Effects of Exogenous Ketone Ester Supplementation on 3-hydroxybutyrate Concentrations in Human Cerebrospinal Fluid (KetoBrain)

University of Aarhus

Status: Completed

Conditions: Ketosis

Treatments: Other: Placebo; Dietary Supplement: Ketone Ester

Study type: Interventional

Funder types: Other

Identifiers

NCT06318299

109227

Details and patient eligibility

About

It is well established that the brain is capable of consuming ketone bodies, especially during low glucose availability, e.g. fasting. Cerebral metabolism of ketone bodies depends on passage of the blood brain barrier and especially the global blood concentration of ketone bodies.

Ketone bodies can be administered exogenously, and the most commonly used in clinical trials is 3-hydroxybutyrate (3-OHB). 3-OHB is carried by simple diffusion and facilitated diffusion through several monocarboxylic acid transporters (MCTs) across the blood-brain barrier.

To our knowledge, no studies in human adults exist that concurrently measure 3-OHB concentrations in blood and cerebrospinal fluid (CSF) after ingestion or infusion of exogenous ketone supplementation, necessitating further study.

Aims:

• The 3-OHB CSF/blood ratio after oral ingestion of 30 g ketone ester - primary endpoint
• The window of effect: Ketone supplementation 1 h or 2 h before CSF sampling
• If concentration measurements by point-of-care testing are non-inferior to mass spectrometry
• If acute 3-OHB ingestion increases plasma brain-derived neurotrophic factor (BDNF) levels

Enrollment: 24 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• All sexes
• Referred to undergo an elective lumbar puncture procedure in the outpatient clinic at Department of Neurology, Aarhus University Hospital.
• Age 18-80 years
• Written and oral consent

Exclusion criteria

• Referred to the clinic suspecting severe neuroinflammation
• Special diet habits, including ketogenic diet, fasting, intermittent fasting etc.
• Daily use of insulin or other medication affecting blood glucose and/or glucose metabolism
• Not able to speak or understand Danish and/or give written and oral consent

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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24 participants in 3 patient groups, including a placebo group

Ketone 1 hour

Active Comparator group

Description:

Ketone ester drink administered one hour before elective lumbar puncture

Treatment:

Dietary Supplement: Ketone Ester

Ketone 2 hours

Active Comparator group

Description:

Ketone ester drink administered two hours before elective lumbar puncture

Treatment:

Dietary Supplement: Ketone Ester

Placebo 1 hour

Placebo Comparator group

Description:

Placebo drink administered one hour before elective lumbar puncture

Treatment:

Other: Placebo