As a specific feature of piracetam and other similar compounds, beneficial effects on cognition are usually associated with impaired brain function such as aging, hypoxia, glucose deprivation, injuries, or even neurodegeneration. Thus, young healthy animals or men usually benefit less from piracetam indicating that this compound is not a “cognition booster” or a drug for neuro-enhancement. As all the pathological conditions mentioned above are typically associated with the vicious cycle between enhanced oxidative stress – elevated reactive oxygen species (ROS) production – mitochondrial damage – reduced energy supply – enhanced ROS production (Leuner et al., 2007; Mattson et al., 2008; Querfurth and LaFerla, 2010), we speculated that piracetam might enhance mitochondrial function or at least protect against mitochondrial damage under such conditions but mainly in brain aging, or dementia. In both situations, similar but also variant alterations of mitochondrial function are present (Leuner et al., 2007; Müller et al., 2010), representing possible targets and also plausible for therapeutic intervention by piracetam (Müller et al., 2010).