Proton (1H) Magnetic Resonance Spectroscopy (MRS) is a non-invasive tool capable of quantifying brain metabolite concentrations in vivo. In the last decade, the field has made substantial methodological progress. Standardization and accessibility have been particularly prioritized, leading to the development of universal pulse sequences, methodological consensus recommendations, and the development of open-source analysis software packages. This review article summarizes progress over the last decade. One remaining challenge is methodological validation with ground-truth data. Therefore, in addition to reviewing progress, we have conducted a meta-analysis of physiological concentration ranges and relaxation rates of brain metabolites by developing a database summarizing nearly 500 peer-reviewed spectroscopy manuscripts. Expectation values for metabolite concentrations and T2 relaxation times are established based upon a meta-analyses of healthy and diseased brains.
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