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Effectiveness of Ketogenic Diet in MELAS Syndrome

Primary Purpose

MELAS Syndrome, Ketogenic Dieting

Status
Not yet recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Ketogenic diet
Sponsored by
Second Affiliated Hospital, School of Medicine, Zhejiang University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for MELAS Syndrome

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Patients who meet the diagnostic criteria of MELAS and have received MELAS standard therapy but are not satisfied with the therapeutic effect, and voluntarily underwent ketogenic therapy Exclusion Criteria: Diseases with porphyria and disturbances in fatty acid transport and oxidation, severe electrolyte metabolism abnormalities, severe hemodynamic instability, acute respiratory infections, uncontrolled systemic infections, severe liver and renal failure, cholesterolemia (>300mgdl), abnormal coagulation, acute pancreatitis, eating disorders, ketogenic diet intolerance, significant weight loss, poor compliance

Sites / Locations

  • Second Affiliated Hospital, School of Medicine, Zhejiang University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

self pre-and post-control

Arm Description

It is a self pre- and post-control, which compares the outcomes of the ketogenic diet with the status that did not receive ketogenic treatment

Outcomes

Primary Outcome Measures

Change from Baseline Clinical Symptom Score in 1 Year
According to the newcastle mitochondrial disease adult scale(NMDAS), including migraine headaches, seizures, stroke-like episodes and etc.
Change from Baseline Biochemical indicators in 1 Year
Blood glucose
Change from Baseline Biochemical indicators in 1 Year
keto, lactate and pyruvate monitoring
Hamilton Anxiety Scale (HAMA)
Change from Baseline Cognitive Function in 1 Year. Cognitive function was assessed using "Fepsy" software
Hamilton Depression Scale(HAMD
Change from Baseline Cognitive Function in 1 Year . Cognitive function was assessed using "Fepsy" software
Wechsler Intelligence Scale(WISC)
Change from Baseline Cognitive Function in 1 Year . Cognitive function was assessed using "Fepsy" software
Mini-mental State Examination(MMSE)
Change from Baseline Cognitive Function in 1 Year . Cognitive function was assessed using "Fepsy" software
Change from Baseline Diagnostic Examination in 1 Year
Cranial MRI(multimodal) Scalp EEG to evaluate posterior head α rhythm, discharge index, interictal epileptic discharges

Secondary Outcome Measures

Demographic Information and Medical History Collection
Gender, age, education level age of onset, genetic test, drug use, past history, personal history, family history

Full Information

First Posted
May 11, 2023
Last Updated
August 25, 2023
Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University
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1. Study Identification

Unique Protocol Identification Number
NCT06013397
Brief Title
Effectiveness of Ketogenic Diet in MELAS Syndrome
Official Title
Clinical Trial of Ketogenic Diet in the Treatment of Mitochondrial Encephalomyopathy With Lactic Acidosis and Stroke-like Episodes(MELAS)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
September 1, 2023 (Anticipated)
Primary Completion Date
June 1, 2038 (Anticipated)
Study Completion Date
June 1, 2038 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The goal of this clinical trial is to evaluate the effectiveness of ketogenic diet in patients with MELAS syndrome. The main questions it aims to answer are: Clarify the curative effects of ketogenic diet in the treatment of MELAS disease. Prevent the aggravation of MELAS disease, and improve the quality of life of patients. Provide reliable evidence-based medical basis for the clinical application of ketogenic diet in the treatment of MELAS syndrome patients. The clinical data of the participants treated with ketogenic diet will be collected, including the completion of ketogenic diet and clinical data at the start of treatment and after 1 month, 3 months, 6 months and 12 months
Detailed Description
Ketogenic diet initiation and follow-up: Before starting ketogenic diet treatment, patients with abnormal indexes such as liver, kidney, lipid, humoral immunity, hematuria, routine biochemical, electrolyte, trace elements and bone metabolism should be excluded, energy and nutrients should be calculated according to their height and weight, and patients will be taught with ketogenic diet treatment education Patients were initiated ketogenic diet after a short period of fasting (fasting no more than 48 hours). After treatment was initiated, 13 of the calculated target energy was given on the first day, 23 of the target energy was given on the second day, and the target amount was reached on the third day. Nutritionists made appropriate adjustments to the target energy according to the level of blood keto measured by patients Weekly follow-up via telemedicine system or social media, outpatient follow-up at the initiation of ketogenic therapy and at 1 month, 3 months, 6 months, and 12 months respectively. Outpatient follow-up was done in a joint clinic with a dietitian and a neurologist to evaluate the effects and side effects of ketogenic therapy on a compliant diet and related clinical examinations Clinical data collection: Demographic information and Medical history collection Gender, age, education level age of onset, genetic test, drug use, past history, personal history, family history Clinical symptom collection According to the Newcastle Mitochondrial Disease Adult Scale(NMDAS), including migraine headaches, seizures, stroke-like episodes and etc. Biochemical indicators Blood glucose, keto, lactate and pyruvate monitoring, dietary status, dietary ratio changes, energy changes, weight changes Cognitive function assessment Cognitive function was assessed using Fepsy software Diagnostic Examination Cranial MRI, scalp EEG

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
MELAS Syndrome, Ketogenic Dieting

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
self pre-and post-control
Arm Type
Experimental
Arm Description
It is a self pre- and post-control, which compares the outcomes of the ketogenic diet with the status that did not receive ketogenic treatment
Intervention Type
Dietary Supplement
Intervention Name(s)
Ketogenic diet
Intervention Description
Ketogenic diet (KD) is a high-fat, low-carbohydrate and moderate protein diet pattern, suitable for refractory epilepsy, glucose carrier protein 1 deficiency, pyruvate dehydrogenase deficiency, tumors and some genetic metabolic diseases. The ketogenic diet has been used to treat epilepsy for nearly 100 years, and its safety has been recognized by the medical community. In 2015, the ketogenic diet was included in the "Clinical Diagnosis and Treatment Guidelines - Epilepsy Volume" and became a commonly used treatment for refractory epilepsy.
Primary Outcome Measure Information:
Title
Change from Baseline Clinical Symptom Score in 1 Year
Description
According to the newcastle mitochondrial disease adult scale(NMDAS), including migraine headaches, seizures, stroke-like episodes and etc.
Time Frame
Baseline, 1 month, 3 months, 6 months and 12 months
Title
Change from Baseline Biochemical indicators in 1 Year
Description
Blood glucose
Time Frame
Baseline, 1 month, 3 months, 6 months and 12 months
Title
Change from Baseline Biochemical indicators in 1 Year
Description
keto, lactate and pyruvate monitoring
Time Frame
Baseline, 1 month, 3 months, 6 months and 12 months
Title
Hamilton Anxiety Scale (HAMA)
Description
Change from Baseline Cognitive Function in 1 Year. Cognitive function was assessed using "Fepsy" software
Time Frame
Baseline, 1 month, 3 months, 6 months and 12 months
Title
Hamilton Depression Scale(HAMD
Description
Change from Baseline Cognitive Function in 1 Year . Cognitive function was assessed using "Fepsy" software
Time Frame
Baseline, 1 month, 3 months, 6 months and 12 months
Title
Wechsler Intelligence Scale(WISC)
Description
Change from Baseline Cognitive Function in 1 Year . Cognitive function was assessed using "Fepsy" software
Time Frame
Baseline, 1 month, 3 months, 6 months and 12 months
Title
Mini-mental State Examination(MMSE)
Description
Change from Baseline Cognitive Function in 1 Year . Cognitive function was assessed using "Fepsy" software
Time Frame
Baseline, 1 month, 3 months, 6 months and 12 months
Title
Change from Baseline Diagnostic Examination in 1 Year
Description
Cranial MRI(multimodal) Scalp EEG to evaluate posterior head α rhythm, discharge index, interictal epileptic discharges
Time Frame
Baseline, 1 month, 3 months, 6 months and 12 months
Secondary Outcome Measure Information:
Title
Demographic Information and Medical History Collection
Description
Gender, age, education level age of onset, genetic test, drug use, past history, personal history, family history
Time Frame
Baseline

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients who meet the diagnostic criteria of MELAS and have received MELAS standard therapy but are not satisfied with the therapeutic effect, and voluntarily underwent ketogenic therapy Exclusion Criteria: Diseases with porphyria and disturbances in fatty acid transport and oxidation, severe electrolyte metabolism abnormalities, severe hemodynamic instability, acute respiratory infections, uncontrolled systemic infections, severe liver and renal failure, cholesterolemia (>300mgdl), abnormal coagulation, acute pancreatitis, eating disorders, ketogenic diet intolerance, significant weight loss, poor compliance
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yao Ding, doctor
Phone
13588015954
Email
zjdingyao@zju.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shuang Wang, doctor
Organizational Affiliation
Second Affiliated Hospital, School of Medicine, Zhejiang University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Second Affiliated Hospital, School of Medicine, Zhejiang University
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310000
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yao Ding, doctor
Phone
13588015854
Email
zjdingyao@zju.edu.cn

12. IPD Sharing Statement

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Effectiveness of Ketogenic Diet in MELAS Syndrome

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