Nutritional ketosis for mild cognitive impairment in Parkinson's disease: A controlled pilot trial. (2019)

• Record Type: Journal Article
• Authors: Krikorian, Robert; Shidler, Marcelle D.; Summer, Suzanne S.; Sullivan, Patrick G.; Duker, Andrew P.; Isaacson, Richard S.; Espay, Alberto J.
• Is Part Of: Clinical parkinsonism & related disorders. Volume 1(2019)
• Page Start: 41
• Page End: 47
• Publication Date: 2019
• Subjects: Parkinson's disease -- Mild cognitive impairment -- Memory -- Nutritional ketosis -- Carbohydrate restriction; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; 616.833005
• DOI: 10.1016/j.prdoa.2019.07.006
• Languages: English
• ISSNs: 2590-1125

Abstract

Abstract: Introduction: Glucose hypometabolism and insulin resistance increase risk for and accelerate progression in Parkinson's disease and neurocognitive disorders. We conducted a proof of concept trial to determine whether ketogenesis, a metabolic adaptation induced by dietary carbohydrate restriction, can improve cognitive performance in Parkinson's disease patients with mild cognitive impairment. Methods: We enrolled patients with mild cognitive impairment associated with Parkinson's disease in an eight-week nutritional intervention with random assignment to either high-carbohydrate consumption typical of the Western dietary pattern ( n = 7) or to a low-carbohydrate, ketogenic regimen ( n = 7). We assessed changes in cognitive performance as well as motor function, anthropometrics, and metabolic parameters. Results: Relative to the high-carbohydrate group, the low-carbohydrate group demonstrated improvements in lexical access ( p = 0.02, Cohen's f effect size = 0.76) and memory ( p = 0.01, f = 0.87) and as well as a trend for reduced interference in memory ( p = 0.06, f = 0.60). The low-carbohydrate group also exhibited reduced body weight ( p < 0.0001, f = 1.89) and increased circulation of beta-hydroxybutyrate ( p = 0.01, f = 0.90). Change in body weight was strongly associated with memory performance ( p = 0.001). Motor function was not affected by the intervention. Conclusion: Nutritional ketosis enhanced cognitive performance in Parkinson's disease-associated mild cognitive impairment in this pilot study. This metabolic intervention and its mechanisms deserve further investigation in the context of neurodegeneration. Highlights: The ketogenic group showed improved executive ability and memory. No effect of the intervention on motor function Change in body weight was strongly associated with cognitive benefit.