Svart · PloS one 2018 · randomized crossover trial · n=9

Regional cerebral effects of ketone body infusion with 3-hydroxybutyrate in humans: Reduced glucose uptake, unchanged oxygen consumption and increased blood flow by positron emission tomography. A randomized, controlled trial.

Cited 107 times in the scientific literature.

Level 2 - randomized trial

Individual randomized crossover trial in humans

PubMed 29489818 · doi:10.1371/journal.pone.0190556 · record verified 2026-08-30

What was done

Nine healthy human subjects were studied in a randomized crossover design on two separate occasions: once with and once without a continuous infusion of 3-hydroxybutyrate. Positron emission tomography (PET) was used to measure regional cerebral glucose utilization, oxygen consumption, and cerebral blood flow across parietal, occipital, temporal, frontal, and cortical grey regions.

What was found

During 3-hydroxybutyrate infusions, blood concentrations reached 5.5 ± 0.4 mmol/l. In all measured brain regions, cerebral glucose utilization decreased by 14% and cerebral blood flow increased by 30%. Cerebral oxygen consumption remained unchanged, accompanied by a decrease in oxygen extraction.

Why it matters

This study provides direct quantitative PET evidence in humans that acute elevation of ketone bodies reduces brain glucose uptake and boosts cerebral blood flow without compromising cerebral oxygen metabolism.

Limits

The sample size was very small (n = 9) and restricted to healthy volunteers. Findings reflect acute intravenous ketone infusion rather than diet-induced ketosis or chronic exposure, and clinical outcomes in neurological disease populations were not evaluated.

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