scholarly journals Cerebrovascular reactivity mapping without hypercapnic challenge in patients with carotid artery stenosis

2019 ◽  
Vol 13 (2) ◽  
pp. 62
Author(s):  
Kaio Felippe Secchinato ◽  
Pedro Henrique Rodrigues Da Silva ◽  
Ana Paula Afonso Camargo ◽  
Octávio Marques Pontes-Neto ◽  
Renata Ferranti Leoni

Vascular reactivity represents the ability of the vascular smooth muscle to dilate or contract in response to changes in metabolic demand or vasoactive stimulus. More specifically, the cerebrovascular reactivity (CVR) has raised interest in several studies that point to its potential to predict stroke risk in patients with cerebrovascular disease. CVR mapping is typically performed using carbon dioxide (CO2) inhalation, breath-holding, or acetazolamide injection as vasoactive challenges, while magnetic resonance imaging (MRI) based on the blood oxygenation level-dependent (BOLD) contrast is acquired. However, such challenges of hypercapnia depend on additional equipment and cooperation of the subjects, limiting their applications, especially in elderly patients. Therefore, the objective of the present study was to map the CVR using resting-state MRI-BOLD, with no hypercapnic challenge, considering the variations in BOLD signal associated with variations in the arterial partial pressure of CO2. The CVR maps obtained with resting data showed a high correlation with those obtained by the conventional experiment with CO2 inhalation (r > 0.70). In addition, the CVR changes observed for the patients were consistent with their clinical reports. These results show that the mapping of CVR obtained with resting-state data may become a useful alternative in the detection of perfusion changes in clinical applications when the hypercapnic challenge is not feasible.

2016 ◽  
Vol 37 (7) ◽  
pp. 2526-2538 ◽  
Author(s):  
Hesamoddin Jahanian ◽  
Thomas Christen ◽  
Michael E Moseley ◽  
Nicholas M Pajewski ◽  
Clinton B Wright ◽  
...  

Measurement of the ability of blood vessels to dilate and constrict, known as vascular reactivity, is often performed with breath-holding tasks that transiently raise arterial blood carbon dioxide (PaCO2) levels. However, following the proper commands for a breath-holding experiment may be difficult or impossible for many patients. In this study, we evaluated two approaches for obtaining vascular reactivity information using blood oxygenation level-dependent signal fluctuations obtained from resting-state functional magnetic resonance imaging data: physiological fluctuation regression and coefficient of variation of the resting-state functional magnetic resonance imaging signal. We studied a cohort of 28 older adults (69 ± 7 years) and found that six of them (21%) could not perform the breath-holding protocol, based on an objective comparison with an idealized respiratory waveform. In the subjects that could comply, we found a strong linear correlation between data extracted from spontaneous resting-state functional magnetic resonance imaging signal fluctuations and the blood oxygenation level-dependent percentage signal change during breath-holding challenge ( R2 = 0.57 and 0.61 for resting-state physiological fluctuation regression and resting-state coefficient of variation methods, respectively). This technique may eliminate the need for subject cooperation, thus allowing the evaluation of vascular reactivity in a wider range of clinical and research conditions in which it may otherwise be impractical.


2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Renata F. Leoni ◽  
Kelley C. Mazzetto-Betti ◽  
Afonso C. Silva ◽  
Antonio C. dos Santos ◽  
Draulio B. de Araujo ◽  
...  

Impaired cerebrovascular reactivity (CVR), a predictive factor of imminent stroke, has been shown to be associated with carotid steno-occlusive disease. Magnetic resonance imaging (MRI) techniques, such as blood oxygenation level-dependent (BOLD) and arterial spin labeling (ASL), have emerged as promising noninvasive tools to evaluate altered CVR with whole-brain coverage, when combined with a vasoactive stimulus, such as respiratory task or injection of acetazolamide. Under normal cerebrovascular conditions, CVR has been shown to be globally and homogenously distributed between hemispheres, but with differences among cerebral regions. Such differences can be explained by anatomical specificities and different biochemical mechanisms responsible for vascular regulation. In patients with carotid steno-occlusive disease, studies have shown that MRI techniques can detect impaired CVR in brain tissue supplied by the affected artery. Moreover, resulting CVR estimations have been well correlated to those obtained with more established techniques, indicating that BOLD and ASL are robust and reliable methods to assess CVR in patients with cerebrovascular diseases. Therefore, the present paper aims to review recent studies which use BOLD and ASL to evaluate CVR, in healthy individuals and in patients with carotid steno-occlusive disease, providing a source of information regarding the obtained results and the methodological difficulties.


2021 ◽  
Author(s):  
Bin Guo ◽  
Fugen Zhou ◽  
Muwei Li ◽  
John C Gore ◽  
Zhaohua Ding

Blood oxygenation level-dependent (BOLD) signals in white matter (WM) have usually been ignored or undetected, consistent with the lower vascular density and metabolic demands in WM than in gray matter (GM). Despite converging evidence demonstrating the reliable detection of BOLD signals in WM evoked by neural stimulation and in a resting state, few studies have examined the relationship between BOLD functional signals and tissue metabolism in WM. By analyzing simultaneous recordings of MRI and PET data, we found that the correlations between low frequency resting state BOLD signals in WM are spatially correlated with local glucose uptake, which also covaried with the amplitude of spontaneous low frequency fluctuations in BOLD signals. These results provide further evidence that BOLD signals in WM reflect variations in metabolic demand associated with neural activity, and suggest they should be incorporated into more complete models of brain function.


2021 ◽  
Vol 12 ◽  
Author(s):  
J. Jean Chen ◽  
Claudine J. Gauthier

Task and resting-state functional MRI (fMRI) is primarily based on the same blood-oxygenation level-dependent (BOLD) phenomenon that MRI-based cerebrovascular reactivity (CVR) mapping has most commonly relied upon. This technique is finding an ever-increasing role in neuroscience and clinical research as well as treatment planning. The estimation of CVR has unique applications in and associations with fMRI. In particular, CVR estimation is part of a family of techniques called calibrated BOLD fMRI, the purpose of which is to allow the mapping of cerebral oxidative metabolism (CMRO2) using a combination of BOLD and cerebral-blood flow (CBF) measurements. Moreover, CVR has recently been shown to be a major source of vascular bias in computing resting-state functional connectivity, in much the same way that it is used to neutralize the vascular contribution in calibrated fMRI. Furthermore, due to the obvious challenges in estimating CVR using gas challenges, a rapidly growing field of study is the estimation of CVR without any form of challenge, including the use of resting-state fMRI for that purpose. This review addresses all of these aspects in which CVR interacts with fMRI and the role of CVR in calibrated fMRI, provides an overview of the physiological biases and assumptions underlying hypercapnia-based CVR and calibrated fMRI, and provides a view into the future of non-invasive CVR measurement.


2013 ◽  
Vol 34 (2) ◽  
pp. 242-247 ◽  
Author(s):  
Binu P Thomas ◽  
Peiying Liu ◽  
Denise C Park ◽  
Matthias JP van Osch ◽  
Hanzhang Lu

White matter (WM) comprises about half of the brain and its dysfunction is implicated in many brain disorders. While structural properties in healthy and diseased WM have been extensively studied, relatively little is known about the physiology underlying these structural characteristics. Recent advances in magnetic resonance (MR) technologies provided new opportunities to better understand perfusion and microvasculature in the WM. Here, we aim to evaluate vasodilatory capacity of the WM vasculature, which is thought to be important in tissue ischemia and autoregulation. Fifteen younger and fifteen older subjects performed a CO2 inhalation task while blood-oxygenation-level-dependent (BOLD) magnetic resonance imaging (MRI) images were continuously collected. The cerebrovascular reactivity (CVR) index showed that the value of CVR in the WM (0.03±0.002%/mm Hg) was positive, but was significantly lower than that in the gray matter (GM) (0.22±0.01%/mm Hg). More strikingly, the WM response showed a temporal delay of 19±3 seconds compared with GM, which was attributed to the longer time it takes for extravascular CO2 to change. With age, WM CVR response becomes greater and faster, which is opposite to the changes seen in the GM. These data suggest that characteristics of WM CVR are different from that of GM and caution should be used when interpreting pathologic WM CVR results.


2020 ◽  
Author(s):  
Jelle A. van Dijk ◽  
Alessio Fracasso ◽  
Natalia Petridou ◽  
Serge O. Dumoulin

AbstractAdvancements in ultra-high field (7 T and higher) magnetic resonance imaging (MRI) scanners have made it possible to investigate both the structure and function of the human brain at a sub-millimeter scale. As neuronal feedforward and feedback information arrives in different layers, sub-millimeter functional MRI has the potential to uncover information processing between cortical micro-circuits across cortical depth, i.e. laminar fMRI. For nearly all conventional fMRI analyses, the main assumption is that the relationship between local neuronal activity and the blood oxygenation level dependent (BOLD) signal adheres to the principles of linear systems theory. For laminar fMRI, however, directional blood pooling across cortical depth stemming from the anatomy of the cortical vasculature, potentially violates these linear system assumptions, thereby complicating analysis and interpretation. Here we assess whether the temporal additivity requirement of linear systems theory holds for laminar fMRI. We measured responses elicited by viewing stimuli presented for different durations and evaluated how well the responses to shorter durations predicted those elicited by longer durations. We find that BOLD response predictions are consistently good predictors for observed responses, across all cortical depths, and in all measured visual field maps (V1, V2, and V3). Our results suggest that the temporal additivity assumption for linear systems theory holds for laminar fMRI. We thus show that the temporal additivity assumption holds across cortical depth for sub-millimeter gradient-echo BOLD fMRI in early visual cortex.


2021 ◽  
pp. 0271678X2110645
Author(s):  
Pieter T Deckers ◽  
Alex A Bhogal ◽  
Mathijs BJ Dijsselhof ◽  
Carlos C Faraco ◽  
Peiying Liu ◽  
...  

Blood oxygenation level-dependent (BOLD) or arterial spin labeling (ASL) MRI with hypercapnic stimuli allow for measuring cerebrovascular reactivity (CVR). Hypercapnic stimuli are also employed in calibrated BOLD functional MRI for quantifying neuronally-evoked changes in cerebral oxygen metabolism (CMRO2). It is often assumed that hypercapnic stimuli (with or without hyperoxia) are iso-metabolic; increasing arterial CO2 or O2 does not affect CMRO2. We evaluated the null hypothesis that two common hypercapnic stimuli, ‘CO2 in air’ and carbogen, are iso-metabolic. TRUST and ASL MRI were used to measure the cerebral venous oxygenation and cerebral blood flow (CBF), from which the oxygen extraction fraction (OEF) and CMRO2 were calculated for room-air, ‘CO2 in air’ and carbogen. As expected, CBF significantly increased (9.9% ± 9.3% and 12.1% ± 8.8% for ‘CO2 in air’ and carbogen, respectively). CMRO2 decreased for ‘CO2 in air’ (−13.4% ± 13.0%, p < 0.01) compared to room-air, while the CMRO2 during carbogen did not significantly change. Our findings indicate that ‘CO2 in air’ is not iso-metabolic, while carbogen appears to elicit a mixed effect; the CMRO2 reduction during hypercapnia is mitigated when including hyperoxia. These findings can be important for interpreting measurements using hypercapnic or hypercapnic-hyperoxic (carbogen) stimuli.


2018 ◽  
Vol 46 (4) ◽  
pp. 1391-1403 ◽  
Author(s):  
Qidong Wang ◽  
Chuangen Guo ◽  
Lan Zhang ◽  
Rui Zhang ◽  
Zhaoming Wang ◽  
...  

Objective To investigate changes in renal oxygenation levels by blood-oxygenation-level dependent (BOLD)-magnetic resonance imaging (MRI), and to evaluate BOLD-MRI for detecting early diabetic renal injury. Methods Seventy-five rats, with unilateral nephrectomy, were randomly divided into streptozotocin-induced diabetes mellitus (DM, n = 65) and normal control (NC, n = 10) groups. BOLD-MRI scans were performed at baseline (both groups) and at 3, 7, 14, 21, 28, 35, 42, 49, 56, 63 and 70 days (DM only). Renal cortical (C) and medullary (M) R2* signals were measured and R2* medulla/cortex ratio (MCR) was calculated. Results DM-group CR2* and MR2* values were significantly higher than NC values following diabetes induction. R2* values increased gradually and peaked at day 35 (CR2*, 33.95 ± 0.34 s–1; MR2*, 43.79 ± 1.46 s–1), then dropped gradually (CR2*, 33.17 ± 0.69 s–1; MR2*, 41.61 ± 0.95 s–1 at day 70). DM-group MCR rose gradually from 1.12 to 1.32 at day 42, then decreased to 1.25 by day 70. Conclusions BOLD-MRI can be used to non-invasively evaluate renal hypoxia and early diabetic renal injury in diabetic rats. MCR may be adopted to reflect dynamic changes in renal hypoxia.


2020 ◽  
Vol 70 ◽  
pp. 50-56
Author(s):  
Giovanni Muscas ◽  
Christiaan Hendrik Bas van Niftrik ◽  
Martina Sebök ◽  
Katharina Seystahl ◽  
Marco Piccirelli ◽  
...  

2015 ◽  
Vol 35 (12) ◽  
pp. 2032-2042 ◽  
Author(s):  
Carlos C Faraco ◽  
Megan K Strother ◽  
Jeroen CW Siero ◽  
Daniel F Arteaga ◽  
Allison O Scott ◽  
...  

Cerebrovascular reactivity (CVR)-weighted blood-oxygenation-level-dependent magnetic resonance imaging (BOLD-MRI) experiments are frequently used in conjunction with hyperoxia. Owing to complex interactions between hyperoxia and hypercapnia, quantitative effects of these gas mixtures on BOLD responses, blood and tissue R2∗, and blood oxygenation are incompletely understood. Here we performed BOLD imaging (3T; TE/TR = 35/2,000 ms; spatial resolution = 3×3×3.5 mm3) in healthy volunteers ( n = 12; age = 29±4.1 years) breathing (i) room air (RA), (ii) normocapnic-hyperoxia (95% O2/5% N2, HO), (iii) hypercapnic-normoxia (5% CO2/21% O2/74% N2, HC-NO), and (iv) hypercapnic-hyperoxia (5% CO2/95% O2, HC-HO). For HC-HO, experiments were performed with separate RA and HO baselines to control for changes in O2. T2-relaxation-under-spin-tagging MRI was used to calculate basal venous oxygenation. Signal changes were quantified and established hemodynamic models were applied to quantify vasoactive blood oxygenation, blood–water R∗2, and tissue-water R∗2. In the cortex, fractional BOLD changes (stimulus/baseline) were HO/RA = 0.011 ± 0.007; HC-NO/RA = 0.014±0.004; HC-HO/HO = 0.020±0.008; and HC-HO/RA = 0.035 ±0.010; for the measured basal venous oxygenation level of 0.632, this led to venous blood oxygenation levels of 0.660 (HO), 0.665 (HC-NO), and 0.712 (HC-HO). Interleaving a HC-HO stimulus with HO baseline provided a smaller but significantly elevated BOLD response compared with a HC-NO stimulus. Results provide an outline for how blood oxygenation differs for several gas stimuli and provides quantitative information on how hypercapnic BOLD CVR and R∗2 are altered during hyperoxia.


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