Exogenous ketosis mitigates hypoxia-induced neural signaling alterations and cerebral oxygenation decline at rest in healthy males

Twelve healthy males completed three randomized crossover sessions: normoxia plus placebo, hypoxia plus placebo, and hypoxia plus ketone ester (KE). Each session included endurance and high-intensity interval exercise followed by a 16-hour period including sleep, and a 30-minute all-out time trial the next day. EEG was recorded at rest and during exercise, and cerebral tissue oxygenation index and cognitive performance were assessed at rest. At rest, KE attenuated the hypoxia-induced increases in alpha and beta power and the declines in cerebral tissue oxygenation index, while cognitive performance was unaffected.