title: Cerebral energetic effects of creatine supplementation in humans.
abstract: There has been considerable interest in the use of creatine (Cr) supplementation to treat neurological disorders. However, in contrast to muscle physiology, there are relatively few studies of creatine supplementation in the brain. In this report, we use high-field MR (31)P and (1)H spectroscopic imaging of human brain with a 7-day protocol of oral Cr supplementation to examine its effects on cerebral energetics (phosphocreatine, PCr; ATP) and mitochondrial metabolism (N-acetyl aspartate, NAA; and Cr). We find an increased ratio of PCr/ATP (day 0, 0.80 +/- 0.10; day 7, 0.85 +/- 09), with this change largely due to decreased ATP, from 2.7 +/- 0.3 mM to 2.5 +/- 0.3 mM. The ratio of NAA/Cr also decreased (day 0, 1.32 +/- 0.17; day 7 1.18 +/- 0.13), primarily from increased Cr (9.6 +/- 1.9 to 10.1 +/- 2.0 mM). The Cr-induced changes significantly correlated with the basal state, with the fractional increase in PCr/ATP negatively correlating with the basal PCr/ATP value (R = -0.74, P < 0.001). As NAA is a measure of mitochondrial function, there was also a significant negative correlation between basal NAA concentrations with the fractional change in PCr and ATP. Thus healthy human brain energetics is malleable and shifts with 7 days of Cr supplementation, with the regions of initially low PCr showing the largest increments in PCr. Overall, Cr supplementation appears to improve high-energy phosphate turnover in healthy brain and can result in either a decrease or an increase in high-energy phosphate concentrations.
authors.affiliation: Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06520, USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Pan
authors.forename: K
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000284:Administration, Oral; D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D003401:Creatine / Q000008:administration & dosage* / Q000378:metabolism / Q000494:pharmacology*; D019587:Dietary Supplements; D004734:Energy Metabolism / Q000187:drug effects*; D005260:Female; D006624:Hippocampus / Q000187:drug effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008928:Mitochondria / Q000378:metabolism; D010725:Phosphocreatine / Q000378:metabolism; D013687:Telencephalon / Q000187:drug effects*
chemical_list: D010725:Phosphocreatine; D001224:Aspartic Acid; D000255:Adenosine Triphosphate; C000179:N-acetylaspartate; D003401:Creatine