In healthy tissue, fat contamination is caused by extracranial lipids when the MRS voxel is placed near the skull, compromising metabolite quantification. We used two empirical criteria to estimate contamination, following previous studies (
Schmitz et al., 2017). First, we identified the resonance frequency of the largest peak in each spectrum. This is expected for NAA at 2ppm (
a). If the largest peak was observed at a resonance frequency different from 2ppm (
b), this indicated that the spectrum was contaminated. Second, we confirmed this contamination by visually inspecting the output of the MRS processing software (Profit,
Schulte and Boesiger, 2006) that included two-dimensional spectra (
c,d), their fits (
e,f) and residual plots (
g,h) for each measurement. The data are plotted as contours where closed loops at fixed heights indicate equal signal intensity (
Stagg, 2014). The J-resolved dimension (Hz) (y-axis) is plotted against the chemical shift dimension (ppm; x axis). The logarithmic color-scale represents the range of chemical compound concentrations. Only the real part of the phased spectrum is shown, resulting in both positive and negative values (
Schulte and Boesiger, 2006). The largest peak of the spectrum is NAA at 2ppm and is indicated by contours colored with the highest values of the color scale (red). Fat contamination results in a noisy spectrum (
d) with large residuals (
h), indicating a poor fit.