| Objective: The aim of this study is to quantitative and semi-quantitative evaluate the changing of metabolite within Broca's areas and the mirror hemisphere before-after treatment in patients with motor aphasia after acute cerebral infarction by using single-voxel proton magnetic resonance spectroscopy (1H-MRS), and to discuss the correlation between the changing of metabolite within Broca's areas and the mirror hemisphere and the pathogenesis and rehabilitation pathogenesis of motor aphasia after acute cerebral infarction, hence providing theoretical direction for rehabilitation training。Material and methods: Thirty-six patients with motor aphasia after acute cerebral infarction in affiliated hospital of North Sichuan Medical College were enrolled into our study and served as experimental group. Conventional MR imaging and 1H-MRS were performed before treatment and 2 weeks after rehabilitation. Language functional scale and neurological functional deficit scales were performed in patient within two hours after each MR scan .The scales outcomes were assessed by the Aphasia Battery in Chinese (ABC) and the National Institute of Health stroke scale (NIHSS) .During the same period, twenty healthy volunteers were served as control group and underwent Conventional MR imaging and 1H-MRS scanning. All scanning were performed with GE SIGNA EXCITE 1.5T MRI scanner. For~1H-MRS scan, Single-voxel (SV) spectra with a point resolved spectroscopy sequence (PRESS) were obtained. The size of region of interests (ROI) was 20 mm×20 mm×20 mm, located in the Broca's area and mirror hemisphere. The Broca's area is composed of white matter and gray matter. The change of area under the waves of NAA, Lac, Cho, Cr were quantitative and semi-quantitative analysis by 1H-MRS scan, the data of the accumulated areas under the waves were compared. The presence of for Lac was determined firstly.Result:1.Quantitative analysis of changing in MRS metabolite ratios: NAA/Cr ratio of the Broca's area in patients with motor aphasia after acute cerebral infarction was decreased significantly than the mirror hemisphere before treatment (P<0.001), however, Cho/Cr ratio was increased significantly (P<0.05). After treatment , NAA/Cr ratio of the Broca's areas was increased significantly than that before treatment (P<0.001), and Cho/Cr ratio of the Broca's areas was increased significantly (P<0.05).2. Semi-quantitative analysis of MRS metabolite: Concentration of NAA within the Broca's area was decreased 47.6% compared with that within the mirror hemisphere before treatment. After treatment, concentration of NAA was increased 27.3% than that before treatment. Before treatment, Concentration cho with the Broca's area increased 25.3% than that within the mirror hemisphere, after treatment, however, concentration of Cho showed no significant difference. 25 of 36 cased and 21 of 36 cases shows Lac peak before and after treatment, respectively, however, no significant difference was observed (P<0.05).3. Concentration of Lac within Broca's area before and after treatment was significant correlated with ABC scale .With concentration of Lac decreased, ABC scale was increased. Other main metabolites showed no significant correlated with clinical scores.Conclusion:1. In the prophase of patients with motor aphasia after acute cerebral infarction, the Broca's areas are in a state of hypometabolism, and concentration of NAA is more sensitive than that of Lac. The Broca's areas are in a state of hypometabolism which may be one of the mechanisms of motor aphasia after acute cerebral infarction.2. After rehabilitation, state of hypometabolism within the Broca's areas were reversed, concentration of Lac within the Broca's area was significant correlated with clinical symptoms. The amelioration of hypometabolism within the Broca's areas may be one of the recovery mechanisms of motor aphasia after acute cerebral infarction.3. Concentration of Cr was stable in the prophase cerebral infarction, could be served as the reference metabolite. After the prophase cerebral infarction, however, concentration of Cr could not be used as the reference metabolite for its decreased obviously.4. Concentration of Lac within the Broca's area was significant correlated with language functional scale. By monitor changing of concentration of Lac within the Broca's area, the severity of clinical symptoms could be predicted.
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