Francini-Pesenti Francesco, Favaretto Silvia, D'Angelo Matteo, Cacciapuoti Martina, Calò Lorenzo A
Clinical Nutrition Unit, DIDAS Medicina dei Sistemi, Azienda Ospedale-Università di Padova, 35128 Padua, Italy.
Neurology Clinic, Department of Neuroscience, Azienda Ospedale-Università di Padova, 35128 Padua, Italy.
Nutrients. 2024 Dec 15;16(24):4324. doi: 10.3390/nu16244324.
Despite advances in pharmacological therapies, migraine patients are often drug resistant. Further therapeutic options in this field are, therefore, desirable. Recent studies have highlighted the efficacy of ketogenic diet (KD) on improving migraine, but data on their long-term efficacy and safety are lacking. In this study, we retrospectively evaluated the long-term effectiveness of the modified Atkins ketogenic diet (MAD) in episodic or chronic drug-resistant migraine patients. 52 patients diagnosed with episodic or chronic drug-resistant migraine under modified Atkins ketogenic diet (MAD) were evaluated. In total, 41 patients followed the diet for 6 months and 33 for 12 months. After both 6 and 12 months, frequency, length, and intensity of migraine episodes, as well as the number of medications significantly decreased with respect to the start of the diet. Body mass index, high sensitivity PCR, diastolic blood pressure, fasting plasma insulin and HOMA index were also significantly reduced both after 6 and 12 months. No major metabolic changes were observed during MAD treatment. In conclusion, KD has been shown to be effective and safe in the long-term treatment of drug-resistant migraine. A high dropout rate still remains an important factor, which often limits its use.
尽管药物治疗取得了进展，但偏头痛患者常常对药物耐药。因此，该领域需要更多的治疗选择。最近的研究强调了生酮饮食（KD）对改善偏头痛的疗效，但缺乏关于其长期疗效和安全性的数据。在本研究中，我们回顾性评估了改良阿特金斯生酮饮食（MAD）对发作性或慢性耐药性偏头痛患者的长期有效性。对52例在改良阿特金斯生酮饮食（MAD）下被诊断为发作性或慢性耐药性偏头痛的患者进行了评估。总共有41例患者遵循该饮食6个月，33例遵循12个月。在6个月和12个月后，偏头痛发作的频率、时长和强度，以及药物使用数量相对于饮食开始时均显著减少。6个月和12个月后，体重指数、高敏PCR、舒张压、空腹血浆胰岛素和HOMA指数也均显著降低。在MAD治疗期间未观察到重大代谢变化。总之，已证明KD在耐药性偏头痛的长期治疗中有效且安全。高脱落率仍然是一个重要因素，这常常限制了其应用。
