A pilot study of a ketogenic diet in bipolar disorder: clinical, metabolic and magnetic resonance spectroscopy findings

作者：Iain H. Campbell, Nicole Needham, Helen Grossi, Ivana Kamenská, Saturnino Luz, Shane Sheehan, Gerard Thompson, Michael J. Thrippleton, Melissa C. Gibbs, Joana Leitao, Tessa Moses, Karl Burgess, Benjamin P. Rigby, Sharon Simpson, Emma McIntosh, Rachel Brown, Ben Meadowcroft, Frances Creasy, Maja Mitchell-Grigorjeva, John Norrie, A. Thomas McLellan, Cheryl Fisher, Tomasz Zieliński, Giulia Gaggioni, Harry Campbell, Daniel J. Smıth · 发表于：BJPsych Open · 年份：2025 · DOI：10.1192/bjo.2024.841 · 被引用次数：30 · 研究领域：Diet and metabolism studies、Bipolar Disorder and Treatment、Electrolyte and hormonal disorders

Background Preliminary evidence suggests that a ketogenic diet may be effective for bipolar disorder. Aims To assess the impact of a ketogenic diet in bipolar disorder on clinical, metabolic and magnetic resonance spectroscopy outcomes. Method Euthymic individuals with bipolar disorder ( N = 27) were recruited to a 6- to 8-week single-arm open pilot study of a modified ketogenic diet. Clinical, metabolic and MRS measures were assessed before and after the intervention. Results Of 27 recruited participants, 26 began and 20 completed the ketogenic diet. For participants completing the intervention, mean body weight fell by 4.2 kg ( P < 0.001), mean body mass index fell by 1.5 kg/m 2 ( P < 0.001) and mean systolic blood pressure fell by 7.4 mmHg ( P < 0.041). The euthymic participants had average baseline and follow-up assessments consistent with them being in the euthymic range with no statistically significant changes in Affective Lability Scale-18, Beck Depression Inventory and Young Mania Rating Scale. In participants providing reliable daily ecological momentary assessment data ( n = 14), there was a positive correlation between daily ketone levels and self-rated mood ( r = 0.21, P < 0.001) and energy ( r = 0.19 P < 0.001), and an inverse correlation between ketone levels and both impulsivity ( r = −0.30, P < 0.001) and anxiety ( r = −0.19, P < 0.001). From the MRS measurements, brain glutamate plus glutamine concentration decreased by 11.6% in the ante...