Rush University, United States of America; Hauenstein Neuroscience Center, Trinity Health, United States of America.
Rush University, United States of America.
Appl Nurs Res. 2023 Dec;74:151745. doi: 10.1016/j.apnr.2023.151745. Epub 2023 Oct 28.
Ketogenic therapies have shown benefit for seizure reduction in epilepsy but their impact on other neurologic conditions is less known. In this literature review, the efficacy of ketogenic therapies were assessed in Parkinson's disease (PD), Alzheimer's disease (AD), and mild cognitive impairment (MCI).
A literature search was conducted using PubMed, Scopus, and Google Scholar focusing on ketogenic therapies in PD, AD, and MCI.
A total of 2565 records were identified with a total of 15 studies (3 for PD and 12 for MCI/AD) meeting criteria for analysis. The ketogenic diet was used in all the PD studies and did show significant improvement in motor function either through vocal quality, gait, freezing, tremor, and/or balance. A variety of ketogenic therapies were utilized in the MCI and AD groups including a ketogenic diet, low-carbohydrate diet, modified Adkins diet, Mediterranean diet with coconut oil supplementation, a ketogenic diet with a ketogenic medium chain triglyceride (kMCT) supplement, as well as ketogenic supplements including a ketogenic drink with kMCT, oral ketogenic compounds (Axona and AC-1202), and MCT oil or emulsion. The ketogenic diet independently showed a non-significant trend towards improvement in cognition. The Mediterranean diet, modified Adkins diet, and low-carbohydrate diet showed statistically significant improvements in some, although not all, of their cognitive measures. Use of ketogenic supplements, drinks, or compounds showed variable results in the AD and MCI groups. The Axona and AC-1202 compounds showed no significant improvement in cognition at the end of their respective 90-day trials. Most MCT supplements did show cognitive improvements, although only after 6 months of adherence. Adherence to the intervention was problematic in most of the diet studies.
Ketogenic therapies have promise in PD, AD, and MCI for symptom improvement although larger studies are needed to support their implementation in clinical practice.
生酮疗法在癫痫的减少发作方面显示出益处，但它们对其他神经疾病的影响则知之甚少。在本次文献综述中，评估了生酮疗法在帕金森病（PD）、阿尔茨海默病（AD）和轻度认知障碍（MCI）中的疗效。
使用 PubMed、Scopus 和 Google Scholar 进行文献检索，重点关注 PD、AD 和 MCI 中的生酮疗法。
共确定了 2565 条记录，其中共有 15 项研究（3 项用于 PD，12 项用于 MCI/AD）符合分析标准。在所有 PD 研究中都使用了生酮饮食，并且在运动功能方面确实显示出了显著的改善，无论是在声音质量、步态、冻结、震颤和/或平衡方面。在 MCI 和 AD 组中，使用了各种生酮疗法，包括生酮饮食、低碳水化合物饮食、改良阿特金斯饮食、地中海饮食加椰子油补充剂、含生酮中链甘油三酯（kMCT）补充剂的生酮饮食，以及生酮补充剂，包括含 kMCT 的生酮饮料、口服生酮化合物（Axona 和 AC-1202）以及 MCT 油或乳剂。生酮饮食独立显示出改善认知功能的非显著趋势。地中海饮食、改良阿特金斯饮食和低碳水化合物饮食在其一些（尽管不是全部）认知测量中显示出统计学上的显著改善。生酮补充剂、饮料或化合物在 AD 和 MCI 组中的使用结果各不相同。Axona 和 AC-1202 化合物在各自 90 天试验结束时均未显示出认知改善。大多数 MCT 补充剂确实显示出认知改善，尽管仅在 6 个月的依从性后。大多数饮食研究中都存在对干预措施的依从性问题。
生酮疗法在 PD、AD 和 MCI 中具有改善症状的潜力，尽管需要更大的研究来支持其在临床实践中的应用。
