Objective: Increasing evidence supports the use of ketogenic diets in the treatment of neurological conditions. These include epilepsy and refractory seizure, Alzheimer’s disease, traumatic brain injury, and migraine headaches. Mitigation of reactive oxygen species, neuroinflammation and regulation of blood glucose levels have been proposed as mechanisms for neurological and neurocognitive benefits. In this study we looked at the effect of ketogenic diet on residual self-reported headache activity in post-concussive syndrome (PCS) patients.
Methods: 10 PCS patients with residual headaches that had previously undergone Enhanced Performance in Cognition (EPIC) therapy as targeted treatment for pathological neurovascular coupling (NVC) were identified. Headache prevalence (HIT-6 questionnaire), cyclic cortisol, fasting blood glucose and NVC (fNCI scanning and Severity Index Score) were measured prior to diet initiation. Patients were placed on a structured ketogenic diet for 8-weeks with ketosis levels verified with urinalysis. Imaging, blood testing and questionnaire were repeated at the conclusion of the dietary intervention phase.
Results: All patients reported improvement in headache activity after 8-weeks of ketogenic diet intervention and 50% demonstrated improvement in fasting blood glucose levels. Patients reported a 25% improvement in their fNCI scoring of NVC following the ketogenic diet intervention.
Conclusion: Though underlying mechanistic data remains to be elucidated and larger cohort studies are needed, ketogenic diet shows promise as a non-pharmacologic intervention for PCS patients suffering from residual headaches.