BACKGROUND: Proton magnetic resonance spectroscopy (H-1-MRS) non-invasively detects changes in chemical substances in the brain, which reflects the pathological metabolism. OBJECTIVE: To investigate changes in N-acetyl-aspartate (NAA). choline (Cho), creatine (Cr), and myoinositol (MI) in the gray and white matter of cerebral prefrontal lobe and cerebellum of patients with differential degrees of post-stroke depression (PSD) using H-1-MRS. DESIGN: A case control study. SETTING: The First Affiliated Hospital of the Dalian Medical University. PARTICIPANTS: A total of 38 patients with stroke (28 male and 10 female patients, aged 40 to 79 years) were selected from the Department of Neurology. 1st Affiliated Hospital. Dalian Medical University, front February to October in 2004. All objects met the DSM-IV criteria for cerebrovascualr disease and depression. The degree of depression was defines according to Hamilton criteria. 38 patients with PSD were divided into two groups according to the time after ischemia, 20 patients in the acute group with less than 10 days after ischemic attack (mild: 16 patients. moderate/severe: 4 patients) and 18 Patients ill the chronic group With more than 11 days after ischemic attack (mild: 15 patients. moderate/severe: 3 patients). Seventeen healthy volunteers with matching age front 41 to 80 years were examined as a control group. The Study was approved by the Medical Ethics Committee of the University Medical Center Utrecht, and each participant signed in informed consent form. METHODS: Spectra were acquired by multi-voxel point-resolved spectroscopy (PRESS) sequence with GE signal. 5T MR/i, localized in prefrontal cerebral lobe and cerebellum. Values of NAA, Cho, MI, and Cr ere compared between different graded PSD patients and control subjects with one-way analysis of variance in software SPSS 11.5. MAIN OUTCOME MEASURES: Metabolite concentration in different brain regions of interest. Difference in metabolites between distinctly graded PSD patients and control subjects. Exclusion of age-effects on metabolites. RESULTS: Metabolite concentrations of different brain regions: A significance rise in the Cho/Cr ratio was The ratio change was more significant detected ill the acute and Chronic group compared to the control group. in the acute group (P < 0.05). There Was no significant difference between these three groups for other metabolites detected by H-1-MRS in tire right frontal white matter. bilateral frontal grey matter. and cerebellum (P > 0.05). Comparison of metabolite levels among, differently graded PSI) patients and control Subjects: a significant increase in the Cho/Cr ratio was detected in the left frontal white matter compared to the control group (P < 0.05). There was no significant difference in age between patients in the stroke groups and the control group (P > 0.05). and similarly. there was no significant correlation between age and absolute or relative values in the control group (P > 0.05). CONCLUSION: Abnormalities of frontal lobe ill PSD were located in the white matter. There was early abnormality of metabolic substance in PSD.