Not. Only in epilepsy. 

thanks

Some limited but positive experience with exertional paroxysmal choreoathetosis due to mutations in glucose transporter (GLUT1). Difficult diet by the way, some prefer modified Atkins diet.

of Course, but also Atkins diet is an alternative kind of ketogenic diet.

I hope this is useful. For discussion, let's separate the topic into different categories. One category would be low-CHO diets that are within the ketogenic ratio and so when consistently followed promote moderate ketosis. For a stimulating discussion of the ketogenic ratio and using this to evaluate studies of diet effects, see -  Zilberter T. "Carbohydrate-biased control of energy metabolism: the darker side of the selfish brain." Front Neuroenergetics. 2011 Dec 20 PMID: 22194720. And also note that a search under "ketogenic diet" in clinicaltrials.gov yields 63 hits, most concern epilepsy, but also cancer, stroke, obesity, metabolic syndrome, Parkinson disease, brain injury are mentioned.

Another category would be methods of inducing moderate ketosis while generally leaving diet unaltered. Moderate ketosis could be promoted by regular ingestion of various ketone precursors such as medium-chain triglycerides, or related medium-length fatty acids (octanoic acid has been under study, though I haven't seen ketones mentioned in that work), or ketone salts (there is a US commercial supplement manufacturer who sells the mixed Na/K salts of beta-hydroxybutyrate), or ketone esters such as the beta-hydroxybutyrate butanediol monoester developed by Dr Richard Veech and Dr Kieran Clarke.

An example on this side would be the work done by Dr S. T. Henderson with caprylic triglyceride, administered to patients with probable Alzheimer's disease. Henderson ST, Poirier J "Pharmacogenetic analysis of the effects ofpolymorphisms in APOE, IDE and IL1B on a ketone body based therapeutic oncognition in mild to moderate Alzheimer's disease; a randomized, double-blind,placebo-controlled study." BMC Med Genet. 2011 Oct 12;12:137. doi:10.1186/1471-2350-12-137. PubMed PMID: 21992747.

http://www.ncbi.nlm.nih.gov/pubmed/22194720

http://www.ncbi.nlm.nih.gov/pubmed/21992747

thanks, your reply was very useful, in particular the references.

Trials on clinicaltrial are usually not very recent and never completed, thus we have difficulties to understand the real impact of ketogenesis on that disorders.

No ,no tengo experiencia en dieta cetogénica para trastornos neurológicos distintos a epilepsia o migraña.

I have followed 4 patients with chronic cluster headache who became headache free as long as they could maintain a strict Atkins diet. They monitored their urinary ketosis with test strips. They all found that the headaches returned when they stopped spilling ketones, improved when they got ketotic again. All three gave up on this management because it was too taxing to follow the diet protocol. All three have done much better now with Botox.

Dear Herbert, have you never considered to publish these case? We have a similar experience with some episodic patients. If you want, we can share our cases and arrange a case series of about 10 patients. Let me know if you are interested.

If you ever again have any patients you'd consider for a trial of a KD but the compliance is difficult, consider a method of inducing mild ketosis by use of MCT oil, or by using "Axona" (that's the specially formulated caprylic triglyceride referred to in my prior answer and a reference is there to Dr S T Henderson's work).  There are publications on the MCT-supplemented diet for epilepsy. (Liu YM, Wang HS. Medium-chain triglyceride ketogenic diet, an effective treatment for drug-resistant epilepsy and a comparison with other ketogenicdiets)

Although it's been said that hepatic ketone body synthesis is downregulated in the fed state, by the actions of insulin or increased cellular oxaloacetate which accepts the AcCoA produced by beta-oxidation, there have been reports of fairly stable moderate ketosis in patients on MCTs without dietary restriction. (Courchesne-Loyer A, Fortier M, Tremblay-Mercier J, Chouinard-Watkins R, Roy M,Nugent S, Castellano CA, Cunnane SC. Stimulation of mild, sustained ketonemia by medium-chain triacylglycerols in healthy humans: estimated potential contribution to brain energy metabolism). But what level of ketosis would be theraputic in such informal individual theraputic trials is of course not known until tried.

http://www.ncbi.nlm.nih.gov/pubmed/23274095

http://www.ncbi.nlm.nih.gov/pubmed/23515148

thanks for all these information, really usefull!

There are current investigators looking at the effect of ketogenic diets on the low metabolic rate presented in the brain of AD patients.  Kindly see the attached publications.

i hope this help

thanks

Hello Again

I also found very interesting articles about aging and Keto-diets, and huntintong's disease.  Please see attached documents.

thanks

sandra

Sandra, you are very kind!

Exactly. There are many published speculations, many pre-clinical observations, and some clinical observations that together suggest that the KD and/or moderate ketosis induced by some ketone precursor, has potential to help address neurodegenerative and metabolic pathologies. And I have wondered about some of our lagging pharmacotherapies for certain difficult pathologies - could these work more effectively in the biochemical milieau of the KD or ketosis?

Investigators and reviewers that have published useful material in this general area include RL Veech, JM Rho, M Maalouf, KJ Bough, SC Cunnane, SA Masino, CE Stafstrom, E Verdin, D D'Agostino, ST Henderson, A Paoli, SD Phinney, JS Volek, EC Westman, and others I apologize for omitting here.

The ketogenic diet effects could possibly be teased apart into overlapping acute and chronic effects of carbohydrate restriction (which likely shares effects with fasting and calorie restriction) and acute and chronic effects of the prominent metabolic result of the KD or use of ketone precursors, the ketone bodies, beta-hydroxybutyrate and acetoacetate.

The literature on beta-hydroxybutyrate itself is broad and interesting, with evidence of direct effects on energy metabolism as a fuel for oxidative metabolism, intracellular regulatory effects as a histone deacetylase inhibitor, intracellular regulatory effects on ChREBP transcription function and so carbohydrate metabolism, extracellular signaling effects as agonist for hydroxycarboxylic acid receptors GPR41 (sympathetic nervous system function etc) and GPR 109A (vascular effects, macrophage function etc).

The oxidative metabolism aspect was stated by Veech in 1995 as reduction of the mitochondrial NAD+/NADH couple with oxidation of the ubiquinone Q/QH2 couple. Such changes would be proximal to many cell activities, and by affecting cell redox potential and ROS signaling could have many proliferating secondary effects.

Sandra, I notice that you are from the University of South Florida.  I believe Dominic D'Agostino, also at that institution, has much background in this area and much experience with ketone precursors.

I'll close this up with an old and a new reference of interest. There are many. I hope others with interest will chime in on this thread so I can learn more.

http://www.ncbi.nlm.nih.gov/pubmed/7768357

http://www.ncbi.nlm.nih.gov/pubmed/24845831

Yes Dr Robert.  I know Dr D' Agostino.  You are right he has done some clever work in the fascinating field of ketogenic diets.  Thanks for your feedbacks, they demonstrate your passion in this field.  

Yours,

sandra