PROTON MAGNETIC-RESONANCE SPECTROSCOPY OF CEREBROSPINAL-FLUID AS AN AID IN NEUROLOGICAL DIAGNOSIS

The proton magnetic resonance (H-1-NMR) spectra were obtained from 38 cerebrospinal fluid (CSF) samples from 34 patients with various centra l nervous system (CNS) diseases and the H2O signals were reduced by th e presaturation method. A doublet signal for CH3 protons of lactate, a s well as a singlet one for alpha-CH proton of glucose, were clearly d etected in all the spectra obtained. The relative lactate concentratio n values were calculated on the basis of the glucose concentrations wh ich had been measured by a routine laboratory method in the hospital a nd the ratios of the peak heights (lactate CH3/glucose alpha-CH). In t he CSF samples examined, the relative lactate values semi-quantitative ly determined in this way were clearly elevated in cerebral infarction and bacterial meningitis, but not in other disorders including viral meningitis. On the other hand, one CSF component whose enhancement was found only in a sample from a hepatic encephalitis patient was identi fied as glutamine from the double quantum filtered-shift correlation s pectrum. These results suggest that H-1-NMR spectroscopy of CSF can be come a powerful aid in biochemical diagnosis of CNS diseases.