scholarly journals Insights Into Cerebral Tissue-Specific Response to Respiratory Challenges at 7T: Evidence for Combined Blood Flow and CO2-Mediated Effects

2021 ◽  
Vol 12 ◽  
Author(s):  
Allen A. Champagne ◽  
Alex A. Bhogal
Keyword(s):  
Blood Flow ◽  
Arrival Time ◽  
Vascular Diseases ◽  
Response Speed ◽  
Blood Oxygen Level Dependent ◽  
Cerebrovascular Reactivity ◽  
Specific Response ◽  
Vascular Networks ◽  
Blood Oxygen Level ◽  
Arterial Transit Time

Cerebrovascular reactivity (CVR) mapping is finding increasing clinical applications as a non-invasive probe for vascular health. Further analysis extracting temporal delay information from the CVR response provide additional insight that reflect arterial transit time, blood redistribution, and vascular response speed. Untangling these factors can help better understand the (patho)physiology and improve diagnosis/prognosis associated with vascular impairments. Here, we use hypercapnic (HC) and hyperoxic (HO) challenges to gather insight about factors driving temporal delays between gray-matter (GM) and white-matter (WM). Blood Oxygen Level Dependent (BOLD) datasets were acquired at 7T in nine healthy subjects throughout BLOCK- and RAMP-HC paradigms. In a subset of seven participants, a combined HC+HO block, referred as the “BOOST” protocol, was also acquired. Tissue-based differences in Rapid Interpolation at Progressive Time Delays (RIPTiDe) were compared across stimulus to explore dynamic (BLOCK-HC) versus progressive (RAMP-HC) changes in CO2, as well as the effect of bolus arrival time on CVR delays (BLOCK-HC versus BOOST). While GM delays were similar between the BLOCK- (21.80 ± 10.17 s) and RAMP-HC (24.29 ± 14.64 s), longer WM lag times were observed during the RAMP-HC (42.66 ± 17.79 s), compared to the BLOCK-HC (34.15 ± 10.72 s), suggesting that the progressive stimulus may predispose WM vasculature to longer delays due to the smaller arterial content of CO2 delivered to WM tissues, which in turn, decreases intravascular CO2 gradients modulating CO2 diffusion into WM tissues. This was supported by a maintained ∼10 s offset in GM (11.66 ± 9.54 s) versus WM (21.40 ± 11.17 s) BOOST-delays with respect to the BLOCK-HC, suggesting that the vasoactive effect of CO2 remains constant and that shortening of BOOST delays was be driven by blood arrival reflected through the non-vasodilatory HO contrast. These findings support that differences in temporal and magnitude aspects of CVR between vascular networks reflect a component of CO2 sensitivity, in addition to redistribution and steal blood flow effects. Moreover, these results emphasize that the addition of a BOOST paradigm may provide clinical insights into whether vascular diseases causing changes in CVR do so by way of severe blood flow redistribution effects, alterations in vascular properties associated with CO2 diffusion, or changes in blood arrival time.

scholarly journals Measuring Cerebrovascular Reactivity: Sixteen Avoidable Pitfalls

2021 ◽  
Vol 12 ◽  
Author(s):  
Olivia Sobczyk ◽  
Jorn Fierstra ◽  
Lakshmikumar Venkatraghavan ◽  
Julien Poublanc ◽  
James Duffin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Vascular Reactivity ◽  
Relevant Information ◽  
Blood Oxygen Level Dependent ◽  
Lessons Learned ◽  
Cerebrovascular Reactivity ◽  
Vascular Pathology ◽  
Blood Oxygen Level ◽  
Vasoactive Agent ◽  
Cerebral Vascular

An increase in arterial PCO2 is the most common stressor used to increase cerebral blood flow for assessing cerebral vascular reactivity (CVR). That CO2 is readily obtained, inexpensive, easy to administer, and safe to inhale belies the difficulties in extracting scientifically and clinically relevant information from the resulting flow responses. Over the past two decades, we have studied more than 2,000 individuals, most with cervical and cerebral vascular pathology using CO2 as the vasoactive agent and blood oxygen-level-dependent magnetic resonance imaging signal as the flow surrogate. The ability to deliver different forms of precise hypercapnic stimuli enabled systematic exploration of the blood flow-related signal changes. We learned the effect on CVR of particular aspects of the stimulus such as the arterial partial pressure of oxygen, the baseline PCO2, and the magnitude, rate, and pattern of its change. Similarly, we learned to interpret aspects of the flow response such as its magnitude, and the speed and direction of change. Finally, we were able to test whether the response falls into a normal range. Here, we present a review of our accumulated insight as 16 “lessons learned.” We hope many of these insights are sufficiently general to apply to a range of types of CO2-based vasoactive stimuli and perfusion metrics used for CVR.

scholarly journals A novel method of quantifying hemodynamic delays to improve hemodynamic response, and CVR estimates in CO2 challenge fMRI

2021 ◽  
pp. 0271678X2097858
Author(s):  
Jinxia (Fiona) Yao ◽  
Ho-Ching (Shawn) Yang ◽  
James H Wang ◽  
Zhenhu Liang ◽  
Thomas M Talavage ◽  
...  
Keyword(s):  
Arrival Time ◽  
Stress Test ◽  
Low Frequency ◽  
Hemodynamic Response ◽  
Blood Oxygen Level Dependent ◽  
Cerebrovascular Reactivity ◽  
Bold Signal ◽  
Hemodynamic Response Function ◽  
Carbon Dioxide Co2 ◽  
Co2 Challenge

Elevated carbon dioxide (CO2) in breathing air is widely used as a vasoactive stimulus to assess cerebrovascular functions under hypercapnia (i.e., “stress test” for the brain). Blood-oxygen-level-dependent (BOLD) is a contrast mechanism used in functional magnetic resonance imaging (fMRI). BOLD is used to study CO2-induced cerebrovascular reactivity (CVR), which is defined as the voxel-wise percentage BOLD signal change per mmHg change in the arterial partial pressure of CO2 (PaCO2). Besides the CVR, two additional important parameters reflecting the cerebrovascular functions are the arrival time of arterial CO2 at each voxel, and the waveform of the local BOLD signal. In this study, we developed a novel analytical method to accurately calculate the arrival time of elevated CO2 at each voxel using the systemic low frequency oscillations (sLFO: 0.01-0.1 Hz) extracted from the CO2 challenge data. In addition, 26 candidate hemodynamic response functions (HRF) were used to quantitatively describe the temporal brain reactions to a CO2 stimulus. We demonstrated that our approach improved the traditional method by allowing us to accurately map three perfusion-related parameters: the relative arrival time of blood, the hemodynamic response function, and CVR during a CO2 challenge.

Blood oxygen-level dependent functional assessment of cerebrovascular reactivity: Feasibility for intraoperative 3 Tesla MRI

2016 ◽  
Vol 77 (2) ◽  
pp. 806-813 ◽  
Author(s):  
Jorn Fierstra ◽  
Jan-Karl Burkhardt ◽  
Christiaan Hendrik Bas van Niftrik ◽  
Marco Piccirelli ◽  
Athina Pangalu ◽  
...  
Keyword(s):  
Functional Assessment ◽  
Blood Oxygen Level Dependent ◽  
Cerebrovascular Reactivity ◽  
3 Tesla ◽  
Blood Oxygen ◽  
Oxygen Level ◽  
Blood Oxygen Level ◽  
3 Tesla Mri

scholarly journals Bolus Arrival Time and Cerebral Blood Flow Responses to Hypercarbia

2014 ◽  
Vol 34 (7) ◽  
pp. 1243-1252 ◽  
Author(s):  
Manus J Donahue ◽  
Carlos C Faraco ◽  
Megan K Strother ◽  
Michael A Chappell ◽  
Swati Rane ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Arterial Spin Labeling ◽  
Arrival Time ◽  
Cerebrovascular Reactivity ◽  
Functional Magnetic Resonance ◽  
Parietal Lobes ◽  
Experimental Parameters ◽  
Repetition Time ◽  
Bolus Arrival Time

The purpose of this study was to evaluate how cerebral blood flow and bolus arrival time (BAT) measures derived from arterial spin labeling (ASL) MRI data change for different hypercarbic gas stimuli. Pseudocontinuous ASL (pCASL) was applied (3.0T; spatial resolution = 4 × 4 × 7 mm 3 ; repetition time/echo time ( TR/TE) = 3,600/11 ms) sequentially in healthy volunteers ( n = 12; age = 30±4 years) for separate experiments in which (i) normocarbic normoxia (i.e., room air), hypercarbic normoxia (i.e., 5% CO2/21% O2/74% N2), and hypercarbic hyperoxia (i.e., carbogen: 5% CO2/95% O2) gas was administered (12 L/minute). Cerebral blood flow and BAT changes were quantified using models that account for macrovascular signal and partial volume effects in all gray matter and regionally in cerebellar, temporal, occipital, frontal, and parietal lobes. Regional reductions in BAT of 4.6% to 7.7% and 3.3% to 6.6% were found in response to hypercarbic normoxia and hypercarbic hyperoxia, respectively. Cerebral blood flow increased by 8.2% to 27.8% and 3.5% to 19.8% for hypercarbic normoxia and hypercarbic hyperoxia, respectively. These findings indicate that changes in BAT values may bias functional ASL data and thus should be considered when choosing appropriate experimental parameters in calibrated functional magnetic resonance imaging or ASL cerebrovascular reactivity experiments that use hypercarbic gas stimuli.

scholarly journals Arterial Spin Labeling and Blood Oxygen Level-Dependent MRI Cerebrovascular Reactivity in Cerebrovascular Disease: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 42 (3-4) ◽  
pp. 288-307 ◽  
Author(s):  
Diederik P.J. Smeeing ◽  
Jeroen Hendrikse ◽  
Esben T. Petersen ◽  
Manus J. Donahue ◽  
Jill B. de Vis
Keyword(s):  
Cerebrovascular Disease ◽  
Arterial Spin Labeling ◽  
Meta Analysis ◽  
Spin Labeling ◽  
Blood Oxygen Level Dependent ◽  
Cerebrovascular Reactivity ◽  
Blood Oxygen ◽  
Oxygen Level ◽  
Blood Oxygen Level ◽  
Occlusive Vascular Disease

Background: The cerebrovascular reactivity (CVR) results of blood oxygen level-dependent (BOLD) and arterial spin labeling (ASL) MRI studies performed in patients with cerebrovascular disease (steno-occlusive vascular disease or stroke) were systematically reviewed. Summary: Thirty-one articles were included. Twenty-three (74.2%) studies used BOLD MRI to evaluate the CVR, 4 (12.9%) studies used ASL MRI and 4 (12.9%) studies used both BOLD and ASL MRI. Thirteen studies (3 significant) found a lower BOLD CVR, 2 studies found a similar CVR and 3 studies found a higher CVR in the ipsilateral compared to the contralateral hemisphere. Nine (5 significant) out of 10 studies found a lower BOLD CVR in the ipsilateral hemispheres of patients compared to controls. Six studies (2 significant) found a lower ASL CVR in the ipsilateral compared to the contralateral hemispheres. Three out of 5 studies found a significant lower ASL CVR in the ipsilateral hemispheres of patients compared to controls. Key Messages: This review brings support for a reduced BOLD and ASL CVR in the ipsilateral hemisphere of patients with cerebrovascular disease. We suggest that future studies will be performed in a uniform way so reference values can be established and could be used to guide treatment decisions in patients with cerebrovascular disease.

scholarly journals BOLD and Perfusion Response to Finger-Thumb Apposition after Acetazolamide Administration: Differential Relationship to Global Perfusion

2003 ◽  
Vol 23 (7) ◽  
pp. 829-837 ◽  
Author(s):  
Gregory G. Brown ◽  
Lisa T. Eyler Zorrilla ◽  
Bassem Georgy ◽  
Sandra S. Kindermann ◽  
Eric C. Wong ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Blood Oxygen Level Dependent ◽  
Bold Response ◽  
Blood Oxygen Level ◽  
Individual Subject ◽  
Cerebrovascular Reserve ◽  
Global Cerebral Blood Flow ◽  
Hand Area ◽  
Cortical Perfusion

The authors studied the effects of altering global cerebral blood flow on both blood oxygen level–dependent (BOLD) response and perfusion response to finger-thumb apposition. A PICORE/QUIPSS II protocol was used to collect interleaved BOLD-weighted and perfusion-weighted images on eight finger-thumb apposition trials. Subjects were studied on a drug-free day and on a day when acetazolamide was administered between the second and third trials. After acetazolamide administration, resting cortical perfusion increased an average of 20% from preadministration levels, whereas the BOLD response to finger-thumb apposition decreased by an average of 35% in the S1M1 hand area. Contrary to predictions from the exhausted cerebrovascular reserve hypothesis and the oxygen limitation model, an effect of acetazolamide on cerebral blood flow response in the S1M1 hand area was not observed. Across the acetazolamide trials, BOLD response was inversely correlated with resting cortical perfusion for individual subject data. These results suggest that resting perfusion affects the magnitude of the BOLD response and is thus an important confounding factor in fMRI studies, and that the physiologic systems that increase cerebral blood flow in response to acetazolamide administration and systems that increase cerebral blood flow in response to altered neural activity appear to have additive effects.

scholarly journals Slowed Temporal and Parietal Cerebrovascular Response in Patients with Alzheimer’s Disease

2020 ◽  
Vol 47 (3) ◽  
pp. 366-373
Author(s):  
Kenneth R. Holmes ◽  
David Tang-Wai ◽  
Kevin Sam ◽  
Larissa McKetton ◽  
Julien Poublanc ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vascular Dysfunction ◽  
Intermediate Stage ◽  
Blood Oxygen Level Dependent ◽  
Cerebrovascular Reactivity ◽  
Blood Oxygen Level ◽  
Cerebrovascular Function ◽  
Anatomical Images ◽  
Cortical Regions

ABSTRACT:Background:Recent investigations now suggest that cerebrovascular reactivity (CVR) is impaired in Alzheimer’s disease (AD) and may underpin part of the disease’s neurovascular component. However, our understanding of the relationship between the magnitude of CVR, the speed of cerebrovascular response, and the progression of AD is still limited. This is especially true in patients with mild cognitive impairment (MCI), which is recognized as an intermediate stage between normal aging and dementia. The purpose of this study was to investigate AD and MCI patients by mapping repeatable and accurate measures of cerebrovascular function, namely the magnitude and speed of cerebrovascular response (τ) to a vasoactive stimulus in key predilection sites for vascular dysfunction in AD.Methods:Thirty-three subjects (age range: 52–83 years, 20 males) were prospectively recruited. CVR and τ were assessed using blood oxygen level-dependent MRI during a standardized carbon dioxide stimulus. Temporal and parietal cortical regions of interest (ROIs) were generated from anatomical images using the FreeSurfer image analysis suite.Results:Of 33 subjects recruited, 3 individuals were excluded, leaving 30 subjects for analysis, consisting of 6 individuals with early AD, 11 individuals with MCI, and 13 older healthy controls (HCs). τ was found to be significantly higher in the AD group compared to the HC group in both the temporal (p = 0.03) and parietal cortex (p = 0.01) following a one-way ANCOVA correcting for age and microangiopathy scoring and a Bonferroni post-hoc correction.Conclusion:The study findings suggest that AD is associated with a slowing of the cerebrovascular response in the temporal and parietal cortices.

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