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.
| Original language | English |
|---|---|
| Article number | 136 |
| Journal | BMC Neurology |
| Volume | 19 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jun 22 2019 |
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Keywords
- Habituation
- Ketogenesis
- Ketogenic diet
- Migraine
- Nociceptive blink reflex
- Pain-related evoked potentials
ASJC Scopus subject areas
- Clinical Neurology
Cite this
A ketogenic diet normalizes interictal cortical but not subcortical responsivity in migraineurs. / Di Lorenzo, Cherubino; Coppola, Gianluca; Bracaglia, Martina; Di Lenola, Davide; Sirianni, Giulio; Rossi, Paolo; Di Lorenzo, Giorgio; Parisi, Vincenzo; Serrao, Mariano; Cervenka, MacKenzie C.; Pierelli, Francesco.
In: BMC Neurology, Vol. 19, No. 1, 136, 22.06.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A ketogenic diet normalizes interictal cortical but not subcortical responsivity in migraineurs
AU - Di Lorenzo, Cherubino
AU - Coppola, Gianluca
AU - Bracaglia, Martina
AU - Di Lenola, Davide
AU - Sirianni, Giulio
AU - Rossi, Paolo
AU - Di Lorenzo, Giorgio
AU - Parisi, Vincenzo
AU - Serrao, Mariano
AU - Cervenka, MacKenzie C.
AU - Pierelli, Francesco
PY - 2019/6/22
Y1 - 2019/6/22
N2 - 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.
AB - 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.
KW - Habituation
KW - Ketogenesis
KW - Ketogenic diet
KW - Migraine
KW - Nociceptive blink reflex
KW - Pain-related evoked potentials
UR - http://www.scopus.com/inward/record.url?scp=85067666518&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067666518&partnerID=8YFLogxK
U2 - 10.1186/s12883-019-1351-1
DO - 10.1186/s12883-019-1351-1
M3 - Article
AN - SCOPUS:85067666518
VL - 19
JO - BMC Neurology
JF - BMC Neurology
SN - 1471-2377
IS - 1
M1 - 136
ER -