TABLE 4.
Overview of the findings associated with ketogenic therapy in patients with AD or mild cognitive impairment1
| Effects | First author | Cognitive battery | Mood/depression | Efficacy in everyday behavior | Blood ketone bodies concentrations | AD protein and peptide concentrations in CSF | Brain ketone uptake | rCBF |
|---|---|---|---|---|---|---|---|---|
| Long-term | Brandt (45) | ∼ MMSE and MCS | ↑ POMS-Bi (at wk 6) | ∼ MDS-HC | ||||
| Craft (46) | ↑ t-tau, ∼ Aβ42 | ↑ [11C] AcAc | ||||||
| Fortier (47) | ∼ MMSE and MoCA,↑ Stroop,↑ RL/RI-16,↑ BVMT-R | ↑ BHB | ↑ Global brain CMRAcAc and CMRKetones∼ CMRGlu | |||||
| Henderson (48) | ↑ε4− ADAS-Cog,↑ε4− ADCS-CGIC (day 45),↑ε4+ MMSE (day 104) | ↑ BHB | ||||||
| Henderson (49) | ↑2 ADAS-Cog↑ε4− ADAS-Cog | |||||||
| Krikorian (50) | ∼ TMT, ↑ V-PAL | ∼ GDS | ||||||
| Rebello (52) | ↑ε4−ADAS-Cog,3∼ TMT and Digit Symbol | |||||||
| Torosyan (54) | ↑ε4− rCBF in the left superior lateral temporal cortex | |||||||
| Acute | Ota (51) | ∼ WAIS-III, WMS-R, Stroop, TMT | ↑ AcAc and BHB | |||||
| Rebello (52) | ↑ε4− BHB3 | |||||||
| Reger (53) | ↑ε4− ADAS-Cog, ∼ Stroop | ↑ BHB | ||||||
| Torosyan (54) | ↑ε4− rCBF in dorsolateral prefrontal and temporal cortices |
AcAc, acetoacetate; AD, Alzheimer disease; ADAS-Cog, Alzheimer's Disease Assessment Scale-Cognitive subscale (58); ADCS-CGIC, AD Cooperative Study–Clinical Global Impression of Change (76); APOE, apoE; Aβ42, amyloid β 42; BHB, serum β-hydroxybutyrate; BVMT-R, Brief Visuospatial Memory Test-Revised (62); CMR, cerebral metabolic rate; CSF, cerebrospinal fluid; GDS, Geriatric Depression Scale (73); Glu, glucose; MCS, Memory Composite Score; MDS-HC, Minimum Data Set for Home Care (75); MMSE, Mini-Mental State Exam (59); MoCA, Montreal Cognitive Assessment (60); POMS-Bi, Profile of Mood States Bipolar Scale (74); rCBF, regional cerebral blood flow; RL/RI-16, Rappel Libre/Rappel Indicé (64); Stroop, Stroop Color Word Interference (66); TMT, Trail Making Test (68); t-tau, total tau; V-PAL, Verbal Paired Associate Learning Test (63); WAIS-III, Wechsler Adult Intelligence Scale-3rd (77); WMS-R, Wechsler Memory Scale-Revised (78); ε4−, APOE ε4(−); ε4+, APOE ε4(+); ↑, improved; ∼, no change.
Homozygous carriers of the ε3 allele.
n = 1 participant only.