Reproducibility of HERMES-measured GABA+ and glutathione in the mesial temporal lobe

There is growing interest in using Hadamard Encoding and Reconstruction for MEGA-Edited Spectroscopy (HERMES) within the mesial temporal lobe (MTL). For cross-sectional group comparisons and longitudinal repeated measures designs, an understanding of the internal and test-retest validity of γ-aminobutyric acid (GABA+) and glutathione (GSH) is critical. We therefore evaluated the reproducibility of the consensus recommended semi-localization by adiabatic selective refocusing (sLASER) localization for edited-MRS acquisitions in a challenging region, the MTL.

Data were acquired in 15 participants. Single voxel HERMES was collected in the left MTL (two acquisitions) and the right MTL (one acquisition). Participants were repositioned between the two left HERMES acquisitions. An ANOVA was used to assess differences between acquisitions. To assess measurement variation in the repeated left of GABA+ and GSH measures within the left MTL difference values and coefficients of variation (CVs) were calculated.

There were no significant differences in metabolite values between any of the acquisitions. The mean difference between the metabolite measures from the repeated left acquisitions centred close to zero, and the average CVs were 14.09 % for GABA+ and 18.94 % for GSH.

The CVs of GABA+ and GSH in the MTL obtained from a HERMES acquisition were comparable to GABA+ or GSH-edited acquisitions in this region, and to data from cortical voxels using HERMES acquisitions.

This supports the use of HERMES in the MTL, a challenging region for MRS. However, larger samples and caution in interpretation may be required in repeated-measures designs.