Creatine is converted to phosphocreatine by creatine kinase. Phosphocreatine can transfer a phosphoryl group to adenosine diphosphate to make adenosine triphos-

phate (ATP). ATP is used as an energy source for multiple biochemical reactions. Creatine helps prevent MPTP-induced neuronal injury in rats (42). High oral doses, capable of increasing central nervous system creatine levels, are generally well tolerated. A recent futility trial demonstrated good tolerability in early PD (43) and it was concluded that further trials were justified.

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