Laboratory of Psychiatric Neuroscience, Centre for Molecular Discovery, Australian Institute of Tropical Health and Medicine (AITHM), Australia; Discipline of Biomedicine, College of Public Health, Medicine and Veterinary Science, James Cook University, Townsville, Queensland, Australia.
Laboratory of Psychiatric Neuroscience, Centre for Molecular Discovery, Australian Institute of Tropical Health and Medicine (AITHM), Australia; Discipline of Biomedicine, College of Public Health, Medicine and Veterinary Science, James Cook University, Townsville, Queensland, Australia.
Prog Neuropsychopharmacol Biol Psychiatry. 2020 Jul 13;101:109913. doi: 10.1016/j.pnpbp.2020.109913. Epub 2020 Mar 6.
Ketogenic diet is a low carbohydrate and high fat diet that has been used for over 100 years in the management of childhood refractory epilepsy. More recently, ketogenic diet has been investigated for a number of metabolic, neurodegenerative and neurodevelopmental disorders. In this comprehensive review, we critically examine the potential therapeutic benefits of ketogenic diet and ketogenic agents on neurodegenerative and psychiatric disorders in humans and translationally valid animal models. The preclinical literature provides strong support for the efficacy of ketogenic diet in a variety of diverse animal models of neuropsychiatric disorders. However, the evidence from clinical studies, while encouraging, particularly in Alzheimer's disease, psychotic and autism spectrum disorders, is limited to case studies and small pilot trials. Firm conclusion on the efficacy of ketogenic diet in psychiatric disorders cannot be drawn due to the lack of randomised, controlled clinical trials. The potential mechanisms of action of ketogenic therapy in these disorders with diverse pathophysiology may include energy metabolism, oxidative stress and immune/inflammatory processes. In conclusion, while ketogenic diet and ketogenic substances hold promise pre-clinically in a variety of neurodegenerative and psychiatric disorders, further studies, particularly randomised controlled clinical trials, are warranted to better understand their clinical efficacy and potential side effects.
生酮饮食是一种低碳水化合物、高脂肪的饮食，在儿童难治性癫痫的治疗中已经使用了 100 多年。最近，生酮饮食也被用于研究多种代谢、神经退行性和神经发育障碍。在这篇全面的综述中，我们批判性地评估了生酮饮食和生酮剂对人类神经退行性和精神疾病以及具有转化意义的动物模型的潜在治疗益处。临床前文献为各种不同的神经精神疾病动物模型中生酮饮食的疗效提供了强有力的支持。然而，来自临床研究的证据虽然令人鼓舞，特别是在阿尔茨海默病、精神病和自闭症谱系障碍方面，但仅限于病例研究和小型试点试验。由于缺乏随机对照临床试验，因此无法确定生酮饮食对精神疾病的疗效。生酮治疗在这些具有不同病理生理学的疾病中的潜在作用机制可能包括能量代谢、氧化应激和免疫/炎症过程。总之，虽然生酮饮食和生酮物质在各种神经退行性和精神疾病的临床前研究中具有潜力，但需要进一步的研究，特别是随机对照临床试验，以更好地了解其临床疗效和潜在副作用。
