Time-restricted ketogenic diet in amyotrophic lateral sclerosis: a case study
Amyotrophic lateral sclerosis (ALS) is an incurable neurodegenerative disorder. The most devastating variant is bulbar-onset ALS, which portends a median survival of 24 months from the onset of symptoms. Abundant evidence indicates that neuron metabolism and mitochondrial function are impaired in AL...
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| Format: | Article |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1329541/full |
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| author | Matthew C. L. Phillips Samuel E. Johnston Pat Simpson David K. Chang Danielle Mather Rognvald J. Dick |
| author_facet | Matthew C. L. Phillips Samuel E. Johnston Pat Simpson David K. Chang Danielle Mather Rognvald J. Dick |
| author_sort | Matthew C. L. Phillips |
| collection | DOAJ |
| description | Amyotrophic lateral sclerosis (ALS) is an incurable neurodegenerative disorder. The most devastating variant is bulbar-onset ALS, which portends a median survival of 24 months from the onset of symptoms. Abundant evidence indicates that neuron metabolism and mitochondrial function are impaired in ALS. Metabolic strategies, particularly fasting and ketogenic diet protocols, alter neuron metabolism and mitochondria function in a manner that may mitigate the symptoms of this disorder. We report the case of a 64-year-old man with a 21-month history of progressive, deteriorating bulbar-onset ALS, with an associated pseudobulbar affect, who implemented a time-restricted ketogenic diet (TRKD) for 18 months. During this time, he improved in ALS-related function (7% improvement from baseline), forced expiratory volume (17% improvement), forced vital capacity (13% improvement), depression (normalized), stress levels (normalized), and quality of life (19% improvement), particularly fatigue (23% improvement). His swallowing impairment and neurocognitive status remained stable. Declines were measured in physical function, maximal inspiratory pressure, and maximal expiratory pressure. Weight loss was attenuated and no significant adverse effects occurred. This case study represents the first documented occurrence of a patient with ALS managed with either a fasting or ketogenic diet protocol, co-administered as a TRKD. We measured improved or stabilized ALS-related function, forced expiratory volume, forced vital capacity, swallowing, neurocognitive status, mood, and quality of life. Measurable declines were restricted to physical function, maximal inspiratory pressure, and maximal expiratory pressure. Now over 45 months since symptom onset, our patient remains functionally independent and dedicated to his TRKD. |
| first_indexed | 2024-03-08T13:18:25Z |
| format | Article |
| id | doaj.art-4e88d55051f1487cae4431a13ca018ee |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-08T13:18:25Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-4e88d55051f1487cae4431a13ca018ee2024-01-18T04:34:59ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-01-011410.3389/fneur.2023.13295411329541Time-restricted ketogenic diet in amyotrophic lateral sclerosis: a case studyMatthew C. L. Phillips0Samuel E. Johnston1Pat Simpson2David K. Chang3Danielle Mather4Rognvald J. Dick5Department of Neurology, Waikato Hospital, Hamilton, New ZealandOlder Persons and Rehabilitation Service, Waikato Hospital, Hamilton, New ZealandDepartment of Respiratory Medicine, Waikato Hospital, Hamilton, New ZealandDepartment of Speech Language Therapy, Waikato Hospital, Hamilton, New ZealandDepartment of Speech Language Therapy, Waikato Hospital, Hamilton, New ZealandOlder Persons and Rehabilitation Service, Waikato Hospital, Hamilton, New ZealandAmyotrophic lateral sclerosis (ALS) is an incurable neurodegenerative disorder. The most devastating variant is bulbar-onset ALS, which portends a median survival of 24 months from the onset of symptoms. Abundant evidence indicates that neuron metabolism and mitochondrial function are impaired in ALS. Metabolic strategies, particularly fasting and ketogenic diet protocols, alter neuron metabolism and mitochondria function in a manner that may mitigate the symptoms of this disorder. We report the case of a 64-year-old man with a 21-month history of progressive, deteriorating bulbar-onset ALS, with an associated pseudobulbar affect, who implemented a time-restricted ketogenic diet (TRKD) for 18 months. During this time, he improved in ALS-related function (7% improvement from baseline), forced expiratory volume (17% improvement), forced vital capacity (13% improvement), depression (normalized), stress levels (normalized), and quality of life (19% improvement), particularly fatigue (23% improvement). His swallowing impairment and neurocognitive status remained stable. Declines were measured in physical function, maximal inspiratory pressure, and maximal expiratory pressure. Weight loss was attenuated and no significant adverse effects occurred. This case study represents the first documented occurrence of a patient with ALS managed with either a fasting or ketogenic diet protocol, co-administered as a TRKD. We measured improved or stabilized ALS-related function, forced expiratory volume, forced vital capacity, swallowing, neurocognitive status, mood, and quality of life. Measurable declines were restricted to physical function, maximal inspiratory pressure, and maximal expiratory pressure. Now over 45 months since symptom onset, our patient remains functionally independent and dedicated to his TRKD.https://www.frontiersin.org/articles/10.3389/fneur.2023.1329541/fullmotor neuron diseaseamyotrophic lateral sclerosisneurodegenerationenergy metabolismmitochondria dysfunctionmetabolic strategy |
| spellingShingle | Matthew C. L. Phillips Samuel E. Johnston Pat Simpson David K. Chang Danielle Mather Rognvald J. Dick Time-restricted ketogenic diet in amyotrophic lateral sclerosis: a case study Frontiers in Neurology motor neuron disease amyotrophic lateral sclerosis neurodegeneration energy metabolism mitochondria dysfunction metabolic strategy |
| title | Time-restricted ketogenic diet in amyotrophic lateral sclerosis: a case study |
| title_full | Time-restricted ketogenic diet in amyotrophic lateral sclerosis: a case study |
| title_fullStr | Time-restricted ketogenic diet in amyotrophic lateral sclerosis: a case study |
| title_full_unstemmed | Time-restricted ketogenic diet in amyotrophic lateral sclerosis: a case study |
| title_short | Time-restricted ketogenic diet in amyotrophic lateral sclerosis: a case study |
| title_sort | time restricted ketogenic diet in amyotrophic lateral sclerosis a case study |
| topic | motor neuron disease amyotrophic lateral sclerosis neurodegeneration energy metabolism mitochondria dysfunction metabolic strategy |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1329541/full |
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