Magnetic resonance spectroscopy of N-acetylaspartate in hypoxic-ischemic encephalopathy

Magnetic resonance imaging and water-suppressed proton magnetic resonance spectroscopic imaging were used to study N-acetylaspartate and other metabolites in a patient with severe hypoxic-ischemic encephalopathy. The N-acetylaspartate signal, a putative marker of neuronal density, was markedly reduced in the forebrain. The relative signal intensity of choline-containing metabolites, which are more abundant in astrocytes than neurons, was increased. These results support the hypothesis that water-suppressed proton magnetic resonance spectroscopic imaging measurements of N-acetylaspartate may be useful for noninvasive detection of selective neuronal loss in a variety of disease states in the human brain.