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Proof of Mechanism of a New Ketogenic Supplement Using Dual Tracer PET (Positron Emission Tomography)

Not Applicable
Completed
Conditions
Mild Cognitive Impairment
Interventions
Dietary Supplement: placebo
Dietary Supplement: ketogenic drink
Registration Number
NCT02551419
Lead Sponsor
Université de Sherbrooke
Brief Summary

A six month, placebo-controlled, parallel group project in which MCI participants will receive 30 g/day of a custom-made MCT-based ketogenic supplement or a matching placebo. Uptake of both the brain's fuels - ketones (as 11C-AcAc) and glucose (as FDG) - both before and after the intervention will be assessed by PET (position emission tomography) ; imaging and ketone pharmacokinetic as primary objective as well as fMRI, diffusion MRI and cognition.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
82
Inclusion Criteria
  • subjective memory complaint
  • Montreal Cognitive Assessment (MoCA) score of 18-26/30 or a Mini-mental state exam (MMSE) score of 24-27/30
  • autonomy for activity of daily living
  • absence of depression
Exclusion Criteria
  • diagnosis of a major cognitive disorder
  • diseases or psychiatric disorders that could interfere with participation
  • uncontrolled diabetes (fasting plasma glucose >7 mM or glycated hemoglobin >6.5%)
  • major depression or history of alcohol or substance abuse within the past 2 years,
  • already supplementing with coconut oil or MCT
  • vitamin B12 deficiency
  • uncontrolled hypertension, dyslipidemia, or thyroid disease,
  • visual or hearing impairment impeding comprehension
  • participation in another intervention trial
  • inability to lie down without moving for 60 min (for the brain imaging)
  • presence of implanted metal objects or devices contraindicated for MRI (phase 1)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboplaceboLactose-free skim milk-based placebo drink containing high-oleic sunflower oil of equivalent energy value to the active arm for a 6 months supplementation
ketogenic drinkketogenic drinkMCT ketogenic drink: ketogenic drink providing 30 g/d of MCT oil in 250 ml of lactose-free skim milk for 6 months supplementation
Primary Outcome Measures
NameTimeMethod
Change in plasma ketoneBaseline and 6 months of intervention

The change in plasma ketone will be measure to obtain a ketone chronic response

Change in global ketone (11C-AcAc) uptake in grey matterBaseline and 6 months of intervention

The change in brain ketone uptake will be quantified by PET and expressed as cerebral metabolic rate of AcAc (CMR-A)

Secondary Outcome Measures
NameTimeMethod
Change in regional CMR-ABaseline and 6 months of intervention

The change in brain ketone uptake will be quantified by PET in different regions of the brain

Blood metabolite profile GlucoseBaseline and 6 months of intervention

Changes in Glucose (mM)

Derived cerebral metabolic rate of total ketonesBaseline and 6 months of intervention

Cerebral metabolic rate of total ketone derived from ketone PET (dCMRket, μmol/100 g/min)

Pharmacokinetic ketone response (phase 2)Baseline and 6 months of intervention

Area under the curve of pharmacokinetic of blood ketone

Change in cognitive status- language domainBaseline and 6 months of intervention

Change in language assessed by Boston Naming Test (Z score)

Change in global brain FDG uptake in grey matter (CMR-G)Baseline and 6 months of intervention

The change in brain glucose uptake will be quantified by PET and expressed as cerebral metabolic rate of glucose (CMR-G)

regional brain volumes by vMRIBaseline and 6 months of intervention

Change in brain volume measure by MRI

Change in cognitive status - episodic memoryBaseline and 6 months of intervention

Change in episodic memory assessed by the 16-item free/cued word learning (Buschke and Grober test- Z score of trial 1, 2, 3 and delay) and the Brief Visuospatial Memory Test-revised (Z score of trial 1)

Change in cognitive status - executive functionBaseline and 6 months of intervention

Change in executive function assessed by condition 4 of the trail making test, condition 3 and 4 of the Stroop test and the 4 conditions of verbal fluency test (all Z score)

Change in cognitive status - processing speedBaseline and 6 months of intervention

Change in processing speed assessed by global score of Digit Span (WAIS III), Digit Symbol (WAIS III), condition 1 and 2 of Stroop test and condition 1,2,3,5 of the trail making test (all Z score)

Blood metabolite profile triglyceridesBaseline and 6 months of intervention

Changes in Triglycerides (mM)

Blood metabolite profile cholesterolBaseline and 6 months of intervention

Changes in Total cholesterol (mM)

Trial Locations

Locations (1)

Research Center on Aging

🇨🇦

Sherbrooke, Quebec, Canada

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