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While glucose is an essential energetic substrate for the brain, we frequently observe a strong decrease in glucose delivery and\/or a glucose metabolic dysregulation following acute brain injury. In parallel, during the last decades, lactate and ketone bodies have been identified as potential alternative fuels to provide energy to the brain, both under physiological conditions and in case of glucose shortage. They are now viewed as integral parts of brain metabolism. In addition to their energetic role, experimental evidence also supports their neuroprotective properties after acute brain injury, regulating in particular intracranial pressure control, decreasing ischemic volume, and leading to an improvement in cognitive functions as well as survival. In this review, we present preclinical and clinical evidence exploring the mechanisms underlying their neuroprotective effects and identify research priorities for promoting lactate and ketone bodies use in brain injury.<\/jats:p>","DOI":"10.1177\/0271678x241245486","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T15:39:25Z","timestamp":1712849965000},"page":"1078-1088","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":38,"title":["Neuroprotective effects of lactate and ketone bodies in acute brain injury"],"prefix":"10.1177","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3641-6281","authenticated-orcid":false,"given":"Guillaume","family":"Plourde","sequence":"first","affiliation":[{"name":"Division of Intensive Care Medicine, Department of Medicine, Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Roumes","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9sonance Magn\u00e9tique des Syst\u00e8mes Biologiques (CRMSB), Univ. 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