Feb 1, 2025

Feb 1, 2025

Feb 1, 2025

Ketones and Brain Injury: Clinical Review

Ketones and Brain Injury: Clinical Review

Ketones and Brain Injury: Clinical Review

This clinical review highlights ketones as a promising therapy for traumatic brain injury (TBI) and stroke. By bypassing glucose metabolism, reducing inflammation, and supporting mitochondrial function, ketones—particularly β-hydroxybutyrate (BHB)—may improve outcomes in acute and chronic brain injury. Human and animal studies suggest benefits in reducing neuronal loss, improving energy availability, and enhancing recovery, though more clinical trials are needed. Ketone esters and ketogenic strategies could play a pivotal role in brain trauma care.

This clinical review highlights ketones as a promising therapy for traumatic brain injury (TBI) and stroke. By bypassing glucose metabolism, reducing inflammation, and supporting mitochondrial function, ketones—particularly β-hydroxybutyrate (BHB)—may improve outcomes in acute and chronic brain injury. Human and animal studies suggest benefits in reducing neuronal loss, improving energy availability, and enhancing recovery, though more clinical trials are needed. Ketone esters and ketogenic strategies could play a pivotal role in brain trauma care.

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Summary of

Ketones and Brain Injury: Clinical Review

By

Csilla Ari

Csilla Ari

, et al.

, et al.

View Study PDF

Purpose

To review the current clinical and preclinical evidence supporting the use of ketones in the treatment of brain injuries, including TBI and stroke.

Methods

This review synthesizes findings from animal studies, clinical case reports, and ongoing trials exploring the impact of ketogenic diets, exogenous ketones, and metabolic shifts on brain injury outcomes. Key mechanisms discussed include mitochondrial support, oxidative stress reduction, and anti-inflammatory effects.

Results

Across models, ketones improved ATP availability, reduced oxidative stress, inhibited the NLRP3 inflammasome, and protected neurons. Clinical reports showed ketone therapies were safe, with early signals of cognitive and motor improvement post-injury. Notably, BHB supported cerebral metabolism during glucose impairment and promoted healing.

Conclusion

Ketone therapy shows multi-pathway neuroprotective effects and offers a compelling adjunctive strategy for brain injury treatment. Clinical validation is ongoing, but early evidence supports its integration into TBI and neurorehabilitation protocols.

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This Ohio State University study explored whether a ketone-salt and caffeine supplement could enhance exercise and cognitive performance in healthy, non-keto-adapted adults. Twelve recreationally trained participants consumed either the supplement or water before cycling to exhaustion. The supplement raised ketone levels over twofold and significantly increased time to exhaustion by 8.3% and Wingate average power by 4.3%. No significant cognitive benefits were observed. The supplement was well tolerated, with no adverse GI events. These findings support the ergogenic use of ketone salts with caffeine for boosting high-intensity exercise performance.

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Effects of a Ketone/Caffeine Supplement on Cycling and Cognitive Performance
This Ohio State University study explored whether a ketone-salt and caffeine supplement could enhance exercise and cognitive performance in healthy, non-keto-adapted adults. Twelve recreationally trained participants consumed either the supplement or water before cycling to exhaustion. The supplement raised ketone levels over twofold and significantly increased time to exhaustion by 8.3% and Wingate average power by 4.3%. No significant cognitive benefits were observed. The supplement was well tolerated, with no adverse GI events. These findings support the ergogenic use of ketone salts with caffeine for boosting high-intensity exercise performance.

Aug 1, 2019

Improvement of cognitive functions by oral intake of Hericium erinaceus
Billed as a medicinal mushroom for centuries, lion’s mane (Hericium erinaceus) is now being studied for its brain‑boosting effects. In this double‑blind, placebo‑controlled trial, 34 adults over 50 were randomized to take powdered H. erinaceus capsules or placebo for 12 weeks; 31 completed the study. Cognitive function was tested at the start, halfway, and end using the Mini Mental State Examination, Benton visual retention, and paired‑associate learning tests. Those who consumed the mushroom saw significant improvement and prevented decline in Mini Mental State scores compared with placebo. No serious side effects were reported, and researchers attribute benefits to neurotrophic compounds in the mushroom.

Jan 1, 2021

Effects of a Ketone/Caffeine Supplement on Cycling and Cognitive Performance
This Ohio State University study explored whether a ketone-salt and caffeine supplement could enhance exercise and cognitive performance in healthy, non-keto-adapted adults. Twelve recreationally trained participants consumed either the supplement or water before cycling to exhaustion. The supplement raised ketone levels over twofold and significantly increased time to exhaustion by 8.3% and Wingate average power by 4.3%. No significant cognitive benefits were observed. The supplement was well tolerated, with no adverse GI events. These findings support the ergogenic use of ketone salts with caffeine for boosting high-intensity exercise performance.

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Improvement of cognitive functions by oral intake of Hericium erinaceus
Billed as a medicinal mushroom for centuries, lion’s mane (Hericium erinaceus) is now being studied for its brain‑boosting effects. In this double‑blind, placebo‑controlled trial, 34 adults over 50 were randomized to take powdered H. erinaceus capsules or placebo for 12 weeks; 31 completed the study. Cognitive function was tested at the start, halfway, and end using the Mini Mental State Examination, Benton visual retention, and paired‑associate learning tests. Those who consumed the mushroom saw significant improvement and prevented decline in Mini Mental State scores compared with placebo. No serious side effects were reported, and researchers attribute benefits to neurotrophic compounds in the mushroom.
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