title: Cerebral metabolic changes in neurologically presymptomatic patients undergoing haemodialysis: in vivo proton MR spectroscopic findings.
abstract: OBJECTIVE
  To prospectively investigate and detect early cerebral metabolic changes in patients with end-stage renal disease (ESRD) by using in vivo proton MR spectroscopy (MRS).
  
  
  METHODS
  We enrolled 32 patients with ESRD and 32 healthy controls between the ages of 26 and 50 years. Short echo time single-voxel proton MRS was acquired from volumes of interest (VOIs) located in the frontal grey and white matter, temporal white matter and basal ganglia. The choline/phospatidylcholine (Cho), myo-inositol (mI), N-acetylaspartate (NAA) and total creatine (tCr) peaks were measured and the metabolic ratios with respect to tCr were calculated.
  
  
  RESULTS
  In the ESRD group, significant elevations of the Cho/tCr and mI/tCr ratios were observed for the frontal grey matter, frontal white matter, temporal white matter and basal ganglia as compared with controls. There was no significant difference in the NAA/tCr ratios at all VOIs between the ESRD patients and the healthy controls.
  
  
  CONCLUSIONS
  Proton MRS is a useful and non-invasive imaging tool for the detection of early cerebral metabolic changes in neurologically presymptomatic ESRD patients.
authors.affiliation: Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Ming-Lun
authors.initials: ML
authors.lastname: Chiu
authors.forename: Chun-Wei
authors.initials: CW
authors.lastname: Li
authors.forename: Jer-Ming
authors.initials: JM
authors.lastname: Chang
authors.forename: I-Chan
authors.initials: IC
authors.lastname: Chiang
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Ko
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Chuang
authors.forename: Reu-Sheng
authors.initials: RS
authors.lastname: Sheu
authors.forename: Chen-Chang
authors.initials: CC
authors.lastname: Lee
authors.forename: Tsyh-Jyi
authors.initials: TJ
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000032:analysis; D001921:Brain / Q000378:metabolism*; D002794:Choline / Q000032:analysis*; D003401:Creatine / Q000032:analysis*; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011522:Protons; D006435:Renal Dialysis
chemical_list: D011522:Protons; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline