1H downfield MRS is an emerging technique for quantification of in vivo NAD+ concentrations in human tissue. Though NAD+ can be detected in the skeletal muscle downfield spectrum (>4.7 ppm) despite its low concentration (<1 mM), quantification of [NAD+] in muscle disorders is further challenged by depleted NAD+ and long scan times. To address this challenge, we developed and optimized a downfield MRS technique for rapid measurement of NAD+ targeting calf skeletal muscle in a large voxel approach. This optimized technique has allowed us rapid measurement of NAD+ and shortened scan time considerably compared to previously published MRS techniques.
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