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Peek AL, Rebbeck TJ, Leaver AM, Foster SL, Refshauge KM, Puts NA, Oeltzschner G. A comprehensive guide to MEGA-PRESS for GABA measurement. Anal Biochem 2023; 669:115113. [PMID: 36958511 PMCID: PMC10805000 DOI: 10.1016/j.ab.2023.115113] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/25/2023]
Abstract
The aim of this guideline is to provide a series of evidence-based recommendations that allow those new to using MEGA-PRESS to produce high-quality data for the measurement of GABA levels using edited magnetic resonance spectroscopy with the MEGA-PRESS sequence at 3T. GABA is the main inhibitory neurotransmitter of the central nervous system and has been increasingly studied due to its relevance in many clinical disorders of the central nervous system. MEGA-PRESS is the most widely used method for quantification of GABA at 3T, but is technically challenging and operates at a low signal-to-noise ratio. Therefore, the acquisition of high-quality MRS data relies on avoiding numerous pitfalls and observing important caveats. The guideline was developed by a working party that consisted of experts in MRS and experts in guideline development and implementation, together with key stakeholders. Strictly following a translational framework, we first identified evidence using a systematically conducted scoping literature review, then synthesized and graded the quality of evidence that formed recommendations. These recommendations were then sent to a panel of 21 world leaders in MRS for feedback and approval using a modified-Delphi process across two rounds. The final guideline consists of 23 recommendations across six domains essential for GABA MRS acquisition (Parameters, Practicalities, Data acquisition, Confounders, Quality/reporting, Post-processing). Overall, 78% of recommendations were formed from high-quality evidence, and 91% received agreement from over 80% of the expert panel. These 23 expert-reviewed recommendations and accompanying extended documentation form a readily useable guideline to allow those new to using MEGA-PRESS to design appropriate MEGA-PRESS study protocols and generate high-quality data.
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Affiliation(s)
- A L Peek
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2141, Australia; NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, Queensland, Australia.
| | - T J Rebbeck
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2141, Australia; NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, Queensland, Australia.
| | - A M Leaver
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2141, Australia.
| | - S L Foster
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2141, Australia; Department of Radiology, Westmead Hospital, Hawkesbury Road, Westmead, New South Wales, 2145, Australia.
| | - K M Refshauge
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2141, Australia.
| | - N A Puts
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, UK.
| | - G Oeltzschner
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, 21205, United States.
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Saleh MG, Papantoni A, Mikkelsen M, Hui SCN, Oeltzschner G, Puts NA, Edden RAE, Carnell S. Effect of Age on GABA+ and Glutathione in a Pediatric Sample. AJNR Am J Neuroradiol 2020; 41:1099-1104. [PMID: 32381543 DOI: 10.3174/ajnr.a6543] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/23/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE Gamma-aminobutyric acid (GABA) is the primary inhibitory neurotransmitter in the human brain and is implicated in several neuropathologies. Glutathione is a major antioxidant in the brain and is considered a marker of oxidative stress. Several studies have reported age-related declines in GABA levels in adulthood, but the trajectory of both GABA and glutathione during childhood has not been well explored. The aim of this study is to establish how GABA and glutathione vary with age during early development. MATERIALS AND METHODS Twenty-three healthy children (5.6-13.9 years of age) were recruited for this study. MR imaging/MR spectroscopy experiments were conducted on a 3T MR scanner. A 27-mL MR spectroscopy voxel was positioned in the frontal lobe. J-difference edited MR spectroscopy was used to spectrally edit GABA and glutathione. Data were analyzed using the Gannet software, and GABA+ (GABA + macromolecules/homocarnosine) and glutathione were quantified using water (GABA+H2O and GlutathioneH2O) and Cr (GABA+/Cr and glutathione/Cr) as concentration references. Also, the relative gray matter contribution to the voxel volume (GMratio) was estimated from structural images. Pearson correlation coefficients were used to examine the association between age and GABA+H2O (and glutathioneH2O), between age and GABA+/Cr (and glutathione/Cr), and between age and GMratio. RESULTS Both GABA+H2O (r = 0.63, P = .002) and GABA+/Cr (r = 0.48, P = .026) significantly correlated with age, whereas glutathione measurements and GMratio did not. CONCLUSIONS We demonstrate increases in GABA and no differences in glutathione with age in a healthy pediatric sample. This study provides insight into neuronal maturation in children and may facilitate better understanding of normative behavioral development and the pathophysiology of developmental disorders.
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Affiliation(s)
- M G Saleh
- From the Russell H. Morgan Department of Radiology and Radiological Science (M.G.S., M.M., S.C.N.H., G.O., N.A.P., R.A.E.E.) .,F.M. Kirby Research Center for Functional Brain Imaging (M.G.S., M.M., S.C.N.H., G.O., N.A.P., R.A.E.E.), Kennedy Krieger Institute, Baltimore, Maryland
| | - A Papantoni
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry (A.P., S.C.), The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - M Mikkelsen
- From the Russell H. Morgan Department of Radiology and Radiological Science (M.G.S., M.M., S.C.N.H., G.O., N.A.P., R.A.E.E.).,F.M. Kirby Research Center for Functional Brain Imaging (M.G.S., M.M., S.C.N.H., G.O., N.A.P., R.A.E.E.), Kennedy Krieger Institute, Baltimore, Maryland
| | - S C N Hui
- From the Russell H. Morgan Department of Radiology and Radiological Science (M.G.S., M.M., S.C.N.H., G.O., N.A.P., R.A.E.E.).,F.M. Kirby Research Center for Functional Brain Imaging (M.G.S., M.M., S.C.N.H., G.O., N.A.P., R.A.E.E.), Kennedy Krieger Institute, Baltimore, Maryland
| | - G Oeltzschner
- From the Russell H. Morgan Department of Radiology and Radiological Science (M.G.S., M.M., S.C.N.H., G.O., N.A.P., R.A.E.E.).,F.M. Kirby Research Center for Functional Brain Imaging (M.G.S., M.M., S.C.N.H., G.O., N.A.P., R.A.E.E.), Kennedy Krieger Institute, Baltimore, Maryland
| | - N A Puts
- From the Russell H. Morgan Department of Radiology and Radiological Science (M.G.S., M.M., S.C.N.H., G.O., N.A.P., R.A.E.E.).,F.M. Kirby Research Center for Functional Brain Imaging (M.G.S., M.M., S.C.N.H., G.O., N.A.P., R.A.E.E.), Kennedy Krieger Institute, Baltimore, Maryland.,Department of Forensic and Neurodevelopmental Sciences (N.A.P.), Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - R A E Edden
- From the Russell H. Morgan Department of Radiology and Radiological Science (M.G.S., M.M., S.C.N.H., G.O., N.A.P., R.A.E.E.).,F.M. Kirby Research Center for Functional Brain Imaging (M.G.S., M.M., S.C.N.H., G.O., N.A.P., R.A.E.E.), Kennedy Krieger Institute, Baltimore, Maryland
| | - S Carnell
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry (A.P., S.C.), The Johns Hopkins University School of Medicine, Baltimore, Maryland
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