Magnetic resonance spectroscopy in psychiatry: potential, pitfalls, and promise

Magnetic resonance spectroscopy (MRS) is a novel noninvasive approach to measuring important metabolites in living tissue. Its application to psychiatry is just beginning. In vivo MRS with 31P provides important information on brain phospholipid metabolism and energy production. In vivo 13C and 1H MRS can reveal information about carbohydrate, protein, and amino acid metabolism. In vivo 7Li and 19F MRS can be used to study the pharmacology of lithium and fluorinated psychopharmacological agents. MRS with 23Na can yield information about electrolyte balance. The limitations of in vivo MRS include poor sensitivity, poor resolution, and the fact that only highly mobile atomic nuclei can be detected. Future clinical application of MRS will benefit from improvements in the technology of localization, use of spectroscopy contrast agents, stronger magnets, and the merging of MRS and imaging technology.