title: Cerebral Lipid Accumulation Detected by MRS in a Child with Carnitine Palmitoyltransferase 2 Deficiency: A Case Report and Review of the Literature on Genetic Etiologies of Lipid Peaks on MRS.
abstract: The majority of lipids in the brain are located in the bilayer membranes. These lipids are not visible by magnetic resonance spectroscopy since they have restricted mobility. Only mobile lipids, such as cholesterol esters or triglycerides in neutral lipid droplets, have enough rotational freedom to generate a signal on spectroscopy. These signals are detected as peaks at 1.3 ppm, originating from the methylene groups in the fatty acid chain, and 0.9 ppm, originating from the distal methyl group. We review the literature on the different genetic conditions that have been found to show lipid peaks on brain spectroscopy and report the first patient with carnitine palmitoyltransferase 2 deficiency shown to have such lipid peaks, thus indicating brain fat accumulation.
authors.affiliation: National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA. ferreiracr@mail.nih.gov.
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Ferreira
authors.affiliation: Department of Pediatrics, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Molly H
authors.initials: MH
authors.lastname: Silber
authors.affiliation: Division of Neurophysiology, Epilepsy and Critical Care, Children's National Health System, Washington, DC, USA.
authors.forename: Taeun
authors.initials: T
authors.lastname: Chang
authors.affiliation: Division of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC, USA.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Murnick
authors.affiliation: Division of Genetics and Metabolism, Children's National Health System, Washington, DC, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Kirmse