Ketone bodies in epilepsy

Abstract

Seizures that are resistant to standard medications remain a major clinical problem. One underutilized option for patients with medication-resistant seizures is the high-fat, low-carbohydrate ketogenic diet. The diet received its name based on the observation that patients consuming this diet produce ketone bodies (e.g., acetoacetate, β-hydroxybutyrate, and acetone). Although the exact mechanisms of the diet are unknown, ketone bodies have been hypothesized to contribute to the anticonvulsant and antiepileptic effects. In this review, anticonvulsant properties of ketone bodies and the ketogenic diet are discussed (including GABAergic and glutamatergic effects). Because of the importance of ketone body metabolism in the early stages of life, the effects of ketone bodies on developing neurons in vitro also are discussed. Understanding how ketone bodies exert their effects will help optimize their use in treating epilepsy and other neurological disorders.

Challenging Oneself Intermittently to Improve Health

“…Ketone bodies have beneficial effects on cells that can counteract disease processes. For example, ketones protect neurons against dysfunction and degeneration in experimental models of epilepsy (McNally and Hartman, 2012) and Alzheimer's disease (Kashiwaya et al, 2013). In addition to being used as an energy source, ketone bodies can modulate signaling pathways and gene expression by, for example, inhibiting certain histone deacetylases (Newman and Verdin, 2014).…”

Food science: Fat chance

“…During fasting, and in people with diabetes, the liver metabolizes fatty acids into ketone bodies called β-hydroxybutyrate, acetoacetic acid and acetone that are used as an energy source when glucose levels are low. No one knows exactly why, but some evidence suggests that ketone bodies might protect against seizures 1 . A low-carbohydrate, high-fat diet creates the state of ketosis -the raised level of ketone bodies, from which the diet gets its name.…”

Ketogenic food pyramid for patients with refractory epilepsy: From theory to clinical practice

“…The importance of macronutrient intake control is directly related to the mechanisms of action of the KD. According to McNally & Hartman 14 , these mechanisms are associated with the ketone body production from fatty acid oxidation.…”