Magnetic resonance spectroscopy (MRS) measures brain metabolites including creatine (Cr), involved in energy metabolism, N-acetyl-aspartate (NAA), reflecting neuronal integrity, and glutamate (Glu), the primary excitatory neurotransmitter, as well as choline (Cho) and myo-Inositol (Ins). Ins is considered a glial marker and Cho reflects cell membrane turnover – both present in larger concentrations in glial cells than in neurons. Assessment of metabolites associated with neuronal integrity — NAA and Glu, and those associated with glial proliferation — Ins and Cho, can present a sensitive description of metabolic events underlying, and even preceding, the structural changes in basal ganglia seen in HIV+ children.