MR spectroscopy in health and disease

Magnetic resonance spectroscopy (MRS) enables the noninvasive quantification of up to 20 neurochemicals in selected brain regions and has found many applications in the study of the cerebellum in health and disease. The neurochemicals accessible by MRS include neuronal and glial markers, neurotransmitters, markers of cellular energetics, and antioxidants and, therefore, provide means to assess neuronal dysfunction/loss, glial activation, energy metabolism, and oxidative stress. As a result, the methodology has been applied to the study of many diseases that affect the cerebellum, including neurodegenerative diseases, cancer, metabolic disorders, alcoholism, and neuropsychiatric disorders. While MRS of the cerebellum poses challenges due to the caudal location of the structure in the brain, these have been overcome both on research and clinical scanners that operate at high and ultra-high magnetic fields, providing the potential for further applications of the technology with greater sensitivity and resolution than ever before to benefit basic and translational investigations in cerebellar disorders.