23838211
J Headache Pain. 2013 Jul 30;14:65
pubmed: 23899115
Trends Neurosci. 2013 Oct;36(10):587-97
pubmed: 23968694
Eur J Neurosci. 2014 Feb;39(3):501-7
pubmed: 24494688
Headache. 2014 Feb;54(2):219-34
pubmed: 24512574
Funct Neurol. 2013 Oct-Dec;28(4):305-8
pubmed: 24598400
Epilepsia. 2014 May;55(5):e44-9
pubmed: 24702645
Eur J Neurol. 2015 Jan;22(1):170-7
pubmed: 25156013
J Lipid Res. 2014 Nov;55(11):2254-60
pubmed: 25170119
Cephalalgia. 2015 Jun;35(7):600-7
pubmed: 25228682
Physiol Rep. 2015 May;3(5):null
pubmed: 26009636
Lancet Neurol. 2015 Oct;14(10):1010-22
pubmed: 26376968
Cephalalgia. 2016 Oct;36(12):1103-1111
pubmed: 26637237
Physiol Behav. 1989 Mar;45(3):571-7
pubmed: 2667005
Neurosci Lett. 2016 Jul 28;626:149-57
pubmed: 27208831
J Headache Pain. 2016;17:58
pubmed: 27245682
J Headache Pain. 2016 Dec;17(1):104
pubmed: 27844455
Neurochem Int. 2018 Jul;117:114-125
pubmed: 28579059
Cephalalgia. 1986 Dec;6(4):229-33
pubmed: 2879628
Cephalalgia. 1986;6 Suppl 5:47-54
pubmed: 2879632
PLoS One. 2017 Oct 9;12(10):e0184406
pubmed: 28991914
J Headache Pain. 2017 Dec 19;18(1):116
pubmed: 29285569
Front Neurol. 2018 Feb 12;9:64
pubmed: 29483892
Headache. 2018 Nov;58 Suppl 3:238-275
pubmed: 30242830
Acta Neurol Scand. 1984 Jan;69(1):9-14
pubmed: 6608203
FASEB J. 1995 May;9(8):651-8
pubmed: 7768357
J Neurochem. 1996 Dec;67(6):2325-34
pubmed: 8931464