A pulse sequence was implemented to observe the magnetization transfer (MT) effect on metabolites, water, and macromolecules in human frontal lobes in vivo at 1.5 Tesla. Signals were compared following the application of three hard pulses of 0.745 T amplitude, applied at frequency offsets of either 2500 Hz or 30 kHz, preceding a conventional point-resolved spectroscopy (PRESS)-localized acquisition with an echo time (TE) of 30 ms and repetition time (TR) of 3 s. This gave an MT effect on water in vivo of 46%, while direct saturation by the MT pulses at 2.5 kHz offset was confirmed to be under 4% for all metabolites. We observed significant MT saturation in vivo for N-acetylated compounds, choline (Cho), myo-inositol, and lactate (Lac); a trend of an effect on glutamate ؉ glutamine (Glx); and the typically observed effect on creatine (Cr). No significant MT effect was seen on the macromolecule signal, which was observed using metabolite nulling. The water signal in vivo is reduced following presaturation of the broad signals at several kHz offset from water resonance, through the magnetization transfer (MT) effect (1). This off-resonance irradiation directly saturates immobile protons bound in large macromolecules, which due to their restricted mobility have a very short T 2 (Ͻ100 s) and a very broad linewidth (Ͼ10 kHz). More freely mobile protons, with longer T 2 and narrow linewidth, are not directly affected by the narrow-bandwidth RF irradiation, but are indirectly affected through MT. When the saturation from the bound pool is transferred, signal from the free pool declines, leading to lower intensities in MR images. The mechanisms for this MT are thought to include chemical exchange of weakly-bound protons (such as amines and hydroxyl groups) with water, dipolar crossrelaxation, and diffusion of water from the surface of macromolecules into the bulk environment.MT effects have also been shown in the brain for creatine (Cr), lactate (Lac), and ethanol (2,3), and one study in animals has shown significant albeit small effects of offresonance MT pulses on most metabolites (4). It is unclear whether the MT effect represents subcellular compartmentation, binding of metabolites to enzymes or other proteins, or some other effect.To date, no MT-MRS studies have focused on brain disease, apart from tumors in rats (5,6). Luo et al. (6) showed a significant MT effect on Lac in the tumor, whereas Roell et al. (5) showed an effect on Lac only postmortem. A new MT effect postmortem was also shown on NAA. Glutamate and glutamine (Glx) showed an effect only in contralateral brain, suggesting that there was normally an MT effect on Glx that was lost in the tumor.The effect of MT pulses on the MRS-visible macromolecule signal has never been explicitly studied in humans. In rats, the macromolecule peaks showed no MT effect in 2D correlation spectroscopy, although inspection of 1D difference spectra at short echo times (TEs) suggests that they may have shown an effect (4).The current study details the implementation of MT-MRS ...