Abstract
In vivo and in vitro studies show that the ketogenic diet (KD) has effects on cerebral metabolism. These changes act in concert to raise brain energy reserves and may contribute to the anticonvulsant action of the diet. In contrast to the sedative effects of many antiepileptic medications, the biochemical changes induced by the KD serve to enhance brain function. However, the precise mechanisms through which higher cerebral energy reserves reduce seizure activity are unknown. We speculate that failure to meet energy needs contributes to the cellular processes involved in the generation, spread, and maintenance of epileptic activity. We further speculate that the KD ameliorates these deficiencies by bypassing less efficient cytosolic glycolytic pathways and maximizing tricarboxylic acid (TCA) cycle function.
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References
Robinson AM, Williamson DH. Physiological roles of ketone bodies as substrates and signals in mammalian tissues. Physiol Rev 1980;60:143–187.
McGarry JD, Mannaerts GP, Foster DW. A possible role for malonyl CoA in the regulation of hepatic fatty acid oxidation and ketogenesis. J Clin Invest 1977;60:265–270.
McGarry JD, Leatherman GF, Foster DW. Carnitine palmitoyltransferase: I. The site of inhibition of hepatic fatty acid oxidation by malonyl-CoA. J Biol Chem 1978;253:4128–4136.
Pan JW, Telang FW, Lee JH, de Graff RA, Rothma DL, Stein DT, Hetherington HP. Measurement of beta-hydroxybutyrate in acute hyperketonemia in human brain. J Neurochem 2001;79:539–544.
Cremer JE, Braun LD, Oldendorf WH. Changes during development in transport processes of the blood-brain barrier. Biochim Biophys Acta 1976;448:633–637.
Owen OE, Morgan AP, Kemp HG, Sullivan JM, Herrera MG, Cahill GF. Brain metabolism during fasting. J Clin Invest 1967;46:1589–1595.
Pan JW, de Graff RA, Rothman DL, Hetherington HP. 13C-[2,4]-β-hydroxybutyrate metabolism in human brain. J Neurochem 2002;81:45.
Fredericks M, Ramsey RB. 3-Oxo acid coenzyme A transferase activity in brain and tumors of the nervous stystem. J Neurochem 1978;31:1529–1531.
Appleton DB, De Vivo DC. An animal model for the ketogenic diet. Epilepsia 1974;15:211–227.
DeVivo DC, Leckie MP, Ferrendelli JS, McDougal DB. Chronic ketosis and cerebral metabolism. Ann Neurol 1978;3:331–337.
Wilder RM. Effects of ketonuria on the course of epilepsy. Mayo Clin Bull 1921;2:307–314.
Haymond MW, Howard C, Ben-Galim E, De Vivo DC. Effects of ketosis on glucose flux in children and adults. Am J Physiol 1983,245:E373–E378.
Lowry OH, Passonneau JV, Hasselberger FX, et al. Effect of ischemia on known substrate and co-factors of the glycolytic pathway in brain. J Biol Chem 1964:239:18–30.
Pan JW, Bebin EM, Chu WJ, Hetherington HP. Ketosis and epilepsy: 31P spectroscopic imaging at 4.1 T. Epilepsia 1999;40:703–707.
De Vivo DC, Leary L, Wang D. Glucose transporter 1 deficiency syndrome and other glycolytic defects. J Child Neurol 2002;17:3S15–S23.
Leary LD, Wang D, Nordli DR, Engelstad K, De Vivo DC. Seizure characterization and electroencephalographic features in glut-1 deficiency syndrome. Epilepsia. 2003 44:701–707.
Pascual JM, Van Heertum RL, Wang D, Engelstad K, De Vivo DC. Imaging the metabolic footprint of Glutl deficiency on the brain. Ann Neurol 2002;52:458–464.
Juhasz C, Chugani DC, Muzik O, Watson C, Shah J, Shah A, Chugani HT. Is epileptogenic cortex truly hypometabolic on interictal positron emission tomography? Ann Neurol 2000:48:88–96.
Nordli DR, De Vivo DC. The ketogenic diet revisited: back to the future. Epilepsia 1997;38:743–749.
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Nordli, D.R., De Vivo, D.C. (2004). Effects of the Ketogenic Diet on Cerebral Energy Metabolism. In: Stafstrom, C.E., Rho, J.M. (eds) Epilepsy and the Ketogenic Diet. Nutrition and Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-808-3_14
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DOI: https://doi.org/10.1007/978-1-59259-808-3_14
Publisher Name: Humana Press, Totowa, NJ
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Online ISBN: 978-1-59259-808-3
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