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A Study on the Broca’s Areas in Motor Aphasia after Acute Cerebral Infarction Using Proton Magnetic Resonance Spectroscopy

Author: ChenHaoLin
Tutor: DiZhaoHua
School: North Sichuan Medical College
Course: Medical Imaging and Nuclear Medicine
Keywords: Acute cerebral infarction Motor aphasia Magnetic resonance spectroscopic imaging
CLC: R743.3
Type: Master's thesis
Year: 2011
Downloads: 37
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Abstract


Objective: relative quantitative, semi-quantitative analysis, 1H-MRS, to study motor aphasia patients with acute cerebral infarction and brain metabolites after treatment Broca's area and the contralateral mirror area relative ratio and the concentration of the semi-quantitative changes discussed The relationship between Broca's area and the contralateral mirror area changes in brain metabolites after cerebral infarction aphasia pathogenesis and recovery mechanisms, provide theoretical guidance for the rehabilitation. PATIENTS AND METHODS: 36 cases of acute cerebral infarction after the initial visit to the Affiliated Hospital of North Sichuan Medical motor aphasia patients before treatment underwent routine MRS and 1H-MRS scan; 20 cases of normal control group underwent conventional MRS and 1H-MRS scanning. Scan using GE SIGNA EXCITE 1.5T superconducting whole body MRI scanner. The scan is complete underwent formal clinical rehabilitation treatment, and again after two weeks in the treatment of patients underwent MRI and 1H-MRS scan. 2 hours after each examination of the patient application of Chinese aphasia Checklist (ABC) score to assess the language features, and the U.S. National Institutes of Health Stroke Scale (NIHSS) score to evaluate its overall neurological deficit situation. ~ 1H-MRS scans using point-resolved single voxel analysis of spectroscopic imaging sequence, the size of the region of interest for the 20mm × 20mm × 20mm, located in the Broca's area and the contralateral hemisphere mirror site, part of the Broca's area of ??the left cerebral hemisphere white and gray matter. 1H-MRS spectral analysis NAA, Cho, Cr crest under the area changes, and their relative ratio respectively, the semi-quantitative method for analysis, Lac, first determines whether it exists, and if present, the measurement of the peak area under . Results the: 1.MRS metabolite ratios relative quantitative analysis showed that: pre-treatment of acute cerebral infarction patients with motor aphasia Broca's area, compared with the contralateral mirror area of ??NAA / Cr was significantly reduced, there is a significant difference (P lt; 0.001); Cho / Cr was significantly higher, there is a significant difference (P lt; 0.05). After treatment, patients with Broca's area NAA / Cr compared with before treatment was significantly higher, there is a significant difference (P lt; 0.001); Cho / Cr compared with before treatment increased, there is a significant difference (P lt; 0.05 ). 2.MRS semi-quantitative metabolite analysis: Before treatment, patients with Broca's area NAA concentration compared with the contralateral mirror area dropped by an average of 47.6%; after treatment than before treatment NAA concentration increased by an average of about 27.3%. Patients with Broca's Cho concentration before treatment compared with the contralateral mirror area increased by an average of about 25.3%; the Cho concentration after treatment than before treatment, no significant difference (P lt; 0.05). Before treatment, patients with Broca's area and the contralateral mirror area Cr concentration no significant difference; Cr concentration was reduced by about 17.5% after treatment, there was a significant difference (P lt; 0.05). Before treatment, the 36 patients, 25 patients with Broca's area appears inverted Lac bimodal; After treatment, there are still 21 cases of inverted Lac bimodal, but its concentration decreased to varying degrees, compared with before treatment, a significant difference ( P lt; 0.05). 3 before treatment, the Lac concentration after aphasia Broca's area with ABC scores between correlation (P lt; 0.05), with the reduction of the Lac concentration ABC ratings presented elevated. There was no significant correlation between the other metabolites and clinical score. Conclusion: 1. Motor aphasia patients with acute cerebral infarction early onset of left Broca's area showed low metabolic state of NAA concentration changes of Lac more sensitive. Low metabolic status of the left Broca's area may be one of the pathogenesis of motor aphasia after acute cerebral infarction. 2. Effective aphasia rehabilitation, the left Broca's area in patients with low metabolic status has improved, there is a correlation between the severity of the the Lac concentration reduction in the same clinical symptoms. The low metabolic condition of the left Broca's area to improve motor aphasia recovery mechanism one might as acute cerebral infarction. 3.Cr in the acute period of acute cerebral infarction concentration can be used as an internal reference;, Cr concentration decreased over time, and should not be used as the reference indicators. 4 ~ 1H-MRS measured a significant correlation between Broca's area Lac with the changed language features clinical score; Broca's aphasia severity can speculate Lac change.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke)
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