Background: A short ketogenic diet (KD) treatment can prevent migraine attacks and correct excessive cortical response. Here, we aim to prove if the KD-related changes of cortical excitability are primarily due to cerebral cortex activity or are modulated by the brainstem. Methods: Through the stimulation of the right supraorbital division of the trigeminal nerve, we concurrently interictally recorded the nociceptive blink reflex (nBR) and the pain-related evoked potentials (PREP) in 18 migraineurs patients without aura before and after 1-month on KD, while in metabolic ketosis. nBR and PREP reflect distinct brain structures activation: the brainstem and the cerebral cortex respectively. We estimated nBR R2 component area-under-the-curve as well as PREP amplitude habituation as the slope pof the linear regression between the 1st and the 2nd block of 5 averaged responses. Results: Following 1-month on KD, the mean number of attacks and headache duration reduced significantly. Moreover, KD significantly normalized the interictal PREP habituation (pre: + 1.8, post: - 9.1, p = 0.012), while nBR deficit of habituation did not change. Conclusions: The positive clinical effects we observed in a population of migraineurs by a 1-month KD treatment coexists with a normalization at the cortical level, not in the brainstem, of the typical interictal deficit of habituation. These findings suggest that the cerebral cortex may be the primary site of KD-related modulation.

A ketogenic diet normalizes interictal cortical but not subcortical responsivity in migraineurs / Di Lorenzo, C.; Coppola, G.; Bracaglia, M.; Di Lenola, D.; Sirianni, G.; Rossi, P.; Di Lorenzo, G.; Parisi, V.; Serrao, M.; Cervenka, M. C.; Pierelli, F.. - In: BMC NEUROLOGY. - ISSN 1471-2377. - 19:(2019). [10.1186/s12883-019-1351-1]

A ketogenic diet normalizes interictal cortical but not subcortical responsivity in migraineurs

Di Lorenzo C.
;
Coppola G.;Bracaglia M.;Di Lenola D.;Serrao M.;Pierelli F.
2019

Abstract

Background: A short ketogenic diet (KD) treatment can prevent migraine attacks and correct excessive cortical response. Here, we aim to prove if the KD-related changes of cortical excitability are primarily due to cerebral cortex activity or are modulated by the brainstem. Methods: Through the stimulation of the right supraorbital division of the trigeminal nerve, we concurrently interictally recorded the nociceptive blink reflex (nBR) and the pain-related evoked potentials (PREP) in 18 migraineurs patients without aura before and after 1-month on KD, while in metabolic ketosis. nBR and PREP reflect distinct brain structures activation: the brainstem and the cerebral cortex respectively. We estimated nBR R2 component area-under-the-curve as well as PREP amplitude habituation as the slope pof the linear regression between the 1st and the 2nd block of 5 averaged responses. Results: Following 1-month on KD, the mean number of attacks and headache duration reduced significantly. Moreover, KD significantly normalized the interictal PREP habituation (pre: + 1.8, post: - 9.1, p = 0.012), while nBR deficit of habituation did not change. Conclusions: The positive clinical effects we observed in a population of migraineurs by a 1-month KD treatment coexists with a normalization at the cortical level, not in the brainstem, of the typical interictal deficit of habituation. These findings suggest that the cerebral cortex may be the primary site of KD-related modulation.
2019
habituation; ketogenesis; ketogenic diet; migraine; nociceptive blink reflex; pain-related evoked potentials; adult; blinking; brain stem; case-control studies; cerebral cortex; evoked potentials; female; habituation, psychophysiologic; humans; male; migraine disorders; pain; retrospective studies; trigeminal nerve; diet, ketogenic
01 Pubblicazione su rivista::01a Articolo in rivista
A ketogenic diet normalizes interictal cortical but not subcortical responsivity in migraineurs / Di Lorenzo, C.; Coppola, G.; Bracaglia, M.; Di Lenola, D.; Sirianni, G.; Rossi, P.; Di Lorenzo, G.; Parisi, V.; Serrao, M.; Cervenka, M. C.; Pierelli, F.. - In: BMC NEUROLOGY. - ISSN 1471-2377. - 19:(2019). [10.1186/s12883-019-1351-1]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1305100
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