The performance enhancing aspect of creatine supplementation in the periphery is well established in the literature, but as time goes by, we learn more about the impact this molecule has on the brain function. PCr levels can be reliably increased in the muscle tissue, but the same cannot be said for the brain where the uptake is limited greatly by the brain blood barrier. Phosphorylated creatine replenishes cellular energy without oxygen, and therefore might exert neuroprotective properties at times of low oxygen availability (such as hypoxia). The protective effect on neurons appears to be mediated by creatine’s ability to donate phosphate groups (secondary) leading to an increase in energy reserve and preservation of ATP (primary). Cerebral hypoxia might lead to impairments on a wide range of cognitive tasks, however we need more data to determine under which conditions and to what extent creatine helps mitigate the damage and loss of function in oxygen deprived subjects. Creatine seems to be capable of improving a wide range of sleep deprivation induced cognitive deficits, and fares fairly well in terms of bolstering executive function, with positive effects also observed on learning, reaction speed and fatigue. Creatine might also exert protective function on dopaminergic function, protecting the neurons from cell death and suppression of toxin- induced dopamine synthesis (possibly mediated via tyrosine hydroxylase and COX2), leading to increased interest in its use in age-related neurological disorders such as Parkinson’s disease, which is characterised by progressive loss of dopaminergic function.

Creatine is unlikely to cause an outright improvement in cognition in otherwise healthy young omnivores- it might be more accurate to describe it as supportive of pro-cognitive effects.

As far as cognitive enhancement is concerned, creatine has been demonstrated to increase memory, learning, and performance in people with low dietary creatine intake, such as vegetarians and vegans. Additionally, it appears that these benefits might extend to individuals who are sleep deprived and elderly people without any obvious cognitive decline.

Researchers found that creatine loading (four times daily x 5g for a week ) before sleep deprivation for duration of 12-36 hours was able to preserve cognition during complex tasks of executive function at 36 hours. There was no significant influence on immediate recall or mood.

A similar protocol replicated the inability to improve memory and attention, with improvements noted vis-a-vis fatigue (over the course of 24 hours) and decline of vigor.