title: Ketone bodies do not directly alter excitatory or inhibitory hippocampal synaptic transmission.
abstract: OBJECTIVE
  To determine the effect of the ketone bodies beta-hydroxybutyrate (betaHB) and acetoacetate (AA) on excitatory and inhibitory neurotransmission in the mammalian CNS.
  
  
  BACKGROUND
  The ketogenic diet is presumed to be an effective anticonvulsant regimen for some children with medically intractable seizures. However, its mechanism of action remains a mystery. According to one hypothesis, ketone bodies have anticonvulsant properties.
  
  
  METHODS
  The authors examined the effect of betaHB and AA on excitatory and inhibitory synaptic transmission in rat hippocampal-entorhinal cortex slices and cultured hippocampal neurons. In cultured neurons, their effect was also directly assayed on postsynaptic receptor properties. Finally, their ability to prevent spontaneous seizures was determined in a hippocampal-entorhinal cortex slice model.
  
  
  RESULTS
  betaHB and AA did not alter synaptic transmission in these models.
  
  
  CONCLUSIONS
  The anticonvulsant properties of the ketogenic diet do not result from a direct effect of ketone bodies on the primary voltage and ligand gated ion channels mediating excitatory or inhibitory neurotransmission in the hippocampus.
authors.affiliation: Department of Neurology, Center for the Study of Nervous System Injury, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: L L
authors.initials: LL
authors.lastname: Thio
authors.forename: M
authors.initials: M
authors.lastname: Wong
authors.forename: K A
authors.initials: KA
authors.lastname: Yamada
mesh_terms: D020155:3-Hydroxybutyric Acid / Q000494:pharmacology*; D015761:4-Aminopyridine; D000090:Acetoacetates / Q000494:pharmacology*; D000818:Animals; D002478:Cells, Cultured; D004032:Diet; D018728:Entorhinal Cortex / Q000166:cytology; D004827:Epilepsy / Q000139:chemically induced / Q000178:diet therapy / Q000503:physiopathology; D005071:Evoked Potentials / Q000187:drug effects; D018690:Excitatory Amino Acid Agonists / Q000494:pharmacology; D005215:Fasting / Q000502:physiology; D018698:Glutamic Acid / Q000493:pharmacokinetics; D005998:Glycine / Q000494:pharmacology; D006624:Hippocampus / Q000166:cytology*; D007608:Kainic Acid / Q000494:pharmacology; D007662:Ketosis / Q000209:etiology; D008564:Membrane Potentials / Q000187:drug effects; D009433:Neural Inhibition / Q000187:drug effects; D009474:Neurons / Q000166:cytology / Q000187:drug effects / Q000502:physiology*; D018408:Patch-Clamp Techniques; D051381:Rats; D018091:Receptors, AMPA / Q000502:physiology; D011963:Receptors, GABA-A / Q000502:physiology; D018009:Receptors, Glycine / Q000502:physiology; D018092:Kainic Acid Receptors / Q000502:physiology; D016194:Receptors, N-Methyl-D-Aspartate / Q000502:physiology; D013268:Stimulation, Chemical; D013570:Synaptic Membranes / Q000737:chemistry / Q000187:drug effects; D009435:Synaptic Transmission / Q000187:drug effects*; D005680:gamma-Aminobutyric Acid / Q000493:pharmacokinetics
chemical_list: D020155:3-Hydroxybutyric Acid; D015761:4-Aminopyridine; D000090:Acetoacetates; D018690:Excitatory Amino Acid Agonists; D018698:Glutamic Acid; D005998:Glycine; D007608:Kainic Acid; D018091:Receptors, AMPA; D011963:Receptors, GABA-A; D018009:Receptors, Glycine; D018092:Kainic Acid Receptors; D016194:Receptors, N-Methyl-D-Aspartate; D005680:gamma-Aminobutyric Acid