PROGNOSTIC VALUE OF PROTON MAGNETIC-RESONANCE SPECTROSCOPY IN ISCHEMIC STROKE

Objective: To determine the correlation between metabolite concentrati ons and clinical outcome during the acute or subacute phase of ischemi c stroke by using single-voxel localized proton magnetic resonance spe ctroscopy (H-1-MRS). Setting: A university hospital neurologic departm ent. Patients and Methods: Combined single-voxel H-1-MRS and magnetic resonance imaging were performed on 26 patients with a recent ischemic stroke ton 8 patients during the first 24 hours after the stroke and on 18 during the first week). For all patients, the signals from N-ace tylaspartate, choline-containing compounds, and creatine-phosphocreati ne were compared with those on the contralateral side as peak area rat ios. The data for H-1-MRS were related to scores on the Scandinavian S troke Scale and the Barthel Index at a 6-month clinical follow-up. Res ults: The signals from N-acetylaspartate, choline-containing compounds , and creatine-phosphocreatine were significantly reduced in all infar cted areas (P<.001, P<.001, and P=.003, respectively, Wilcoxon signed rank test). A lactate signal was present in 19 patients. The statistic al analysis showed a significant positive correlation between N-acetyl aspartate signals and Scandinavian Stroke Scale scores and between red uction of N-acetylaspartate signals and Barthel Index scores (Spearman rank correlation test). Patients in whom lactate was present had Scan dinavian Stroke Scale scores significantly lower than patients in the group without lactate (Mann-Whitney U test). Conclusion: Single-voxel H-1-MRS performed during the acute or subacute phase of ischemic strok e may provide prognostic information.