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  • Print publication year: 2009
  • Online publication date: August 2010

4 - Normal regional variations: brain development and aging

Summary

Key points

Substantial regional variations in proton brain spectra exist; differences between gray and white matter, anterior–posterior gradients, and differences between the supra- and infra-tentorial brain are common.

Spectra change rapidly over the first few years of life; at birth, NAA is low, and choline and myo-inositol are high. By about 4 years of age, spectra from most regions have a more “adult-like” appearance.

In normal development, only subtle age-related changes are found between the ages of 4 and 20 years.

In normal aging, only subtle age-related changes are found. A recent meta-analysis indicated the most common findings are mildly increased choline and creatine in frontal brain regions of elderly subjects (> 68 years), and stable or slightly decreasing (parietal regions only) NAA.

Introduction

Interpretation of spectra from patients with neuropathology requires a knowledge of the normal regional and age-related spectral variations seen in the healthy brain. This is a difficult issue, since spectra are quite dependent on the technique used to record them (particularly choice of echo time, and field strength), and also show quite large regional and age-related (at least in young children) dependencies. However, while there still remain some gaps in the literature (e.g. detailed, regional studies in very young children), for the most part regional and age-related changes in brain spectra are now well-characterized. This chapter reviews what is known about regional metabolite variations, as well as metabolic changes associated with brain development, and aging.

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