Intra‐ and inter‐session reliability and repeatability of 1H magnetic resonance spectroscopy for determining total creatine concentrations in multiple brain regions

Abstract Using proton magnetic resonance spectroscopy (1H MRS) to determine total creatine (tCr) concentrations will become increasingly prevalent, as the role of creatine (Cr) in supporting brain health gains interest. Methodological limitations and margins of error in repeated 1H MRS, which often...

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Main Authors: Jedd Pratt, James McStravick, Aneurin J. Kennerley, Craig Sale
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Experimental Physiology
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Online Access:https://doi.org/10.1113/EP092252
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author Jedd Pratt
James McStravick
Aneurin J. Kennerley
Craig Sale
author_facet Jedd Pratt
James McStravick
Aneurin J. Kennerley
Craig Sale
author_sort Jedd Pratt
collection DOAJ
description Abstract Using proton magnetic resonance spectroscopy (1H MRS) to determine total creatine (tCr) concentrations will become increasingly prevalent, as the role of creatine (Cr) in supporting brain health gains interest. Methodological limitations and margins of error in repeated 1H MRS, which often surpass reported effects of supplementation, permeate existing literature. We examined the intra‐ and inter‐session reliability and repeatability of 1H MRS for determining tCr concentrations across multiple brain regions (midbrain, visual cortex and frontal cortex). Eighteen healthy adults aged 20–32 years were recruited (50% female; n = 14 intra‐session; n = 15 inter‐session). 1H Magnetic resonance imaging and spectroscopy were completed at 3 T. Intra‐session analyses involved repeated 1H MRS of the midbrain, visual cortex and frontal cortex without participant or voxel repositioning, whereas inter‐session analyses involved measurements of the same regions, but with participant and voxel repositioning between repeated measurements. The 1H MRS data (174 spectra) were analysed using TARQUIN and OSPREY, and voxel fractions (grey/white matter and CSF) were determined using segmentation. Our findings show that tCr concentrations can be determined reliably and repeatably using 1H MRS, within an error of <2%, and that large inter‐regional differences in tCr concentration are present in the human brain. We provide new minimum detectable change data for tCr concentrations, a detailed discussion of the inherent error sources in repeated 1H MRS, including the substantial effect of the analysis package on tCr quantification, and suggestions for how these should be managed to improve the interpretability and clinical value of future research. More studies are needed to determine whether our findings can be replicated in other centres and different populations.
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spelling doaj-art-8bd8bbfee799444fa34fb90f671ffec62025-08-20T03:01:02ZengWileyExperimental Physiology0958-06701469-445X2025-03-01110346447710.1113/EP092252Intra‐ and inter‐session reliability and repeatability of 1H magnetic resonance spectroscopy for determining total creatine concentrations in multiple brain regionsJedd Pratt0James McStravick1Aneurin J. Kennerley2Craig Sale3Department of Sport and Exercise Sciences Manchester Metropolitan University Institute of Sport Manchester UKDepartment of Sport and Exercise Sciences Manchester Metropolitan University Institute of Sport Manchester UKDepartment of Sport and Exercise Sciences Manchester Metropolitan University Institute of Sport Manchester UKDepartment of Sport and Exercise Sciences Manchester Metropolitan University Institute of Sport Manchester UKAbstract Using proton magnetic resonance spectroscopy (1H MRS) to determine total creatine (tCr) concentrations will become increasingly prevalent, as the role of creatine (Cr) in supporting brain health gains interest. Methodological limitations and margins of error in repeated 1H MRS, which often surpass reported effects of supplementation, permeate existing literature. We examined the intra‐ and inter‐session reliability and repeatability of 1H MRS for determining tCr concentrations across multiple brain regions (midbrain, visual cortex and frontal cortex). Eighteen healthy adults aged 20–32 years were recruited (50% female; n = 14 intra‐session; n = 15 inter‐session). 1H Magnetic resonance imaging and spectroscopy were completed at 3 T. Intra‐session analyses involved repeated 1H MRS of the midbrain, visual cortex and frontal cortex without participant or voxel repositioning, whereas inter‐session analyses involved measurements of the same regions, but with participant and voxel repositioning between repeated measurements. The 1H MRS data (174 spectra) were analysed using TARQUIN and OSPREY, and voxel fractions (grey/white matter and CSF) were determined using segmentation. Our findings show that tCr concentrations can be determined reliably and repeatably using 1H MRS, within an error of <2%, and that large inter‐regional differences in tCr concentration are present in the human brain. We provide new minimum detectable change data for tCr concentrations, a detailed discussion of the inherent error sources in repeated 1H MRS, including the substantial effect of the analysis package on tCr quantification, and suggestions for how these should be managed to improve the interpretability and clinical value of future research. More studies are needed to determine whether our findings can be replicated in other centres and different populations.https://doi.org/10.1113/EP092252braincreatinemagnetic resonance spectroscopyreliabilityreproducibility
spellingShingle Jedd Pratt
James McStravick
Aneurin J. Kennerley
Craig Sale
Intra‐ and inter‐session reliability and repeatability of 1H magnetic resonance spectroscopy for determining total creatine concentrations in multiple brain regions
Experimental Physiology
brain
creatine
magnetic resonance spectroscopy
reliability
reproducibility
title Intra‐ and inter‐session reliability and repeatability of 1H magnetic resonance spectroscopy for determining total creatine concentrations in multiple brain regions
title_full Intra‐ and inter‐session reliability and repeatability of 1H magnetic resonance spectroscopy for determining total creatine concentrations in multiple brain regions
title_fullStr Intra‐ and inter‐session reliability and repeatability of 1H magnetic resonance spectroscopy for determining total creatine concentrations in multiple brain regions
title_full_unstemmed Intra‐ and inter‐session reliability and repeatability of 1H magnetic resonance spectroscopy for determining total creatine concentrations in multiple brain regions
title_short Intra‐ and inter‐session reliability and repeatability of 1H magnetic resonance spectroscopy for determining total creatine concentrations in multiple brain regions
title_sort intra and inter session reliability and repeatability of 1h magnetic resonance spectroscopy for determining total creatine concentrations in multiple brain regions
topic brain
creatine
magnetic resonance spectroscopy
reliability
reproducibility
url https://doi.org/10.1113/EP092252
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AT aneurinjkennerley intraandintersessionreliabilityandrepeatabilityof1hmagneticresonancespectroscopyfordeterminingtotalcreatineconcentrationsinmultiplebrainregions
AT craigsale intraandintersessionreliabilityandrepeatabilityof1hmagneticresonancespectroscopyfordeterminingtotalcreatineconcentrationsinmultiplebrainregions