Development and aging of the cerebrum: assessment with proton MR spectroscopy.

BACKGROUND AND PURPOSE MR spectroscopy allows the noninvasive evaluation of in vivo brain metabolites. Our purpose was to use this technique to assess metabolic alterations in the human cerebrum during growth, maturation, and aging. METHODS Ninety normal human brains in subjects aged 4 to 88 years were examined with multivoxel proton MR spectroscopy. Spectra were obtained from specific voxels of 2.5 cm3 in the gray and white matter of the centrum semiovale. The ratios of N-acetylaspartate (NAA) to choline (Cho) were calculated to describe age-dependent alterations in cerebral metabolites. RESULTS White matter NAA/Cho ratios showed rapid growth during the first decade and reached a maximum value in the second or early third decade, followed by a steady decline starting in the latter half of the third decade. The maximum peak ages for NAA/Cho were 21.9, 17.6, and 15.9 years (mean, 18.5 years) for the anterior, middle, and posterior white matter, respectively. A significant cerebral laterality of the white matter NAA/Cho was found in male subjects during development. The growth spurt and age-related decline of the white matter NAA/Cho were steeper in male than in female subjects. In contrast, the gray matter NAA/Cho showed a gradual decline with age. CONCLUSION Proton MR spectroscopy shows significant regional and sex differences in the level of cerebral metabolites during the process of growth, maturation, and aging. This technique may play an important role in clinical applications for various conditions of metabolic disorders of the human brain.