Creatine supplementation and exercise as possible therapeutic treatments in Parkinson’s Disease: A review

Parkinson’s disease (PD) is the second most common progressive neurodegenerative condition after Alzheimer’s Disease. It is characterized by a progressive loss of dopaminergic neurons inthe substantia nigra region of the brain. Symptoms and signs manifest as motor disorders affecting balance and physical capacity, and non-motor symptoms such as cognitive decline and mood disorders. People with PD face considerable difficulties coping with associated physical and psychological changes that affect their quality of life. The main form of treatment is pharmacological, which alleviates some of the symptoms but does not slow the progression of the disease. Creatine monohydrate (Cr) may have therapeutic benefits in conditions where energy dysfunction and high rates of apoptosis are present. Cr supplementation may provide a protective effect by augmenting cytosolic high energy phosphate stores, thereby prolonging the survival of ‘at risk’ cells of neurodegenerative diseases. Emerging evidence suggests supplementation may offer specific benefits in the treatment of mood disorders associated withPD. Many different types of exercise improve physical capacity, balance, and quality of life.Research has recently demonstrated the potential benefits in PD of diverse modes of exercise, such as aquatic exercise and boxing. Combining exercise with Cr supplementation can enhance exercise induced muscular strength and power adaptations and may further improve exercise capacity and neuromuscular function. This review will critique evidence relating to the potential efficacy of Cr supplementation and exercise as a putative therapeutic approach in the treatment of the physiological and psychological challenges presented by PD.