Proton magnetic resonance spectrometry for noninvasive exploration of human brain metabolism: current and future clinical applications.

Magnetic resonance spectrometry (MRS) is now a routine investigation method in neurology. In some situations, its diagnostic sensitivity is better tha n MRI. in this review, we propose a critical analysis of the large body of literature on brain MRS concerning a wide range of pathologies and many dif ferent protocols. The diagnostic value of MRS is not fully determined in al l neurological diseases, but the specific properties of MRS (detection of n euron-specific and glial-specific metabolites, quantitative data, reversibi lity of metabolic lesions) make it a high-performance tool for quantifying neuron, glial and membrane abnormalities. After reviewing the methodological advances in MRS and discussing restricti ons on interpretation of spectral data, we describe variations in metabolic patterns detected by MRS in different groups of diseases. The currently re asonable indications for MRS exploration are presented as well as new avenu es for research. Based on MRS data, we propose a metabolic definition of en cephalopathy which could be useful in better understanding the role of MRS in modern neurology.