¹H-MRS has developped methods that allows the assessment of glutamine/glutamate (Glx) and myo-inositol (Ins), organic osmolytes that participate in cerebral cell volume regulation. The metabolic and osmotic situation produced in chronic liver failure is clearly reflected in ¹H-MRS of the brain, which consistently show increases in the Glx signal accompanied by Ins depletion (Figure 5). An association between clinical or subclinical hepatic encephalopathy and increases in brain glutamine has been described. Furthermore, a normalization of brain Glx and Ins (Figure 6 and 7) has been demonstrated after restoration of liver function (succesful liver transplantation).