Efficacy of Modified Atkins Ketogenic Diet in Chronic Cluster Headache: An Open-Label, Single-Arm, Clinical Trial

INTRODUCTION: Drug-resistant cluster headache (CH) is still an open clinical challenge. Recently, our group observed the clinical efficacy of a ketogenic diet (KD), usually adopted to treat drug-resistant epilepsies, on migraine. AIM: Here, we aim to detect the effect of KD in a group of drug-resistant chronic CH (CCH) patients. MATERIALS AND METHODS: Eighteen drug-resistant CCH patients underwent a 12-week KD (Modified Atkins Diet, MAD), and the clinical response was evaluated in terms of response (≥50% attack reduction). RESULTS: Of the 18 CCH patients, 15 were considered responders to the diet (11 experienced a full resolution of headache, and 4 had a headache reduction of at least 50% in terms of mean monthly number of attacks during the diet). The mean monthly number of attacks for each patient at the baseline was 108.71 (SD = 81.71); at the end of the third month of diet, it was reduced to 31.44 (SD = 84.61). CONCLUSION: We observed for the first time that a 3-month ketogenesis ameliorates clinical features of CCH. CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier NCT03244735.