Proton MR Spectroscopy in Brain Metabolic Disorders

Metabolic disorders of the central nervous system (CNS) include pathologies with extremely different pathogenesis. The clinical diagnosis of these disorders is often very difficult and requires sophisticated laboratory investigations. Proton magnetic resonance (MR) spectroscopy (1H-MRS) has recently been used in a number of clinical studies to supplement conventional MRI as it is able to provide in vivo biochemical assay of a given brain tissue. Brain data on several neurometabolic diseases suggest that 1H-MRS can provide in vivo chemical-pathologic characterization of the abnormality visualized by magnetic resonance imaging (MRI) and can detect metabolic alterations in tissue appearing normal on conventional MRI. This may help for differential diagnosis and can be important in the evaluation of disease outcome. Indices provided by 1H-MRS have been demonstrated to be relevant to patients' clinical status, to represent sensitive indicators of early neurologic involvement and to be helpful in monitoring effects of therapeutic interventions. This suggests that, in the next future, a more extensive use of brain 1H-MRS in the management of patients with metabolic disorders affecting CNS should be encouraged.