Alterations in regional cerebral metabolism have been demonstrated by in vivo proton magnetic resonance spectroscopy of 8 children (7 - 16 years) with established multiple sclerosis at the Max-Planck-Institut fur biophysikalische Chemie, Postfach, and Abt. Kinderheilkunde, Schwerpunkr Neuropadiatrie, Georg-August-Universitat, Gottingen, Federal Republic of Germany. MS plaques showed a decrease in N-acetylaspartate and creatines, and an increase in cholines and myo-inositol. Cortical gray matter related to MS lesions showed a reduction of N-acetylaspartate. Functional impairment in MS was linked to gross metabolic disturbances of neuronal cell chemistry. 
COMMENT. Proton magnetic resonance spectroscopy has revealed metabolic alterations associated with multiple sclerosis in focal lesions and in the adjacent cortex. The method could aid in the differentiation of MS plaques from other disorders and in monitoring response to therapy. For additional articles on MS in children.