The concentration of N-acetyl aspartate, creatine + phosphocreatine, and choline in different parts of the brain in adulthood and senium

Christiansen, Peter Munk; Toft, P; Larsson, Henrik; Stubgaard, M.; Henriksen, O.

doi:10.1016/0730-725x(93)90197-l

Cited by 174 publications

(139 citation statements)

References 9 publications

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“…Not surprisingly, we observed significant differences in the normal metabolite ratios using TE of 136 and 272 (23,24) and did not show significant interregional differences. These normal reference values may prove useful to control for possible metabolite T2 changes when investigating by 1H-MRS diseases of the brainstem and cerebellum in which subtle signal changes are observed as olivo-ponto-cerebellar atrophy (25).…”

Section: Discussionmentioning

confidence: 68%

Single‐voxel long TE 1H‐MR spectroscopy of the normal brainstem and cerebellum

Mascalchi

Brugnoli

Guerrini

et al. 2002

Magnetic Resonance Imaging

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Purpose:To evaluate the feasibility of single voxel 1H-MRS of the CNS structures contained in the posterior cranial fossa and to determine the distribution of the normal metabolite ratios, concentrations, and T2 relaxation times in the midbrain, pons, medulla, dentate nucleus and cerebellar vermis. Materials and Methods:A total of 147 single voxel 1H-MR spectra with a point-resolved proton spectroscopy sequence (PRESS) sequence and echo time (TE) of 136 or 272 msec were obtained in the midbrain, pons, medulla, dentate, and vermis of 31 healthy volunteers. In seven additional patients; the concentrations and T2 relaxation times of metabolites were obtained in the same locations (except the medulla) with an external phantom calibration method and a four TE PRESS technique.Results: Ten (27%) of 36 spectra acquired in the medulla were of poor quality. A similar ranking of the N-acetyl aspartate (NAA)/creatine (Cr) ratio and choline(Cho)/Cr ratios in the five locations for the two TEs was observed, with the highest values in the pons (mean NAA/Cr ϭ 4.16 Ϯ 0.6 and Cho/Cr ϭ2.66 Ϯ 0.6 at TE 272) and the lowest values in the dentate and vermis (mean NAA/Cr ϭ 1.66 Ϯ 0.2 and Cho/Cr ϭ 1.20 Ϯ 0.2 at TE 272). The analysis of variance showed significant regional differences of the NAA and Cr concentrations, which had the highest values in the dentate. Non-significant regional differences were observed for the concentration of Cho and for the T2 of the metabolites. Conclusion:With the exception of the medulla, single voxel 1H-MRS enables an in vivo biochemical analysis of the CNS structures contained in the posterior cranial fossa. Regional differences in the metabolite ratios and concentrations must be considered when employing 1H-MRS for evaluation of diseases of the brainstem and cerebellum.

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Section: Discussionmentioning

confidence: 68%

Single‐voxel long TE 1H‐MR spectroscopy of the normal brainstem and cerebellum

Mascalchi

Brugnoli

Guerrini

et al. 2002

Magnetic Resonance Imaging

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“…The in vivo T 1 /T 2 values used were: NAAϭ1.5/0.43 s; Cr ϭ 1.6/0.21 s; and Cho ϭ 1.2/0.36 s (11,12,15). The use of single T 1 /T 2 ignores possible regional variations in these values (11,16). However, it did not affect our analysis, which compared voxels contained in similar anatomies in the same person/phantom temporally or cross-sectionally, and in which percent rather than absolute variations were computed.…”

Section: Metabolite Quantificationmentioning

confidence: 99%

Reproducibility of 3D proton spectroscopy in the human brain

Babb

Soher

et al. 2002

Magnetic Resonance in Med

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The inter-and intrasubject reproducibility of the metabolite levels of N-acetylaspartate (NAA), creatine (Cr), and choline (Cho), obtained with three-dimensional (3D) multivoxel proton spectroscopy ( 1 H-MRS), was analyzed in eight healthy volunteers. Serial, back-to-back measurements on a phantom showed the methodology and instrumentation to be highly reproducible, with a median coefficient of variation (CV) of 3.8%. In the human brain, the metabolite levels' variability was larger, with intrasubject median CVs for a total of 1876 signal voxels of 13.8%, 18.5%, and 20.1% for NAA, Cr, and Cho, respectively. These variations possibly arise from small, unavoidable, ؎1-2 mm volume-of-interest (VOI) repositioning uncertainties, which vary each 0.75-cm 3 voxel's partial fluid/gray/white-matter fractions. Comparing the CVs between eight subjects in a total of 324 selected voxels gave total interindividual CVs of 15.6%, 23.3%, and 24.4%, compared with intraindividual CVs in the same voxels of 14.4%, 14.8%, and 15.3%, for NAA, Cr, and Cho, respectively. Replacing the signal(s) from each voxel by the average of itself with its six canonical neighbors reduces the intrasubject median CVs to 8.3%, 9.5%, and 9.7%. The measurement uncertainties can be reduced at a cost of either spatial resolution (by using larger voxels Key words: absolute quantification; brain; multivoxel localization; proton spectroscopy; reproducibility 1 H-MRS frequently augments MRI in studies of focal as well as diffuse brain pathologies, e.g., for multiple sclerosis (MS), cancer, AIDS, trauma, Alzheimer's disease (AD), and stroke (1). Due to the progressive nature of these disorders, MRS is usually performed serially, over time, to assess the disease's advance or its response to treatment. The evaluation of the MRS data is based primarily on the comparison of either relative or absolute levels of the three major 1 H-MRS-observable metabolites: NAA, Cr, and Cho, in regions of suspected pathology, with corresponding healthy ones. Reported metabolite variations in these diseases range between 10 -20% for HIV infection and focal epilepsy to upwards of 30% in MS and AD (1).However, to objectively evaluate the significance of such changes, it is necessary to establish how reproducible the measured metabolite levels are in normal controls, both cross-sectionally and temporally. Only then, when changes in suspected region(s) in a patient are significant compared with these normal variations, can one be confident that they represent true pathology and not normal biological fluctuations or intrinsic errors of the instrumentation and method(s).To address the reproducibility issues, we conducted a study to identify and quantify the: 1) stability of the machine and the methodology, using back-to-back measurements on a phantom; 2) intraindividual temporal variations in the brain of a volunteer; and 3) interindividual variations across a cohort of healthy subjects. Previous studies on this topic mostly employed single-voxel MRS techniques (2-5), and more recently, s...

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“…The calculated metabolite concentrations and ratios in the patients were compared with the values obtained from the relevant brain regions in healthy volunteers of the relevant age groups, which were recently reported in a study from our laboratory using the same method and parameters as in the present study. 19 The metabolite resonance peaks were assigned as described by Michaelis et al 20 …”

Section: Methodsmentioning

confidence: 99%

Long-term follow-up of cerebral infarction patients with proton magnetic resonance spectroscopy.

Gideon

Sperling

Arlien-Søborg

et al. 1994

Stroke

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Background and Purpose With proton magnetic resonance spectroscopy it is possible to measure the content of various brain metabolites in vivo, including N-acetylaspartate (which may be used as a neuronal marker), creatine, choline, and lactate. The content of these brain metabolites was measured serially from the acute stage to the chronic stage of infarction. Regional cerebral blood flow was also measured within the affected areas. These factors were compared with the clinical outcome.Methods Six patients with ischemic stroke were examined serially from the acute stage ( s 2 days) to the chronic stage (>6 months) with proton magnetic resonance spectroscopy. Cerebral blood flow was measured with single-photon emission-computed tomography with Tc-labeled

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The concentration of N-acetyl aspartate, creatine + phosphocreatine, and choline in different parts of the brain in adulthood and senium

Cited by 174 publications

References 9 publications

Single‐voxel long TE 1H‐MR spectroscopy of the normal brainstem and cerebellum

Single‐voxel long TE 1H‐MR spectroscopy of the normal brainstem and cerebellum

Reproducibility of 3D proton spectroscopy in the human brain

Long-term follow-up of cerebral infarction patients with proton magnetic resonance spectroscopy.

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