N-acetylaspartate (NAA) peak
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View Andrew Murphy's current disclosures- N-acetylaspartate peak
- N-acetylaspartate (NAA)
N-acetylaspartate (NAA) is one of the more important compounds assessed on MR spectroscopy, and resonates at 2.0 ppm chemical shift (its concentration in healthy adults is 8-10 mM) 1. The synthesis of NAA, adenosine diphosphate-dependent, occurs in the neuronal mitochondria 2.
NAA is the acetylated form of the amino acid, aspartate, which is found in high concentrations in neurons and is a marker of neuronal viability. It is therefore reduced in any process that destroys neurons, such as high grade tumors, radionecrosis, non-neuronal tumors (e.g. cerebral metastases and primary CNS lymphoma).
Markedly elevated NAA peak and NAA: creatinine ratio are pathognomonic for Canavan disease 7. The NAA peak level may decrease after gene therapy.
Many studies have shown the reduction of NAA, in specific brain areas, in schizophrenic patients: hippocampus, mesial regions of the temporal lobes and frontal lobes 3-6.
References
- 1. Inglese M, Rusinek H, George IC, Babb JS, Grossman RI, Gonen O. Global average gray and white matter N-acetylaspartate concentration in the human brain. (2008) NeuroImage. 41 (2): 270-6. doi:10.1016/j.neuroimage.2008.02.034 - Pubmed
- 2. Clark JB. N-acetyl aspartate: a marker for neuronal loss or mitochondrial dysfunction. (1998) Developmental neuroscience. 20 (4-5): 271-6. doi:10.1159/000017321 - Pubmed
- 3. Nasrallah HA, Skinner TE, Schmalbrock P, Robitaille PM. Proton magnetic resonance spectroscopy (1H MRS) of the hippocampal formation in schizophrenia: a pilot study. (1994) The British journal of psychiatry : the journal of mental science. 165 (4): 481-5. doi:10.1192/bjp.165.4.481 - Pubmed
- 4. Renshaw PF, Yurgelun-Todd DA, Tohen M, Gruber S, Cohen BM. Temporal lobe proton magnetic resonance spectroscopy of patients with first-episode psychosis. (1995) The American journal of psychiatry. 152 (3): 444-6. doi:10.1176/ajp.152.3.444 - Pubmed
- 5. Yurgelun-Todd DA, Renshaw PF, Gruber SA, Ed M, Waternaux C, Cohen BM. Proton magnetic resonance spectroscopy of the temporal lobes in schizophrenics and normal controls. (1996) Schizophrenia research. 19 (1): 55-9. doi:10.1016/0920-9964(95)00071-2 - Pubmed
- 6. Buckley PF, Moore C, Long H, Larkin C, Thompson P, Mulvany F, Redmond O, Stack JP, Ennis JT, Waddington JL. 1H-magnetic resonance spectroscopy of the left temporal and frontal lobes in schizophrenia: clinical, neurodevelopmental, and cognitive correlates. (1994) Biological psychiatry. 36 (12): 792-800. doi:10.1016/0006-3223(94)90591-6 - Pubmed
- 7. Nihaal Reddy, Sonia F. Calloni, Hilary J. Vernon, Eugen Boltshauser, Thierry A. G. M. Huisman, Bruno P. Soares. Neuroimaging Findings of Organic Acidemias and Aminoacidopathies. (2018) RadioGraphics. 38 (3): 912-931. doi:10.1148/rg.2018170042 - Pubmed
- 8. Martinez MA, Florenzano NV, Macchia EA. [Metabolism of N-acetyl-L-aspartate: its diagnostic and prognostic value]. (2016) Revista de neurologia. 62 (8): 361-70. Pubmed
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