{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:06:05Z","timestamp":1753884365624,"version":"3.41.2"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"1144","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJR"],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p> The aim of this study is to demonstrate the role of proton magnetic resonance spectroscopy (1H-MRS) in the detection of brain microstructural changes in patients with Crigler-Najjar syndrome type-I (CNs-I), and its correlation with demographic, neurodevelopmental and laboratory findings. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Prospective study was conducted on 25 children with CNs-I and 25 age and sex-matched children, who served as control. They underwent multivoxel 1H-MRS of basal ganglion at echo time 135\u2013144\u2009ms. N-acetyl aspartate\/Creatine (NAA\/Cr) and Choline (Ch)\/Cr were calculated and correlated with demographic, clinical, and laboratory findings of patients with CNs-I. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> There was a significant difference in NAA\/Cr and Ch\/Cr between patients and controls. The cut-off value for NAA\/Cr and Ch\/Cr used to differentiate patients from controls were 1.8 and 1.2 with an area under the curve (AUC) of 0.91 and 0.84 respectively. There was a significant difference in MRS ratios between patients with neurodevelopmental delay (NDD) and patients without NDD. The cut-off values for NAA\/Cr and Ch\/Cr used to differentiate between patients with NDD and patients without NDD were 1.47 and 0.99, with AUC of 0.87 and 0.8 respectively. The NAA\/Cr and Ch\/Cr were well correlated with family history (p = 0.006\u2009and p &lt; 0.001) respectively, consanguinity (p &lt; 0.001\u2009and p = 0.001), neurodevelopmental delay (p = 0.001\u2009and p = 0.004), serum bilirubin level (r = \u22120.77, p &lt; 0.001), (r = \u22120.49, p = 0.014), phototherapy (p &lt; 0.001\u2009and p = 0.32), blood transfusion (p &lt; 0.001\u2009and p = 0.001) respectively. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> 1H-MRS can be a useful tool in the detection of neurological changes in patients with CNs-I; NAA\/Cr and Ch\/Cr parameters are well correlated with demographic, clinical, and laboratory findings. <\/jats:p><\/jats:sec><jats:sec><jats:title>Advances in knowledge<\/jats:title><jats:p> Our study is the first report on using MRS in assessing neurological manifestations in CNs. 1H-MRS can be a useful tool in the detection of neurological changes in patients with CNs-I. 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