PROGNOSTIC-SIGNIFICANCE OF METABOLIC CHANGES DETECTED BY PROTON MAGNETIC-RESONANCE SPECTROSCOPY IN ISCHEMIC STROKE

Proton magnetic resonance spectroscopy has proved to be useful for mon itoring a number of metabolites in cerebral infarction. Combined magne tic resonance imaging and spectroscopy investigations were carried out in 14 patients with a recent ischaemic stroke (< 1 week); follow-up e xaminations were performed from day 28 to day 252 after stroke. The ai m of this study was to assess the correlation between the changes of N -acetyl-aspartate, choline, creatine-phosphocreatine, lactate and clin ical evolution measured by the Scandinavian Neurological Scale (SNS). Initially the lactate magnetic resonance signal was present in all pat ients and the other metabolite contents were significantly reduced (P < 0.001; unpaired t-test) as compared with those on the contralateral side. Spear-man's rank correlation test showed a positive correlation between the initial reduction of N-acetyl-aspartate content and the SN S (P < 0.05), and between the final N-acetyl-aspartate content and the SNS (P < 0.001). Our results suggest that serial examination in strok e patients may provide further prognostic information and encourage co ntrolled clinical studies.