Decadelong low basal ganglia NAA/tCr from elevated tCr supports ATP depletion from mitochondrial dysfunction and neuroinflammation in Gulf War illness.

19 in 2001 used long echo time of 272 ms at 1.5T, and both found statistically significant reductions of the NAA/tCr ratio in the right basal ganglia and a nonsignificant trend on the left.

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Moreover, the [tCr] values measured at short TE were consistently elevated compared with controls across the three GWI syndrome variants and in both the right and left basal ganglia, with differences from controls being large and statistically significant in syndrome variants 1 and 3 bilaterally but paradoxically smaller and marginally significant in syndrome variant 2, the most clinically severe.

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