An amino acid whose role is to maintain energy homeostasis by keeping cellular ATP levelsconstant in cells with high and fluctuating energy demands, such as those found in muscles andthe brain.
Why it matters:
Beyond physical performance, the body of literature continues to expand. Since 2012, there have been ~134,000 research articles published focused on creatine. Of those articles: ~32,900 focused on the brain and ~17,300 focused on TBI Recovery.
Neural creatine concentrations are altered after mTBI and sub-concussive injury, with a reduction (or no change) in gray matter areas and an increase in white matter areas.
What you should know:
The post-concussion syndrome symptoms reported after mTBI share some similarity to those reported in individuals with impairments in creatine metabolism, and may both be due to a shared underlying cellular energy deficit.
TBI studies demonstrate that creatine supplementation can have both neuroprotective effects in animal models (e.g., protect mitochondrial function, antioxidant effects and increased ATP) and in clinical cohorts (e.g., improve recovery, reduce headache, dizziness, fatigue, and improve cognition).
Research has shown that creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation, and concussion and/or spinal cord neuroprotection.
A number of clinical applications of creatine supplementation have been studied involving neurodegenerative diseases (e.g., muscular dystrophy, Parkinson’s, Huntington’s disease).
When considering the influence of supplementation strategies on cognitive processes, it appears that creatine is most likely to exert an influence in situations whereby cognitive processes are stressed, e.g. during sleep deprivation, experimental hypoxia, or during the performance of more complex, and thus more cognitively demanding tasks.
Evidence exists indicating that increased brain creatine may be effective at reducing the severity of, or enhancing recovery from mild traumatic brain injury.
Creatine supplementation shows some potential as a neuroprotective when administered prior to or after TBI.
Consistent with creatine’s cellular role, supplementation reduced neuronal damage, protected against the effects of cellular energy crisis and improved cognitive and somatic symptoms.
There is a potential for creatine supplementation to improve cognitive processing, especially in conditions characterized by brain creatine deficits, which could be induced by acute stressors (e.g., exercise, sleep deprivation) or chronic, pathologic conditions (e.g., creatine synthesis enzyme deficiencies, mild traumatic brain injury, aging, Alzheimer’s disease, depression).
