This review summarises the ways in which magnetic resonance spectroscopy (M
RS) and related methods can be used as windows on brain energy metabolism i
n vivo. P-31-MRS can measure acute changes in non-oxidative ATP synthesis i
n transient states, and at steady state reflects the balance of ATP demand
and mitochondrial function. C-13-MRS labelling methods can measure a variet
y of carbon fluxes. The few P-31- and C-13-MRS studies of the response to f
unctional activation suggest quite large increases in oxidative metabolism,
Functional magnetic resonance imaging measures the hyperoxygenation that r
esults from increase in cerebral blood flow in excess of glucose oxidation,
attenuated somewhat by a smaller increase in oxygen consumption. Previous
positron emission tomography studies disagree on the size of activation res
ponse, These are powerful but demanding techniques, valuable in understandi
ng both normal physiology and pathophysiology, However, discrepancies remai
n to be reconciled, and this will require increasing sophistication of both
techniques and analytical models. Copyright (C) 2000 S. Karger AG, Basel.