Clinical Feed

Challenges and Solutions in Quantifying Brain β-Hydroxybutyrate (BHB) with 1H-MRS Following Oral Keto-Ester Consumption

Purpose: {beta}-hydroxybutyrate (BHB), a ketone body and alternative cerebral energy substrate, can be measured in vivo using J-difference edited proton magnetic resonance spectro

GIST

Purpose: {beta}-hydroxybutyrate (BHB), a ketone body and alternative cerebral energy substrate, can be measured in vivo using J-difference edited proton magnetic resonance spectroscopy (1H-MRS). Oral ketone supplementation with substrates such as the ketone monoester (R)-3-hydroxybutyl-(R)-3-hydroxybutyrate (KME) and 1,3-butanediol (BD) have gained attention as a mechanism to elevate circulating BHB and induce ketosis without dietary restrictions. Elevated brain ketone availability is of growing therapeutic interest as a strategy to support neuronal energetics in conditions such as epilepsy, neurodegenerative disease, and alcohol use disorder (AUD). However, both pathways introduce BD into the bloodstream, which crosses the blood-brain barrier. Critically, BD exhibits a spectral signature that closely resembles the prominent BHB peak in JDE-MR spectroscopic imaging (MRSI), identified in a pilot AUD study. Methods: Two separate JDE-MRSI acquisitions tailored for BHB and BD editing were implemented, exploiting frequency separation between the BHB (4.14ppm) and BD (3.95ppm) coupling partners of the observed 1.2ppm resonance to independently quantify each metabolite.

Clinical Editorial

bioRxiv (Biomedical Preprints) published a clinical update in Research Highlights on 09 Jul 2026. The item focuses on Challenges and Solutions in Quantifying Brain β-Hydroxybutyrate (BHB) with 1H-MRS Following Oral Keto-Ester Consumption. Review the original article for the full source wording and details.

Original source: https://www.biorxiv.org/content/10.64898/2026.07.04.736442v1?rss=1