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In a study of elderly subjects, acetyl-L-carnitine treatment reduced physical and mental fatigue, reduced muscle pain, and improved cognitive function [37]

Evolving management of low-density lipoprotein cholesterol: a personalized approach to preventing atherosclerotic cardiovascular disease across the risk continuum

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BMJ 379:e071050 Petschner P, Gonda X, Baksa D, Eszlari N, Trivaks M, Juhasz G, Bagdy G (2018) Genes linking mitochondrial function, cognitive impairment and depression are associated with endophenotypes serving precision medicine

Since GBB and crotonobetaine after L-carnitine challenge are likely primarily generated in the gut, these brain increases are likely to be secondary to increased transport of these metabolites