Mélanie Fortier1, Christian-Alexandre Castellano2, Etienne Croteau3, Francis Langlois4, Christian Bocti5, Valérie St-Pierre2, Camille Vandenberghe2, Michaël Bernier3, Maggie Roy6, Maxime Descoteaux7, Kevin Whittingstall8, Martin Lepage9, Éric E Turcotte9, Tamas Fulop5, Stephen C Cunnane10. 1. Research Center on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, Quebec, Canada. Electronic address: melanie.fortier2@usherbrooke.ca. 2. Research Center on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, Quebec, Canada. 3. Research Center on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, Quebec, Canada; Department of Pharmacology and Physiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada. 4. CIUSSS de l'Estrie - CHUS, Sherbrooke, Quebec, Canada. 5. Research Center on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, Quebec, Canada; Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada. 6. Research Center on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, Quebec, Canada; Department of Pharmacology and Physiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada; Department of Computer Science, Université de Sherbrooke, Sherbrooke, Quebec, Canada. 7. Department of Computer Science, Université de Sherbrooke, Sherbrooke, Quebec, Canada. 8. Department of Radiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada; CR-CHUS, CIUSSS de l'Estrie - CHUS, Sherbrooke, Quebec, Canada. 9. CR-CHUS, CIUSSS de l'Estrie - CHUS, Sherbrooke, Quebec, Canada; Sherbrooke Molecular Imaging Center, Université de Sherbrooke, Sherbrooke, Quebec, Canada; Department of Nuclear Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada; Department of Radiobiology, Université de Sherbrooke, Sherbrooke, QC, Canada. 10. Research Center on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, Quebec, Canada; Department of Pharmacology and Physiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada; Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
Abstract
INTRODUCTION: Unlike for glucose, uptake of the brain's main alternative fuel, ketones, remains normal in mild cognitive impairment (MCI). Ketogenic medium chain triglycerides (kMCTs) could improve cognition in MCI by providing the brain with more fuel. METHODS:Fifty-two subjects with MCI were blindly randomized to 30 g/day of kMCT or matching placebo. Brain ketone and glucose metabolism (quantified by positron emission tomography; primary outcome) and cognitive performance (secondary outcome) were assessed at baseline and 6 months later. RESULTS:Brain ketone metabolism increased by 230% for subjects on the kMCT (P < .001) whereas brain glucose uptake remained unchanged. Measures of episodic memory, language, executive function, and processing speed improved on the kMCT versus baseline. Increased brain ketone uptake was positively related to several cognitive measures. Seventy-five percent of participants completed the intervention. DISCUSSION: A dose of 30 g/day of kMCT taken for 6 months bypasses a significant part of the brain glucose deficit and improves several cognitive outcomes in MCI.
RCT Entities:
INTRODUCTION: Unlike for glucose, uptake of the brain's main alternative fuel, ketones, remains normal in mild cognitive impairment (MCI). Ketogenic medium chain triglycerides (kMCTs) could improve cognition in MCI by providing the brain with more fuel. METHODS: Fifty-two subjects with MCI were blindly randomized to 30 g/day of kMCT or matching placebo. Brain ketone and glucose metabolism (quantified by positron emission tomography; primary outcome) and cognitive performance (secondary outcome) were assessed at baseline and 6 months later. RESULTS: Brain ketone metabolism increased by 230% for subjects on the kMCT (P < .001) whereas brain glucose uptake remained unchanged. Measures of episodic memory, language, executive function, and processing speed improved on the kMCT versus baseline. Increased brain ketone uptake was positively related to several cognitive measures. Seventy-five percent of participants completed the intervention. DISCUSSION: A dose of 30 g/day of kMCT taken for 6 months bypasses a significant part of the brain glucose deficit and improves several cognitive outcomes in MCI.
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