Trial reportNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2022
Ketogenic diet in refractory migraine: possible efficacy and role of ketone bodies-a pilot experience.
Trial report in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Bibliometric analysis of ketogenic diet for pain based on dual databases: global trends and research hotspots from the Web of Science Core Collection and Scopus (2006-2025).Frontiers in nutrition · 2026Pooled it
- Ketosis and migraine: a systematic review of the literature and meta-analysis.Frontiers in nutrition · 2023Pooled it
- Dietary Modulation of Migraine: Metabolic, Neuroinflammatory and Microbiota-Mediated Mechanisms.Journal of clinical medicine · 2026Review
- A review on gut microbiota and migraine severity: a complex relationship.Inflammopharmacology · 2026Review
- Associations between dietary intake of mitochondria-related nutrients with the risk of migraine: a prospective study of 202,656 participants.The journal of headache and pain · 2025Article
- The Hypometabolic State of the Migraine Brain: Is a Ketogenic Diet the Answer?Brain and behavior · 2025Review
- Metabolic Dysfunction and Dietary Interventions in Migraine Management: The Role of Insulin Resistance and Neuroinflammation-A Narrative and Scoping Review.Brain sciences · 2025Review
- Ketogenic Diet Improves Sleep Quality and Daytime Sleepiness in Chronic Migraine: A Pilot Study.Neurology international · 2024Article
- The Evidence for Diet as a Treatment in Migraine-A Review.Nutrients · 2024Review
- Migraine Management in Medically Complex Patients: a Narrative Review.Current neurology and neuroscience reports · 2024Review
- The Brain, the Eating Plate, and the Gut Microbiome: Partners in Migraine Pathogenesis.Nutrients · 2024Review
- CGRP Antagonism and Ketogenic Diet in the Treatment of Migraine.Medicina (Kaunas, Lithuania) · 2024Review
- The Effect of Three Different Ketogenic Diet Protocols on Migraine and Fatigue in Chronic and High-Frequency Episodic Migraine: A Pilot Study.Nutrients · 2023Article
- Association between Malnutrition and Migraine Risk Assessed Using Objective Nutritional Indices.Nutrients · 2023Article
- 2:1 ketogenic diet and low-glycemic-index diet for the treatment of chronic and episodic migraine: a single-center real-life retrospective study.The journal of headache and pain · 2023Article
- The Relationship of Ketogenic Diet with Neurodegenerative and Psychiatric Diseases: A Scoping Review from Basic Research to Clinical Practice.Nutrients · 2023Article
- Review
- Nummular headache: a case report of remission following ketogenic diet and botulinum toxin type A injections.Frontiers in neurology · 2023Article
- Breaking the cycle: unraveling the diagnostic, pathophysiological and treatment challenges of refractory migraine.Frontiers in neurology · 2023Review
- Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRefractory migraine is a particularly disabling form of chronic migraine, unresponsive to multiple prophylactic strategies. Ketogenic diet (KD) is useful to treat migraine but poorly tested for refractory migraine.
objectiveWe started exploring the efficacy and safety of KD, as compared to a non-ketogenic dietary regimen similar in reduction of carbohydrate intake (low-carb diet, LCD), in refractory migraine. Secondary objective was to explore whether ketones have a role in the prophylaxis induced by KD on migraine.
resultsIn a first trial, 22 patients with refractory migraine were included and completed the study. Thirteen (mean age 36.8 ± 12.9 years, 11 females, 2 males) were assigned to the KD arm and eight (mean age 50.9 ± 10.8 years; all females), not eligible for KD, to LCD. Patients treated with KD showed a significant reduction in the frequency of migraine attacks, intensity of headache, and amount of drug intake. No significant benefit was seen in the LCD group. A relationship between ketone production and effect on headache was observed among patients with a good response to KD. In a second study, additional 31 refractory migraineurs were treated with these two dietary regimens, 26 with the same KD scheme and 5 with a LCD. Results were comparable with those of the first study.
conclusionsKD might be a useful option in refractory migraine. Ketones seem to have a role in migraine modulation and their regular measurement might be useful to monitor KD in migraineurs. Larger, randomized, and controlled trials are needed to confirm these data.
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