Alraddadi Eman A, Khojah Abdulrahman M, Alamri Faisal F, Kecheck Husun K, Altaf Wid F, Khouqeer Yousef
Department of Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
Front Neurosci. 2023 Jun 29;17:1201971. doi: 10.3389/fnins.2023.1201971. eCollection 2023.
Epilepsy is one of the most common neurological disorders affecting people of all ages representing a significant social and public health burden. Current therapeutic options for epilepsy are not effective in a significant proportion of patients suggesting a need for identifying novel targets for the development of more effective therapeutics. There is growing evidence from animal and human studies suggesting a role of impaired brain energy metabolism and mitochondrial dysfunction in the development of epilepsy. Candidate compounds with the potential to target brain energetics have promising future in the management of epilepsy and other related neurological disorders. Creatine is a naturally occurring organic compound that serves as an energy buffer and energy shuttle in tissues, such as brain and skeletal muscle, that exhibit dynamic energy requirements. In this review, applications of creatine supplements in neurological conditions in which mitochondrial dysfunction is a central component in its pathology will be discussed. Currently, limited evidence mainly from preclinical animal studies suggest anticonvulsant properties of creatine; however, the exact mechanism remain to be elucidated. Future work should involve larger clinical trials of creatine used as an add-on therapy, followed by large clinical trials of creatine as monotherapy.
癫痫是影响各年龄段人群的最常见神经系统疾病之一，构成了重大的社会和公共卫生负担。目前针对癫痫的治疗方案对相当一部分患者无效，这表明需要确定新的靶点以开发更有效的治疗方法。越来越多来自动物和人体研究的证据表明，脑能量代谢受损和线粒体功能障碍在癫痫的发生发展中起作用。具有靶向脑能量学潜力的候选化合物在癫痫及其他相关神经系统疾病的治疗方面有着广阔的前景。肌酸是一种天然存在的有机化合物，在诸如脑和骨骼肌等具有动态能量需求的组织中充当能量缓冲剂和能量穿梭体。在本综述中，将讨论肌酸补充剂在以线粒体功能障碍为病理核心成分的神经系统疾病中的应用。目前，主要来自临床前动物研究的有限证据表明肌酸具有抗惊厥特性；然而，确切机制仍有待阐明。未来的工作应包括开展更大规模的肌酸作为辅助治疗的临床试验，随后进行肌酸作为单一疗法的大型临床试验。
