Ketogenic diet as a treatment option for different CNS diseases

Abstract

Ketogenic diet is a replacing of carbohydrates by fats in everyday food. This approach was proposed for treatment of different brain diseases including Parkinson disease, cancer, trauma, however. currently it is approved only for curing of epilepsy and Alzheimer disease.

Ketone bodies are synthesized from fats in liver. Generally they include β-hydroxybutirate (BHB), acetoacetate and acetone. BHB and acetoacetate can permeate through blood brain barrier and are used by neurons as a fuel. It is believed that beneficial properties of ketogenic diet can be explained by moderate increase of ketone bodies plasma concentration.

Potentially, ketone bodies can influence neurons on three different levels. 1) They can be energy substrates and may change several metabolic pathways. 2) They can be signaling molecules for instance due to binding to specific plasma membrane. 3) They can influence neurons on epigenetic level because BHB is recognized as a histone deacetylase inhibitor.

Several molecular mechanisms were proposed for explanation of beneficial properties of ketone bodies. However, the main mechanism is still a discussible question. Most likely different metabolic and signaling pathways are involved.