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Abstract:

Purpose

Ketogenic diet (KD) is recommended to avoid intense [18F]FDG myocardial physiologic uptake in PET imaging. Neuroprotective and anti-seizure effects of KD have been suggested, but their mechanisms remain to be elucidated. This [18F]FDG PET study aims to evaluate the effect of KD on glucose brain metabolism.

Method

Subjects who underwent KD prior to whole-body and brain [18F]FDG PET between January 2019 and December 2020 in our department for suspected endocarditis were retrospectively included. Myocardial glucose suppression (MGS) on whole-body PET was analyzed. Patients with brain abnormalities were excluded. Thirty-four subjects with MGS (mean age: 61.8 ± 17.2 years) were included in the KD population, and 14 subjects without MGS were considered for a partial KD group (mean age: 62.3 ± 15.1 years). Brain SUVmax was first compared between these two KD groups to determine possible global uptake difference. Semiquantitative voxel-based intergroup analyses were secondarily performed to determine possible inter-regional differences by comparing KD groups with and without MGS, separately, to 27 healthy subjects fasting for at least 6 h (mean age of 62.4 ± 10.9 years), and KD groups between them (p-voxel < 0.001, and p-cluster < 0.05, FWE-corrected).

Results

A 20% lower brain SUVmax was found in subjects under KD with MGS in comparison to those without MGS (Student’s t-test, p = 0.02). Whole-brain voxel-based intergroup analysis revealed that patients under KD with and without MGS had relative hypermetabolism of limbic regions including medial temporal cortices and cerebellum lobes and relative hypometabolism of bilateral posterior regions (occipital), without significant difference between them.

Conclusion

KD globally reduces brain glucose metabolism but with regional differences, requiring special attention to clinical interpretation. On a pathophysiological perspective, these findings could help understand underlying neurological effects of KD through possible decrease of oxidative stress in posterior regions and functional compensation in the limbic regions.

What does this mean in practical terms?

Someone give me the buzz word explanation. Does keto diet increas brains or does it reduce some obscure medical condition?

The conclusion sounds like it might be good for parts of the brain. But I can’t figure out if the hyper metabolism part is a negative or not.

Me too. My smoothbrain hurts.

I wish every post to this sub had a ELI5 included.

Since the Keto Diet prevents seizures, they are researching why. This test seems to show It displaces brain glucose processing.

It does this by improving memory processing and shunting some portion of spatial reasoning to the emotional processing centers. They couldn't see this changed any behaviors.

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It’s good for your noodle.

What I got is, the metabolism changes, but it’s a net positive due to significant reduction in oxidative stress

The title of this post sounds like a line from Dr. Brown in Back to the Future.

I think it needs to be stated a little more clearly. I get what you’re saying, but we both have to do a lot of inferring.

Although the overall tone does seem to support your take on it.

Just like humans always do it, impatient and rushed.

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Anecdotally it was much better for my attention problems than any amount of any medication.

For sure. When I’m in ketosis i function at another level mentally. Word recall is the most noticeable improvement, but it’s wide reaching. If I add coffee to that it’s like limitless; the benefits become systemic.