Magnetic Resonance Spectroscopy as a Biomarker for Chronic Traumatic Encephalopathy

Michael L. Alosco, PhD; Johnny Jarnagin, BS; Benjamin Rowland, PhD; Huijun Liao, BS; Robert A. Stern, PhD; Alexander Lin, PhD


Semin Neurol. 2017;37(5):503-509. 

In This Article

Literature Review Methods

The first part of this review briefly describes the neuropathology of CTE based on work by McKee et al.[1,3] To identify articles examining MRS in the setting of RHI exposure, a literature search was performed on PubMed using keywords, including "chronic traumatic encephalopathy," "neuropathology," "repetitive head impacts," "repetitive brain trauma," "concussion," "subconcussive," "magnetic resonance spectroscopy," "MRS," or "neurochemistry." Reference sections of articles were examined to identify additional studies on MRS and RHI exposure. Given the limited evidence on this topic, we did not implement strict quality control methods for study inclusion/exclusion. All studies must have used MRS in human subjects with a history of RHI exposure (e.g., contact sport athletes, military veterans).

Application of MRS in subjects with active RHI exposure (e.g., active contact sport athletes) was identified as evidence for the acute effects of RHI exposure. Research articles that reported on MRS findings in subjects with a remote history of RHI exposure (e.g., former contact sport athletes) were identified as evidence for the chronic effects of RHI exposure. Studies that examined acute postconcussion neurochemical changes in the setting of active RHI exposure[18,19,20,21] were not included, given that the findings may have been solely related to a single acute/subacute concussion. We instead emphasized studies that examined recurrent subconcussive head trauma in the absence of clinical concussion to optimize generalizability to CTE.