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Neurology 2000;54:325
© 2000 American Academy of Neurology
Articles

Ketone bodies do not directly alter excitatory or inhibitory hippocampal synaptic transmission

Liu Lin Thio, MD, PhD, Michael Wong, MD, PhD and Kelvin A. Yamada, MD

Address correspondence and reprint requests to Dr. Kelvin A. Yamada, Washington University School of Medicine, Department of Neurology, Box 8111, 660 S. Euclid Ave., St. Louis, MO 63110.

OBJECTIVE: To determine the effect of the ketone bodies ß-hydroxybutyrate (ßHB) and acetoacetate (AA) on excitatory and inhibitory neurotransmission in the mammalian CNS.

BACKGROUND: The ketogenic diet is presumed to be an effective anticonvulsant regimen for some children with medically intractable seizures. However, its mechanism of action remains a mystery. According to one hypothesis, ketone bodies have anticonvulsant properties.

METHODS: The authors examined the effect of ßHB and AA on excitatory and inhibitory synaptic transmission in rat hippocampal-entorhinal cortex slices and cultured hippocampal neurons. In cultured neurons, their effect was also directly assayed on postsynaptic receptor properties. Finally, their ability to prevent spontaneous seizures was determined in a hippocampal-entorhinal cortex slice model.

RESULTS: ßHB and AA did not alter synaptic transmission in these models.

CONCLUSIONS: The anticonvulsant properties of the ketogenic diet do not result from a direct effect of ketone bodies on the primary voltage and ligand gated ion channels mediating excitatory or inhibitory neurotransmission in the hippocampus.

Key words: Epilepsy—Seizure—Ketogenic diet—ß-Hydroxybutyrate—Acetoacetate—Autapse—Glutamate—GABA—4-Aminopyridine—Brain slice




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