Les effets de la consommation d'un supplément d'ester de cétones sur le métabolisme énergtique du cerveau chez des individus avec déficience cognitive légère; une étude randomisée contrôlée


Étienne Myette-Côté

Centre de recherche sur le vieillissement de l'IUGS


Domaine : vieillissement

Programme Formation postdoctorale - Citoyens canadiens et résidents permanents

Concours 2019-2020


Société Alzheimer Canada

Long before the onset of Alzheimer's disease (AD), a chronic deficit in brain glucose uptake of ~10-15% is already present in people at increased risk of AD. This brain glucose deficit is worse in mild cognitive impairment (MCI) and worsens further in AD. When blood glucose decreases for more than 4-5 hours, i.e. during fasting, brain function is maintained because the body produces ketone bodies, which are the brain's main alternative fuel to glucose. Unlike for glucose, brain ketone uptake is still normal in MCI and AD compared to cognitively healthy older people. The problem for the brain in MCI and AD is that it needs more ketones to meet its energy needs than are usually produced endogenously. Our strategy to try to bypass the brain glucose deficit in MCI is to provide an exogenous source of ketones. Using this approach, we recently showed that a ketogenic medium chain triglyceride (30 g/d) drink significantly improved cognitive function in MCI in direct relation to the extent that ketones bypassed the brain glucose deficit.

The objective of this study is to conduct a Phase 2, RCT in MCI while on a ketone ester (KE) drink (15 g/meal = 45 g/d) or placebo for six months. The primary outcome will be change in brain energy status (ketone and glucose) assessed by positron emission tomography (PET) imaging method. Secondary outcomes will include cognitive function, quality-of-life, brain Amyloid-beta load, and pro-inflammatory status. We hypothesize that overcoming the brain glucose deficit with ketones will improve cognitive function in MCI and will reduce brain amyloid-beta load and peripheral blood markers of inflammation. Improved cognitive function in this study will lead to a multi-center trial designed to assess whether the KE drink delays progression of MCI to AD.