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A 2025 systematic review in the HSS Journal identified 36 studies from 1993 to 2024, with consistent findings across multiple animal models and injury types

In preclinical models, ERR activation: Stimulates expression of genes associated with aerobic exercise adaptation Enhances mitochondrial biogenesis and oxidative respiration Increases fatty acid oxidation in skeletal and cardiac muscle Supports endurance capacity and metabolic flexibility Because of these effects, the compound has been described in the literature as an exercise mimetic a molecule that may reproduce certain biochemical signatures of physical training without the training stimulus itself

16 Glutamate also appears to play a primary role in cortical spreading depolarization (CSD), believed to be the physiologic basis of migraine aura