Using the localized spin-echo 1 H MRS technique, the water resonance and methyl resonance peaks of the cerebral metabolites N-acetylaspartate (NAA at 2.0 ppm) and phosphocreatine/creatine (Cr at 3.0 ppm) were studied in the human visual cortex to detect and quantify the blood oxygenation level dependent (BOLD) effect during visual stimulation at 4 T. Significant BOLD effects, which reflect the increases of spectral peak height (H) accompanied by the decreases of spectral linewidth (⌬ 1/2 ), were observed in NAA (H: 2.5%; ⌬ 1/2 : ؊1.7%) and Cr (H: 3.1%; ⌬ 1/2 : ؊1.8%) as well as in water (H: 3.1%; ⌬ 1/2 : ؊2.3%). Because NAA and Cr mainly exist in the brain cells, the BOLD effects on these cerebral metabolite resonances only measure the susceptibility component spreading into the extravascular cellular compartment. In contrast, water is affected in the intraand the extravascular compartments. Therefore, the water signal measures the BOLD effects in both compartments. BOLD responses in water were similar to those observed in metabolites. The similarity indicates that the susceptibility spreading into the extravascular parenchyma contributed significantly to the observed BOLD effects at 4 T. The functional magnetic resonance imaging (fMRI) technique based on the blood oxygenation level dependent (BOLD) contrast has become a preferred neuroimaging methodology (1-6). The magnitude of the BOLD change due to elevated neuronal activity is determined by the local susceptibility changes (7-10). These changes originate from the variations of deoxyhemoglobin content in blood and spread both in the intravascular and extravascular tissue compartments. Neuronal activity induces both metabolic and hemodynamic changes in focal areas. The neuron firing elevates cerebral blood flow (CBF) and increases the oxygen supply around the activated sites. The oxidative metabolism extracts the oxygen carried by hemoglobin in blood and utilizes it for oxidative phosphorylation. This process occurs in the mitochondria of neurons and astrocytes/glia that coincide with the site of neuronal activity. Increases in the oxygen supply through CBF change and the oxygen utilization through oxidative metabolism result in changes in the blood oxygenation level and deoxyhemoglobin content beginning in the capillary areas. Then the blood in the capillaries passes through the postcapillary venules and drains into the venous vessels, resulting in changes in the deoxyhemoglobin content in these vessels and spreading the susceptibility gradients around and away from the actual sites of neuronal activity (11). These alterations in susceptibility gradients are detectable inside the vessels (intravascular compartment) and in the tissue near the vessels (extravascular compartment) using MRI. The relative BOLD contribution from intra-and extravascular compartments depends on the vascular architectures, magnetic field strength, image acquisition methods, as well as cerebral blood volume changes induced by neuronal activity (12,13). Generally, the extravascular BOLD...