Figure 4 –

Summary of HE metabolite profiles from the edit-OFF spectra. (A) Cr-referenced metabolite estimates (mean + SD & individual estimates) for all MRS voxels, including glutamine, glutamate, Myo-inositol, glutathione, and total choline. (B) Correlations between Cr-referenced metabolite estimates and clinical metrics. (C) Water-referenced metabolite estimates for all voxels. (D) Correlations between water-referenced metabolite estiamtes and clinical metrics. The HE-typical metabolite profile (increased Gln accompanied by mI reduction) was consistently found in all MRS voxels. Additionally, increased GSH (thalamus & motor cortex) and reduced tCho (cerebellum, thalamus & motor cortex) were found in some voxels. Metabolite estimates correlated strongly with clinical metrics. Glutamine vs. blood ammonia levels correlation coefficients were high in all MRS voxels, but not significant after multiple comparison corrections.