Thread by @KetoCounselor

Today we are going to talk about white matter disease and what it means for the brain. Settle in for a thread. 🧵(1/27)

The brain is mostly made up of gray matter and white matter. The gray matter covers the outside of our brain, which is called the cortex, meaning the bark. White matter is mostly on the inside. (2/27)

White matter consists of nerve fibers that connect different parts of the brain, and it's covered in a myelin sheath. This protective sheath appears white because it's made up exclusively of fat, along with a few other types of molecules. (3/27)

White matter's role is to conduct information and move it from one part of the brain to another. (4/27)

Chronic ischemic brain disease, CNS small vessel disease, leukoaraiosis, white matter hyperintensities, white matter lesions, lacunar infarcts, microvascular disease, or small vessel disease. All of these names refer to the same thing, which is white matter disease. (5/27)

White matter disease means that the blood vessels supplying the white matter have either closed up, broken off, or swollen under pressure, leading to insufficient oxygen and micronutrient supply to nerve cells. (6/27)

Tiny blood vessels die off, which reduces or entirely eliminates the energy source for the brain cells supplied by that particular blood vessel. White matter disease is a term referring to sustained damage to a specific part of the brain caused by reduced blood flow. (7/27)

In the brain, these things typically happen in the periventricular spaces, which is the center of the brain. The reason for this is that the blood vessels in this part of the brain have the smallest diameter, as small as a strand of hair. (8/27)

Hence, even a small amount of damage in this area can lead to issues. Inflammation causes this damage. (9/27)

Newly discovered functional subsets of microglia have been found to contribute to the white matter response in CNS disease onset and progression. (10/27)

Microglia show different molecular patterns and morphologies depending on the disease type and brain region, particularly in white matter. (11/27)

In the later stages of the disease, overactive microglia can perpetuate disease progression in white matter diseases through their pro-inflammatory, oxidative, and excitotoxic effects, impairing myelin repair and inducing neurodegeneration. (12/27)

Let me give an example of what this looks like. Some microglia get put on overdrive in a highly inflammatory environment and start chomping down on things they shouldn't. (13/27)

They start to munch (phagocytosis) cells and structures that are not dead yet. Some of that is myelin in white matter. And if we had chilled the immune system out, much myelin might have been saved. (14/27)

Do you know what makes microglia happy, calm, and functioning? A ketogenic diet. Think I am making this stuff up? I am not. Keep reading. ⬇️ (15/27)

Anti-depression effects of ketogenic diet are mediated via the restoration of microglial activation and neuronal excitability... (16/27) sciencedirect.com/science/articl…

Neuroprotective and Anti-inflammatory Activities of Ketogenic Diet on MPTP-induced Neurotoxicity (17/27) link.springer.com/article/10.100…

The role of microglia in neuroprogressive disorders: mechanisms and possible neurotherapeutic effects of induced ketosis (18/27) sciencedirect.com/science/articl…

Sorry. Do you need some more to feel convinced? No problem. I got you! How about the article titled, The role of microglia in neuroprogressive disorders: mechanisms and possible neurotherapeutic effects of induced ketosis ⬇️(19/27)

"… trials of the ketogenic diet and other ketosis-inducing strategies for … the amelioration on microglial activity and neuroinflammation …" (20/27) sciencedirect.com/science/articl…

How about one more? The Therapeutic Role of Ketogenic Diet in Neurological Disorders. (21/27) mdpi.com/2072-6643/14/9…

So why is a mental health counselor interested in brain health making threads about this? Because some of you (or your loved ones) will have these mood, memory, and balance symptoms. (22/27)

Current treatments, as you can imagine, are uninspired—physical therapy, medicating hypertension and diabetes, and watching your cholesterol. 🙄 (23/27) my.clevelandclinic.org/health/disease…

Maybe instead of telling people not to worry about the white matter damage being picked up on scans as "aging" and to not worry about it, we could have neurologists offer a ketogenic diet. (24/27)

Maybe a neurologist could explain to someone that a ketogenic diet, in one fell swoop, can stop, slow, or maybe even reverse their white matter disease by addressing metabolic and immune system dysfunction directly. 🤷(25/27)

Why isn't microglial activation and function being targeted with a ketogenic diet as a potential therapeutic strategy for treating white matter diseases? As you can see, the science is already there. (26/27)

Consider retweeting the first of this thread. People with white matter disease have the right to know all the ways they can feel better. (27/27) #brainhealthmatters

Whoops my thread got unruly! Ignore the duplicate.