Investigate The Contents And Changes Of Common Metabolites Within Bilateral Hemisphere Language Central Area In Patients With Stuttering Using 1H-MRS

ObjectiveTo investigate the contents and changes of common metabolites within bilateral hemisphere language central area in patients with stuttering, using proton magnetic resonance spectroscopy (1H-MRS). The aim is to evaluate the value of the qualitative diagnosis of the disease from the level of molecular imaging to provide basic data of magnetic resonance spectroscopy and new research tools for the study of language central lesions, such as aphasia, stuttering, etc.Materials and Methods1. The choice of subjectsCooperation with the stuttering correction centers in Jinan City, Shandong Province, 33 cases of stuttering who had not yet been corrected (28 males, 5 females, mean age 22.09±3.65 years, range 20-25 years old) were selected in the study from January 2010 to October 2010. At the same time, 13 healthy adults( 10 males, 3 females, mean age 22.38±1.39 years, range 20-25 years old) without stuttering were randomly selected as a control group from college students, people who are health check. All subjects were right-handed. Age (t =0.395, P = 0.695), gender (t =-0.627, P = 0.534) between groups were not different statistically.2. Apparatus and equipment1.5T superconducting magnetic resonance scanner (Germany Siemens Sonota) was used. Head coil is a four-channel phased array. Sequences include the conventional sequence and MRS sequences.All subjects carried out axial T2-weighted imaging(TR 4800ms, TE 95ms), T1-weighted imaging(TR 500ms, TE 7.7ms), mobile attenuated inversion recovery sequence T2FLAIR(TR 9000ms, TE 108ms), sagittal and coronal T1-weighted scan (TR 2000ms, TE 90ms), axial FOV 240mm×240mm, thickness 5.0mm, 1.0mm spacing , scan line parallel to the joint line before and after (AC-PC line). Sagittal and coronal scanning lines are parallel and perpendicular to the interhemispheric pool.When the conventional serial scan is complete, transverse, sagittal and coronal T1-weighted images were used for positioning proton magnetic resonance spectroscopy. 1H-MRS is a two-dimensional chemical shift imaging technology (CSI) sequence. The parameters are as follows: FOV 160mm, spectral region of interest is: left to right 120mm, front to rear 140mm, top to bottom 10mm, each voxel area was 10mm×12mm×12mm, TR: 1000ms, TE 135ms, water suppression frequency of 50Hz, bandwidth of 1200Hz, acquisition 2 times. The Region of interest was located in the trunk of corpus callosum level. When placing the ROI, avoid cerebrospinal fluid, skull plate barrier's role in the interest areas as much as possible. Meanwhile, add the 8 groups of saturated zone around the region of interest, making sure that the skull, baffle fat, cerebrospinal fluid did not affect the signal acquisition. Before the scan, close all coils outside except the four-channel head coil; Should also inform patients resting with eyes closed during the scanning ahead of time, can not move their heads. After scanning, the original spectral data was transferred to the Spectrum tab of workstations. Post-processing software automatically processes and get MRS curves, and the area under the peak of various substances and the list of ratio between substances we want to get,such as NAA, Cho, Cr, Cr2, MI and so on. Subsequently, if not satisfied, we can manually adjust the MRS curves, in order to make material content values more precise.3. Statistical AnalysisSPSS 17.0 statistical analysis software package was used. All measurement data are indicated with?χ±s. Single-sample Kolmogorov-Smirnov test and Levene test were used to test data normality and homogeneity of variance. Paired T test analysis was used to analyze the content differences of a material between bilateral language center within one group. Independent samples T Test was used to analyze the content of a material difference in ipsilateral language center area between the two groups. Taking the P <0.05 as a difference, P <0.01 for the significant difference.Results1. Content differences of NAA,Cr,Cho,Cr2, NAA/Cr,NAA/Cr2,NAA/(Cr+Cr2),NAA/(Cr+Cho),Cho/Cr,Cho/Cr2,Cho/(Cr+Cr2),MI/Cho,MI/Cr,MI/Cr2,MI/(Cr+Cr2) and MI/(Cr+Cho) between bilateral language center within the control group was not statistically significant (P>0.05); Content difference of MI between bilateral language center within the control group was statistically significant (P<0.05);2. Content differences of Cr2,NAA/Cr,NAA/Cr2,NAA/(Cr+Cr2),NAA/(Cr+Cho),Cho/Cr,Cho/Cr2 and Cho/(Cr+Cr2) between bilateral language center within the stuttering group was not statistically significant (P>0.05); Content differences of NAA,Cr,Cho,MI,MI/Cho,MI/Cr,MI/Cr2,MI/(Cr+Cr2) and MI/(Cr+Cho) between bilateral language center within the stuttering group was statistically significant (P<0.05);3. Content differences of NAA,Cr,Cho,Cr2,MI,NAA/Cr,NAA/Cr2,NAA/(Cr+Cr2),NAA/(Cr+Cho),Cho/Cr2,Cho/(Cr+Cr2)and MI/(Cr+Cr2) in the left side of the language center between stuttering group and the healthy control group was not statistically significant (P> 0.05); Content differences of Cho/Cr,MI/Cr and MI/(Cr+Cho) in the left side of the language center between stuttering group and the healthy control group was statistically significant (P<0.05);4. Content differences of NAA,Cr,Cho,Cr2,NAA/Cr,NAA/Cr2,NAA/(Cr+Cr2),NAA/(Cr+Cho),Cho/Cr,Cho/Cr2,Cho/(Cr+Cr2),MI/Cr,MI/Cr2,MI/(Cr+Cr2) and MI/(Cr+Cho) in the right side of the language center between stuttering group and the healthy control group was not statistically significant (P> 0.05); Content differences of MI and MI/Cho in the right side of the language center between stuttering group and the healthy control group was statistically significant (P<0.05); ConclusionCurrently, the diagnosis of stuttering has no specific examination methods. In this study, magnetic resonance spectroscopy (1H-MRS) data analysis suggest that, content and relative content of NAA,Cr,Cho,MI,MI/Cho,MI/Cr,MI/Cr2,MI/(Cr+Cr2) and MI/(Cr+Cho) in bilateral hemisphere language center area were different significantly in patients with stuttering. Content and relative content of Cho/Cr,MI,MI/Cr,MI/Cho and MI/(Cr+Cho) in the language center are different between stuttering and control groups. Currently, there is no specific means of diagnosis of stuttering check. The method of 1H-MRS has a high diagnostic value of stuttering disorders.