The Hypometabolic State of the Migraine Brain: Is a Ketogenic Diet the Answer? Article Swipe
Lakshini Gunasekera
,
Jason C. Ray
,
Helmut Butzkueven
,
Terence J. O’Brien
,
Elspeth Hutton
,
Neha Kaul
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1002/brb3.70860
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1002/brb3.70860
Background Migraine pathophysiology involves a constellation of metabolic abnormalities. These interlinked contributory factors include mitochondrial dysfunction, an altered gut microbiome, neuroinflammation, oxidative stress, weight imbalance, and altered glucose metabolism. The ketogenic diet is an emerging therapy which may restore hypometabolism seen in chronic migraine. We describe contributions of metabolic dysfunction to chronic migraine pathophysiology and discuss the role of ketogenic diet therapy to improve cerebral metabolism. Methods A literature search of articles from OVID Medline, Embase, and Cochrane Library were reviewed until May 6, 2024. A total of 50 articles were included comprising case reports, case series, observational clinical trials, and narrative review articles. Results Migraine pathophysiology involves significant hypometabolism, seen on functional imaging studies, so therapeutics which target these underlying deficiencies may ameliorate chronic migraine symptoms. The ketogenic diet reduces migraine days, pain intensity, and acute analgesic use. Current studies are limited by small sample sizes, inconsistent methodology precluding direct comparison between studies or pooling of results, and limited longitudinal follow‐up. Conclusion While there is biological plausibility to reason that a ketogenic diet could correct metabolic mismatch in people with migraine, further randomized clinical trials with larger sample sizes are required to confirm the positive results of preliminary, uncontrolled studies.
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1002/brb3.70860
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/brb3.70860
- OA Status
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- Cited By
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The Hypometabolic State of the Migraine Brain: Is a Ketogenic Diet the Answer?Work title
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reviewOpenAlex work type
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enPrimary language
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2025Year of publication
- Publication date
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2025-09-01Full publication date if available
- Authors
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Lakshini Gunasekera, Jason C. Ray, Helmut Butzkueven, Terence J. O’Brien, Elspeth Hutton, Neha KaulList of authors in order
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https://doi.org/10.1002/brb3.70860Publisher landing page
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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2Total citation count in OpenAlex
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2025: 2Per-year citation counts (last 5 years)
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