Article

Effects of Creatine Supplementation in Rett Syndrome: A Randomized, Placebo-Controlled Trial

Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
Journal of developmental and behavioral pediatrics: JDBP (Impact Factor: 2.12). 07/2011; 32(6):454-60. DOI: 10.1097/DBP.0b013e31822177a8
Source: PubMed

ABSTRACT To evaluate the effects of creatine monohydrate (CMH) supplementation on global DNA methylation and disease-specific clinical symptoms in female patients with Rett syndrome (RTT).
Double-blind, randomized, placebo-controlled crossover trial of female patients with RTT. Participants received 200 mg/kg of either CMH or placebo daily for 6 months and switched following a 4-week washout period. Primary endpoints were change in global DNA methylation and in a RTT-specific symptom score as defined by medical history and clinical evaluation with Rett Syndrome Motor and Behavioral Assessment. Secondary endpoints were changes in biochemical markers of methionine metabolism.
Eighteen female patients aged 3 to 25 years with clinically diagnosed typical RTT and MECP2 mutation at clinical Stages III or IV were studied. CMH supplementation resulted in a statistically significant increase of global methylation by 0.11 (95% confidence interval 0.03-0.19, p = .009) compared with placebo. Total and subscores of Rett Syndrome Motor and Behavioral Assessment tended to improve but without statistical significance.
CMH supplementation increases global DNA methylation statistically significantly. Scores were lower for creatine than for placebo reflecting clinical improvement but not reaching statistical significance. Biochemical variables of methionine-homocysteine remethylation are unaffected. Multicenter studies are urgently warranted to evaluate the long-term effects of CMH supplementation in an optimally homogenous RTT population over a prolonged period.

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Available from: Michael Freilinger, Apr 25, 2014
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    • "A recent randomized trial of creatine (the product of the guanidinoacetate methyltranferase reaction using SAM) supplementation in genetically conformed Rett patients, demonstrated an increase in DNA methylation, although plasma levels of homocysteine, methionine , SAM and SAH remained stable. Despite this, no clinical improvements were noticed (Freilinger et al 2011). A limitation of our study is the small sample size and the wide variation in age. "
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