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Increased dopamine activity is thought to play a role in the pathophysiology of Tourette syndrome (TS). Since ketogenic diet (KD) is thought to change several neurotransmitter systems, we hypothesized that modified KD could be beneficial in treatment of tics. A single-site prospective study with intention-to-treat design was performed with 26 children with TS. After an observation period, participants were randomized into two groups: Group a started diet immediately, and group B started after a further observation period of 3-5 months. Participants were examined with validated diagnostic instruments to assess severity of tics and comorbidity at diet start, after one month and thereafter every three months. The mean number of days on diet was 65.62 days. The diet was well tolerated but difficult to maintain. There were no significant differences in effect of diet between the groups or over time, but a tendency towards positive effect of diet was seen (p = 0.1025).

Modified Atkins Diet for Tics Requiring Treatment in Tourette Syndrome: A Randomized Controlled Trial of Early Versus Late Initiation