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Table 2 Typical metabolites examined in neurological 1H magnetic resonance spectroscopy [[13]]

From: Neuroimaging in repetitive brain trauma

Metabolite Chemical shift resonance peak (ppm) Comment
Lipid 0.9-1.5 Not usually visible in MRS unless released by pathological process such as trauma
Lactate 1.3 End product of anaerobic glycolysis. Indicator of hypoxia and impairment of perfusion
N-acetyl aspartate (NAA) 2.0 Synthesized in neurons. Marker of neuronal viability
Glutamate/glutamine (Glx) 2.2-2.5 Glutamate is the primary excitatory neurotransmitter in the brain. Glutamine is found in astrocytes. Glx may be predictive of outcome after severe TBI and associated with immunoexcitotoxicity or secondary dysfunction
Choline (Cho) 3.2 Membrane marker. Elevated in cases of high membrane turnover. May indicate diffuse axonal injury
Myo-inositol (mI) 3.5 Astrocyte marker and osmolyte. Involved in the metabolism of phosphatidyl inositol (a membrane phospholipid) - expected to increase after TBI due to membrane damage. May also be a glial marker
Creatine (Cr) 3.0 Found in metabolic active tissues, used in energy storage and transfer. Used as an internal standard for other metabolites (for example, NAA/Cr, Cho/Cr)
  1. MRS, magnetic resonance spectroscopy; TBI, traumatic brain injury.