A ketogenic diet normalizes interictal cortical but not subcortical responsivity in migraineurs.

ABSTRACT: 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: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: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: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:ClinicalTrials.gov NCT03775252 (retrospectively registered, December 09, 2018).

SUBMITTER: Di Lorenzo C 

PROVIDER: S-EPMC6588932 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature