Magnetic resonance spectroscopy

What is magnetic resonance spectroscopy (MRS)?

MRS is a specialised imaging technique that utilises magnetic resonance imaging to investigate biochemical alterations within tissues. Two notable methods of MRS are 1H-MRS (proton-MRS) and 31P-MRS (phosphorus-MRS). Each technique is sensitive to different metabolic compounds. 1H-MRS can be used to measure N-acetylaspartate, an amino acid that is used as a marker of neuronal viability. Decreased levels are associated with neuron death or dysfunction. 1H-MRS is also used to measure creatine, a compound involved in energy metabolism, glutamate, a neurotransmitter, and glutamine, a metabolite of glutamate. 31P-MRS is used to measure phospholipid levels, such as phosphomonoesters and phosphodiesters, that provide information about cellular energy metabolism and membrane synthesis.

What is the evidence for MRS?

All patients

High quality evidence finds decreases in glutathione in the anterior cingulate and decreases in myo-inositol in the medial prefrontal region of people with schizophrenia. Moderate or moderate to high quality evidence finds N-acetylaspartate is decreased in the frontal lobe, temporal lobe, thalamus, hippocampus, cerebellum, and cingulate cortex. Lower quality evidence finds N-acetylaspartate may be decreased in the parietal cortex, basal ganglia and occipital lobe (white matter only) and increased in the striatum and lenticular nucleus. There are reductions in frontal glutamate, prefrontal phosphomonoesters, and hippocampal choline/creatine, and increases in frontal glutamine. There were no differences in GABA levels in the medial frontal cortex.

Unmedicated patients (drug free or drug naive)

Moderate to high quality evidence finds decreases in N-acetylaspartate in the thalamus and decreases in frontal white matter (using <3T MRI scanners only) in unmedicated patients. There are also increases in glutamate+glutamine in the medial prefrontal cortex, and increases in choline in the basal ganglia.

First-episode psychosis patients

Moderate quality evidence finds decreased phosphomonoesters levels and increased phosphodiesters levels in the prefrontal cortex and temporal cortex in first-episode psychosis.

People at clinical or genetic high risk for schizophrenia

Moderate to low quality evidence finds people at clinical or genetic high-risk showed N-acetylaspartate reductions in the thalamus and N-acetylaspartate/creatine reductions in the prefrontal cortex. There are also N-acetylaspartate/creatine reductions in the anterior cingulate and hippocampus of first-degree relatives. There were increased frontal glutamate/glutamine levels, decreased prefrontal phosphomonoester levels, and increased prefrontal phosphodiester levels in first-degree relatives.

December 2019

Last updated at: 1:23 am, 9th February 2020
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NeuRA Libraries

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