Abstract
Concussion is the most common form of mild traumatic brain injury (mTBI). Although most patients' symptoms resolve within a month, patients with post-concussion syndrome (PCS) may continue to experience symptoms for years and have limited treatment options. This pilot study assessed the feasibility and symptom-related effects of a ketogenic diet (KD) in patients with PCS symptoms. The Ketogenic Diet in Post-Concussion Syndrome (KD-PCS) was a single-arm trial of a 2-month KD high in non-starchy vegetables and supplemented with medium-chain triglyceride (MCT) oil. Macronutrient targets were ≥70% fat, ≤10% carbohydrate, and the remainder as protein as energy. We assessed feasibility by daily self-reported measure of urine acetoacetate and collection of 3-day food records and serum beta-hydroxybutyrate at multiple timepoints. We assessed symptoms by administering the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and Modified Balance Error Scoring System (M-BESS) at baseline and month 2 and the Post-Concussion Symptom Scale (PCSS) at baseline, month 1, and month 2. Fourteen participants enrolled in the KD-PCS. Twelve participants completed the study and 11 implemented the KD (73% fat, 9% carbohydrate, and 18% protein) and achieved ketosis. One participant complained of MCT-related diarrhea that resolved and another reported nausea and fatigue that resulted in withdrawal from the study. Among compliant participants, the visual memory domain of the ImPACT improved by 12 points (p = 0.02) and PCSS scores improved by 9 points, although not statistically significant. This pilot trial suggests that the KD is a feasible experimental treatment for PCS and justifies further study of its efficacy.
Highlights
Concussions are the leading form of mild traumatic brain injury
Fourteen participants enrolled in the ketogenic diet (KD)-post-concussion syndrome (PCS) over a course of 18 months
Two participants withdrew from the study after completion of the baseline study visit—one withdrew due to complications with dietary adherence and the other participant was lost to follow-up prior to the month 1 visit
Summary
Concussions are the leading form of mild traumatic brain injury (mTBI). The CDC reported the U.S population sustains 1.7 million concussions annually and, underreported by as much as 80%, the annual rate of concussion has more than doubled in the past decade [1]. While 90% of patients have resolution of symptoms within 4 weeks, the remainder experience persistent and Ketogenic Diet in Post-concussion Syndrome oftentimes debilitating symptoms for months or even years [2], a condition termed post-concussion syndrome (PCS) [3]. Treatment is aimed at symptoms but rarely addresses the underlying injury. This is an important limitation in treating post-concussion syndrome and can lead to prolonged recovery periods
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
