Magnetic resonance spectroscopy in psychiatry

Introduction Magnetic resonance spectroscopy (MRS) holds great promise for the diagnosis and management of psychiatric disease. The technique has been available for humans since 1973 but was limited to major medical centers where experimental spectroscopy sequences and dedicated support personnel were available, limiting clinical accessibility to researchers rather than clinicians. The advent of commercial clinical spectroscopy software, which was approved by the US Food and Drug Administration in 1995, made clinical MRS widely available, and the number of psychiatric MRS studies proliferated. The increasing interest in psychiatric MRS results from the low sensitivity and specificity shown in most structural imaging studies for detecting psychiatric disease (e.g.,[1]). To date, there are few anatomical markers of psychiatric disease that are considered "reliable." This finding correlates well with the clinical impression that psychiatric diseases are primarily functional, caused by chemical imbalances or microscopic structural differences that are not detectable with current technology. While clinical MR examinations of psychiatric patients are occasionally performed, the clinical indication is usually to rule out any organic causes for the patient’s behavioral anomalies, rather than to make a diagnosis of a particular psychiatric disease.