THERAPEUTIC ACTIONS

SCOPE: Recent findings indicate that ketogenic diet is neuroprotective and electrical stimulation can improve functional recovery from peripheral nerve injury. However, it is not clear whether ketogenic diet and electrical stimulation play synergistical role in the peripheral nerve recovery following injury.

METHODS AND RESULTS: We used ketogenic diet consisting of 3:1 ratio of fat to carbohydrate+protein and coupled it with electrical stimulation treatment in a rat model of peripheral nerve crush injury. Neuromuscular recovery was evaluated by electromyography, and axonal regeneration and myelination by histological methods. We also investigated the effects on IGF-1 and IGF-1 receptor expression in peripheral nerve tissue, pre- and post-nerve injury. Combination of ketogenic diet and electrical stimulation synergistically increased muscle force in biceps femoris and gluteus maximus and prevented development of hypersensitivity in biceps femoris. It promoted peripheral nerve regeneration by increasing total axons, axons density, and axonal diameter, as well as myelin thickness and axon/fiber ratio. These effects were due to modulation of IGF system as the treatment expression of IGF-1 and IGF-1 receptor in regenerated nerve tissue.

CONCLUSION: Our results establish that ketogenic diet and electrical stimulation promote peripheral nerve regeneration. Patients recovering from peripheral nerve injury may benefit from this combinational approach. This article is protected by copyright. All rights reserved.