{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T11:10:44Z","timestamp":1793185844967,"version":"4.5.0"},"reference-count":66,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"PNRR\u2014MAD","award":["2022\u201312376035"],"award-info":[{"award-number":["2022\u201312376035"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Parkinson\u2019s Disease (PD) is the fastest-growing neurological disorder, characterized by the degeneration of dopaminergic neurons. Treatments remain symptomatic, and objective biomarkers for therapeutic response are lacking. This review aims to evaluate the potential of Proton Magnetic Resonance Spectroscopy (1H-MRS) to provide objective and reproducible biomarkers for monitoring treatment response in PD. This systematic review followed PRISMA guidelines. Articles were searched in PubMed, Web of Science, Scopus, and Embase, and studies employing 1H-MRS to evaluate pharmacological treatments in PD were included, analyzing pre- and post-treatment changes. Six studies were included, investigating cannabinoids, dopamine agonists, monoamine oxidase B inhibitors, and levodopa. Key metabolites analyzed were N-acetylaspartate, Creatine, Choline, myo-Inositol, and Glx (glutamate+glutamine). Increases in NAA, a marker of neuronal integrity and mitochondrial function, suggested neuroprotective mechanisms of dopaminergic drugs, while stable Cho and mI levels, markers of membrane metabolism and inflammatory processes, suggested limited short-term responsiveness. This is the first systematic review evaluating 1H-MRS for monitoring neurometabolic changes induced by pharmacological treatments in PD. Observed metabolite changes appear to reflect treatment mechanisms and potential neuroprotective properties. Findings suggest that 1H-MRS may serve as an objective biomarker for assessing therapeutic efficacy and potential neuroprotective drug effects, although further studies are needed to confirm its clinical utility.<\/jats:p>","DOI":"10.3390\/ijms26199351","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T08:56:44Z","timestamp":1758790604000},"page":"9351","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Using 1H-Magnetic Resonance Spectroscopy to Evaluate the Efficacy of Pharmacological Treatments in Parkinson\u2019s Disease: A Systematic Review"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0282-405X","authenticated-orcid":false,"given":"Lilla","family":"Bonanno","sequence":"first","affiliation":[{"name":"IRCCS Centro Neurolesi \u201cBonino-Pulejo\u201d, Via Palermo S.S. 113, Contrada Casazza, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriana","family":"Caporlingua","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi \u201cBonino-Pulejo\u201d, Via Palermo S.S. 113, Contrada Casazza, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jole","family":"Castellano","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi \u201cBonino-Pulejo\u201d, Via Palermo S.S. 113, Contrada Casazza, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Quartarone","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi \u201cBonino-Pulejo\u201d, Via Palermo S.S. 113, Contrada Casazza, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0709-5914","authenticated-orcid":false,"given":"Rosella","family":"Ciurleo","sequence":"additional","affiliation":[{"name":"IRCCS Centro Neurolesi \u201cBonino-Pulejo\u201d, Via Palermo S.S. 113, Contrada Casazza, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1016\/S1471-1931(00)00028-8","article-title":"Pathophysiology of the basal ganglia in Parkinson\u2019s disease","volume":"23","author":"Obeso","year":"2000","journal-title":"Trends Neurosci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1136\/jnnp.2007.131045","article-title":"Parkinson\u2019s disease: Clinical features and diagnosis","volume":"79","author":"Jankovic","year":"2008","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/S1474-4422(09)70068-7","article-title":"Non-motor symptoms of Parkinson\u2019s disease: Dopaminergic pathophysiology and treatment","volume":"8","author":"Chaudhuri","year":"2009","journal-title":"Lancet Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S1474-4422(21)00030-2","article-title":"Challenges in the diagnosis of Parkinson\u2019s disease","volume":"20","author":"Tolosa","year":"2021","journal-title":"Lancet Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0140-6736(23)01478-2","article-title":"The pathogenesis of Parkinson\u2019s disease","volume":"403","author":"Morris","year":"2024","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.neuroscience.2024.12.009","article-title":"Molecular basis of the development of Parkinson\u2019s disease","volume":"565","author":"Absalyamova","year":"2025","journal-title":"Neuroscience"},{"key":"ref_7","first-page":"461","article-title":"The role of oxidative stress in Parkinson\u2019s disease","volume":"3","author":"Dias","year":"2013","journal-title":"J. Park. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Isik, S., Yeman Kiyak, B., Akbayir, R., Seyhali, R., and Arpaci, T. (2023). Microglia Mediated Neuroinflammation in Parkinson\u2019s Disease. Cells, 12.","DOI":"10.3390\/cells12071012"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.conb.2021.09.001","article-title":"Synaptic proteostasis in Parkinson\u2019s disease","volume":"72","author":"Nachman","year":"2022","journal-title":"Curr. Opin. Neurobiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2651","DOI":"10.1016\/j.jmb.2020.01.037","article-title":"Autophagy in Parkinson\u2019s Disease","volume":"432","author":"Hou","year":"2020","journal-title":"J. Mol. Biol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/S0306-4522(00)00077-4","article-title":"Enhanced vulnerability to oxidative stress by a-synuclein mutations and c-terminal truncation","volume":"97","author":"Kanda","year":"2000","journal-title":"Neuroscience"},{"key":"ref_12","first-page":"3","article-title":"The emerging evidence of the Parkinson pandemic","volume":"8","author":"Dorsey","year":"2018","journal-title":"J. Park. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1148\/radiol.2015142764","article-title":"Proton MR spectroscopy for diagnosis and evaluation of treatment efficacy in Parkinson disease","volume":"278","author":"Mazuel","year":"2016","journal-title":"Radiology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1016\/S0140-6736(21)00218-X","article-title":"Parkinson\u2019s disease","volume":"397","author":"Bloem","year":"2021","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1136\/pmj.76.900.602","article-title":"Pharmacological treatment of Parkinson\u2019s disease","volume":"76","author":"Bhatia","year":"2000","journal-title":"Postgrad. Med. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/S0140-6736(14)61393-3","article-title":"Parkinson\u2019s disease","volume":"386","author":"Kalia","year":"2015","journal-title":"Lancet"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1007\/s40265-015-0389-7","article-title":"Safinamide: First global approval","volume":"75","author":"Deeks","year":"2015","journal-title":"Drugs"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2685","DOI":"10.1212\/WNL.43.12.2685","article-title":"Catechol-O-methyltransferase inhibitor tolcapone prolongs levodopa\/carbidopa action in parkinsonian patients","volume":"43","author":"Roberts","year":"1993","journal-title":"Neurology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1212\/WNL.44.5.913","article-title":"Effect of peripheral catechol-O-methyltransferase inhibition on the pharmacokinetics and pharmacodynamics of levodopa in parkinsonian patients","volume":"44","author":"Nutt","year":"1994","journal-title":"Neurology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/0306-3623(94)90082-5","article-title":"General properties and clinical possibilities of new selective inhibitors of catechol O-methyltransferase","volume":"25","author":"Kaakkola","year":"1994","journal-title":"Gen. Pharmacol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2498","DOI":"10.1056\/NEJMoa033447","article-title":"Parkinson Study Group. Levodopa and the progression of Parkinson\u2019s disease","volume":"351","author":"Fahn","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1056\/NEJMoa1809983","article-title":"Randomized Delayed-Start Trial of Levodopa in Parkinson\u2019s Disease","volume":"380","author":"Verschuur","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_23","unstructured":"Jankovic, J., and Tolosa, E. (2002). Mechanisms of cell death in Parkinson\u2019s disease. Parkinson\u2019s Disease and Movement Disorders, Lippincott Williams & Wilkins. [4th ed.]."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s12640-009-9030-4","article-title":"Comparative neuroprotective effects of rasagiline and aminoindan with selegiline on dexamethasone-induced brain cell apoptosis","volume":"15","author":"Tazik","year":"2009","journal-title":"Neurotox. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/j.1755-5949.2010.00150.x","article-title":"Pharmacological Therapy in Parkinson\u2019s Disease: Focus on Neuroprotection","volume":"17","author":"Kincses","year":"2011","journal-title":"CNS Neurosci. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.2174\/156802608785161402","article-title":"Dopamine receptor agonists for protection and repair in Parkinson\u2019s disease","volume":"8","author":"Bonini","year":"2008","journal-title":"Curr. Top. Med. Chem."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.neuropharm.2011.04.030","article-title":"Amantadine protects dopamine neurons by a dual action: Reducing activation of microglia and inducing expression of GNDF in astroglia","volume":"61","author":"Ossola","year":"2011","journal-title":"Neuropharmacology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1136\/jnnp-2019-322338","article-title":"Parkinson\u2019s disease: Etiopathogenesis and treatment","volume":"91","author":"Jankovic","year":"2020","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.bbadis.2008.09.009","article-title":"Targets for neuroprotection in Parkinson\u2019s disease","volume":"1792","author":"Yacoubian","year":"2009","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Movement Disorder Society Task Force on Rating Scales for Parkinson\u2019s Disease (2003). The Unified Parkinson\u2019s Disease Rating Scale (UPDRS): Status and recommendations. Mov. Disord., 18, 738\u2013750.","DOI":"10.1002\/mds.10473"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Franco, R., Garrig\u00f3s, C., Lillo, J., and Rivas-Santisteban, R. (2024). The Potential of Metabolomics to Find Proper Biomarkers for Addressing the Neuroprotective Efficacy of Drugs Aimed at Delaying Parkinson\u2019s and Alzheimer\u2019s Disease Progression. Cells, 13.","DOI":"10.3390\/cells13151288"},{"key":"ref_32","first-page":"519816","article-title":"Magnetic Resonance Spectroscopy: An in Vivo Molecular Imaging Biomarker for Parkinson\u2019s Disease? Biomed","volume":"2014","author":"Ciurleo","year":"2014","journal-title":"Res. Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.ejrad.2003.08.009","article-title":"High-field proton MRS of human brain","volume":"48","author":"Trojsi","year":"2003","journal-title":"Eur. J. Radiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1602\/neurorx.2.2.197","article-title":"Efficacy of Proton Magnetic Resonance Spectroscopy in Neurological Diagnosis and Neurotherapeutic Decision Making","volume":"2","author":"Lin","year":"2005","journal-title":"NeuroRx"},{"key":"ref_35","first-page":"31","article-title":"MR spectroscopy in multiple sclerosis","volume":"17","author":"Filippi","year":"2007","journal-title":"J. Neuroimaging"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Bonanno, L., Ciurleo, R., Marino, S., Ruvolo, C., Morabito, R., Bramanti, A., and Corallo, F. (2022). Effect of MAO-B Inhibitors on Neurometabolic Profile of Patients Affected by Parkinson Disease: A Proton Magnetic Resonance Spectroscopy Study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11071931"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1002\/nbm.1940020505","article-title":"Brain metabolites as 1H NMR markers of neuronal and glial disorders","volume":"2","author":"Gill","year":"1989","journal-title":"NMR Biomed."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2046","DOI":"10.1093\/brain\/123.10.2046","article-title":"Early proton magnetic resonance spectroscopy in normal-appearing brain correlates with outcome in patients following traumatic brain injury","volume":"123","author":"Garnett","year":"2000","journal-title":"Brain"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1089\/neu.2009.0896","article-title":"Neurometabolite concentrations in gray and white matter in mild traumatic brain injury: An 1H-magnetic resonance spectroscopy study","volume":"26","author":"Gasparovic","year":"2009","journal-title":"J. Neurotrauma"},{"key":"ref_40","first-page":"61","article-title":"Proton MR Spectroscopy of the Brain in 14 Patients with Parkinson Disease","volume":"16","author":"Bowen","year":"1995","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1046\/j.1468-1331.2000.00111.x","article-title":"Basal ganglia metabolite concentrations in idiopathic Parkinson\u2019s disease and multiple system atrophy measured by proton magnetic resonance spectroscopy","volume":"7","author":"Clarke","year":"2000","journal-title":"Eur. J. Neurol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1002\/mds.10214","article-title":"Quantitative 1H magnetic resonance spectroscopy and MRI of Parkinson\u2019s disease","volume":"17","author":"Schuff","year":"2002","journal-title":"Mov. Disord."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1002\/mrm.20761","article-title":"Proton MRS of the unilateral substantia nigra in the human brain at 4 tesla: Detection of high GABA concentrations","volume":"55","author":"Terpstra","year":"2006","journal-title":"Magn. Reson. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1002\/nbm.1203","article-title":"Reduced brain glutamate in patients with Parkinson\u2019s disease","volume":"21","author":"Griffith","year":"2008","journal-title":"NMR Biomed."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/j.1552-6569.2012.00733.x","article-title":"Whole-brain proton MR spectroscopic imaging in Parkinson\u2019s disease","volume":"24","author":"Levin","year":"2014","journal-title":"J. Neuroimaging"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.parkreldis.2012.11.012","article-title":"Marked N-acetylaspartate and choline metabolite changes in Parkinson\u2019s disease patients with mild cognitive impairment","volume":"19","author":"Nie","year":"2013","journal-title":"Park. Relat. Disord."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s11682-013-9251-2","article-title":"Application of proton magnetic resonance spectroscopy on substantia nigra metabolites in Parkinson\u2019s disease","volume":"8","author":"Zhou","year":"2014","journal-title":"Brain Imaging Behav."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1007\/s11604-017-0714-z","article-title":"Examining alterations in GABA concentrations in the basal ganglia of patients with Parkinson\u2019s disease using MEGA-PRESS MRS","volume":"36","author":"Elmaki","year":"2018","journal-title":"Jpn. J. Radiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e00792","DOI":"10.1002\/brb3.792","article-title":"Detection and application of neurochemical profile by multiple regional 1H-MRS in Parkinson\u2019s disease","volume":"7","author":"Guan","year":"2017","journal-title":"Brain Behav."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Gu, W., He, C., Chen, J., and Li, J. (2022). Proton Magnetic Resonance Spectroscopy for the Early Diagnosis of Parkinson Disease in the Substantia Nigra and Globus Pallidus: A Meta-Analysis With Trial Sequential Analysis. Front. Neurol., 13.","DOI":"10.3389\/fneur.2022.838230"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Guan, J.T., Zheng, X., Lai, L., Sun, S., Geng, Y., Zhang, X., Zhou, T., Wu, H.Z., Chen, J.Q., and Yang, Z.X. (2022). Proton Magnetic Resonance Spectroscopy for Diagnosis of Non-Motor Symptoms in Parkinson\u2019s Disease. Front. Neurol., 13.","DOI":"10.3389\/fneur.2022.594711"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1002\/mds.26323","article-title":"Longitudinal study of the substantia nigra in Parkinson disease: A high-field 1H-MR spectroscopy imaging study","volume":"30","author":"Bao","year":"2015","journal-title":"Mov. Disord."},{"key":"ref_53","first-page":"156","article-title":"Brain proton magnetic resonance spectroscopy in patients with Parkinson\u2019s disease","volume":"21","author":"Shoeibi","year":"2022","journal-title":"Curr. J. Neurol."},{"key":"ref_54","first-page":"n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"Br. J. Manag."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"420","DOI":"10.5195\/jmla.2018.345","article-title":"The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: A systematic review","volume":"106","author":"Eriksen","year":"2018","journal-title":"J. Med. Libr. Assoc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1177\/0269881114550355","article-title":"Effects of cannabidiol in the treatment of patients with Parkinson\u2019s disease: An exploratory double-blind trial","volume":"28","author":"Chagas","year":"2014","journal-title":"J. Psychopharmacol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1002\/mds.870120306","article-title":"Unchanged basal ganglia N-acetylaspartate and glutamate in idiopathic Parkinson\u2019s disease measured by proton magnetic resonance spectroscopy","volume":"12","author":"Clarke","year":"1997","journal-title":"Mov. Disord."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.neulet.2015.05.044","article-title":"Metabolic changes in de novo Parkinson\u2019s disease after dopaminergic therapy: A proton magnetic resonance spectroscopy study","volume":"599","author":"Ciurleo","year":"2015","journal-title":"Neurosci. Lett."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2170","DOI":"10.1002\/mds.21576","article-title":"Influences of dopaminergic treatment on motor cortex in Parkinson disease: A MRI\/MRS study","volume":"22","author":"Lucetti","year":"2007","journal-title":"Mov. Disord."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/j.1755-5949.2008.00065.x","article-title":"Cannabidiol: A promising drug for neurodegenerative disorders?","volume":"15","author":"Iuvone","year":"2009","journal-title":"CNS Neurosci. Ther."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1212\/WNL.49.2.438","article-title":"Changes in putamen N-acetylaspartate and choline ratios in untreated and levodopa-treated Parkinson\u2019s disease: A proton magnetic resonance spectroscopy study","volume":"49","author":"Ellis","year":"1997","journal-title":"Neurology"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1023\/A:1020609530444","article-title":"A proton magnetic resonance spectroscopy study of the striatum and cerebral cortex in Parkinson\u2019s disease","volume":"14","author":"Turjanski","year":"1999","journal-title":"Metab. Brain Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s100720170051","article-title":"Proton magnetic resonance spectroscopy (1H-MRS) of motor cortex and basal ganglia in de novo Parkinson\u2019s disease patients","volume":"22","author":"Lucetti","year":"2001","journal-title":"Neurol. Sci."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1007\/s00702-009-0309-7","article-title":"Mitochondria in neurodegenerative disorders: Regulation of the redox state and death signaling leading to neuronal death and survival","volume":"116","author":"Naoi","year":"2009","journal-title":"J. Neural Transm."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1002\/nbm.1940040203","article-title":"A review of chemical issues in 1H NMR spectroscopy: N-acetyl-L-aspartate, creatine and choline","volume":"4","author":"Miller","year":"1991","journal-title":"NMR Biomed."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/nbm.1940040106","article-title":"The use of in vivo proton NMR to study the effects of hyperammonemia in the rat cerebral cortex","volume":"4","author":"Deutz","year":"1991","journal-title":"NMR Biomed."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/19\/9351\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:49:19Z","timestamp":1760035759000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/19\/9351"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,25]]},"references-count":66,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["ijms26199351"],"URL":"https:\/\/doi.org\/10.3390\/ijms26199351","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,25]]}}}