As with the other imaging modalities, MRS reports of WE are primarily case studies. For example, a Japanese man who had consumed alcohol for 50 years and had eaten poorly for several days as a result of a cold presented with gait disturbances and incoherent speech. MRS before and after thiamine treatment found an initial low level of NAA/tCr in the thalamus, which appeared to increase with thiamine replacement. NAA/tCr levels in the cerebellum did not increase, although a lactate peak initially present in the cerebellum resolved (Murata et al. 2001). MRS conducted in two patients with non–alcohol-related thiamine deficiency (i.e., caused by gastric and pancreatic cancer) compared with five healthy study participants showed similar results: relatively low NAA/tCr levels in the thalamus resolved after treatment with thiamine (Mascalchi et al. 2002).
