A case study on a Japanese man who had consumed alcohol for 50 years, eaten poorly for several days, and presented with acute WE due to vitamin-B deficiency revealed low levels of NAA/tCr in the thalamus and cerebellum and a typically undetected (i.e., in healthy controls) lactate peak in the cerebellum. Thiamine treatment elevated NAA/tCr in the thalamus, but not in the cerebellum (Murata et al., 2001). A similar study reproduced the lactate findings, but reported no effect on NAA (Rugilo et al., 2003), while another reported reversible changes in NAA but no effect of WE on the lactate peak (Mascalchi et al., 2002).
