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Effectiveness of ketogenic diet in treatment of patients with refractory chronic migraine

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Abstract

Background and purpose

Ketogenic diet (KD) is based on restriction of carbohydrate intake. Metabolism is forced to obtain energy starting from β-oxidation of fatty acids which, turned into ketone bodies, can also be used by central nervous system (CNS). KD use in treatment of chronic migraine has recently been considered. We set out to verify modification of symptoms in patients with refractory chronic migraine in response to KD.

Methods

Fifty patients were enrolled of which 38 completed the procedures the study and 23 were considered in the statistics. All of the patients considered in our study were affected by medication overuse headache (MOH). They were on a KD for 3 months. The following parameters have been checked at t = 0 and every 30 days for 6 months: migraine episode length (n. hours/day), frequency (n. days/month), level of pain of every episode measured on a scale from 1 to 3 (1 = mild; 2 = moderate; 3 = severe), and n. analgesic drugs taken/month.

Results

Days with symptoms decreased from 30 (median value) to 7.5 with p < 0.0001. The duration of the migraine episodes decreased from 24 h (median value) to 5.5 h with p < 0.0016. The patients’ pain level, initially at maximum value for 83% of the participants, improved for 55% of them (p < 0.0024). The number of drugs taken in a month decreased from 30 doses (median value) to 6 doses.

Conclusions

It can be stated that a 3-month KD resulted in a reduction of painful symptoms of drug refractory chronic migraine. This result may suggest an improvement in quality of life of the patients, even without a tabulated data collection.

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Authors and Affiliations

  1. Endocrinology and Metabolism Unit, Humanitas Gradenigo, Turin, Italy

    Daria Bongiovanni, Stefania Corvisieri, Claudia Del Favero & Fabio Orlandi

  2. Women’s Headache Center, Department of Surgical Sciences, University of Turin, Turin, Italy

    Chiara Benedetto, Gianni Allais & Silvia Sinigaglia

  3. Clinical Nutrition Unit, City of Health and Science, Turin, Italy

    Maurizio Fadda

Authors
  1. Daria Bongiovanni
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  2. Chiara Benedetto
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  3. Stefania Corvisieri
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  4. Claudia Del Favero
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  5. Fabio Orlandi
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  6. Gianni Allais
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  7. Silvia Sinigaglia
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  8. Maurizio Fadda
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Contributions

DB and CDF performed study design, collected the data, performed data analysis, and wrote the manuscript. FO, SC, and GBA performed study design, collected the data, and collaborated to data analysis and manuscript writing. MF performed data analysis. CB and SS revised the manuscript critically for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Maurizio Fadda.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

Study protocol was approved by our local ethics committee at the City of Health and Science, Turin, Italy (27/02/2019 protocol no. 022551, file no. CS2/1006). This observational study was based solely on information and investigations that were carried out as part of the routine clinical care of the patients. This article was written in accordance with the requirements of the Declaration of Helsinki (2001).

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Informed consent was obtained from adult patients.

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Bongiovanni, D., Benedetto, C., Corvisieri, S. et al. Effectiveness of ketogenic diet in treatment of patients with refractory chronic migraine. Neurol Sci 42, 3865–3870 (2021). https://doi.org/10.1007/s10072-021-05078-5

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  • DOI: https://doi.org/10.1007/s10072-021-05078-5

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