Hepatic encephalopathy (HE) associated with elevated brain ammonia levels. The detoxification of ammonia leads to regionally selective alterations in several brain metabolites. The present study investigates these neurotransmitter changes in HE patients in the GABAergic and glutamatergic system. Using MEGA-PRESS, MR spectroscopy was performed in cerebellum, thalamus, and motor cortex. Preliminary results unravel increased GABA levels accompanied by elevated glutamine and reduced myo-Inositol in the cerebellum, but an absence of GABA level changes in the two other regions. These initial findings may lead to further explanation of cognitive and motor deficits in HE, but need to be substantiated further.