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Mikulis DJ. Cerebrovascular Reserve Imaging: Problems and Solutions. Magn Reson Imaging Clin N Am 2024; 32:93-109. [PMID: 38007286 DOI: 10.1016/j.mric.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
The current standard of practice for assessing patients with cerebrovascular steno-occlusive disease is based on measuring resting blood flow metrics using MR imaging and CT perfusion imaging. However, the reliability of these methods decreases as the degree and number of stenoses increase. The reason for this is that measures of adequate baseline blood flow in highly collateralized circulations do not account for possible shortfalls in recruitable blood flow or increased metabolic demand. The following offers a clinically tested solution for this purpose using cerebrovascular reactivity methodology that applies a quantifiable vasodilatory stimulus improving reproducibility and repeatability essential for optimizing patient management.
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Affiliation(s)
- David J Mikulis
- The Krembil Brain Institute, Institute of Medcial Science, Department of Medical Imaging, The University of Toronto, The University Health Network, The Toronto Western Hospital, 399 Bathurst Street, Room 3MC-431, Toronto, ON M5T 2S8, Canada.
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2
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Biondetti E, Chiarelli AM, Germuska M, Lipp I, Villani A, Caporale AS, Patitucci E, Murphy K, Tomassini V, Wise RG. Breath-hold BOLD fMRI without CO 2 sampling enables estimation of venous cerebral blood volume: potential use in normalization of stimulus-evoked BOLD fMRI data. Neuroimage 2024; 285:120492. [PMID: 38070840 DOI: 10.1016/j.neuroimage.2023.120492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 10/30/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024] Open
Abstract
BOLD fMRI signal has been used in conjunction with vasodilatory stimulation as a marker of cerebrovascular reactivity (CVR): the relative change in cerebral blood flow (CBF) arising from a unit change in the vasodilatory stimulus. Using numerical simulations, we demonstrate that the variability in the relative BOLD signal change induced by vasodilation is strongly influenced by the variability in deoxyhemoglobin-containing cerebral blood volume (CBV), as this source of variability is likely to be more prominent than that of CVR. It may, therefore, be more appropriate to describe the relative BOLD signal change induced by an isometabolic vasodilation as a proxy of deoxygenated CBV (CBVdHb) rather than CVR. With this in mind, a new method was implemented to map a marker of CBVdHb, termed BOLD-CBV, based on the normalization of voxel-wise BOLD signal variation by an estimate of the intravascular venous BOLD signal from voxels filled with venous blood. The intravascular venous BOLD signal variation, recorded during repeated breath-holding, was extracted from the superior sagittal sinus in a cohort of 27 healthy volunteers and used as a regressor across the whole brain, yielding maps of BOLD-CBV. In the same cohort, we demonstrated the potential use of BOLD-CBV for the normalization of stimulus-evoked BOLD fMRI by comparing group-level BOLD fMRI responses to a visuomotor learning task with and without the inclusion of voxel-wise vascular covariates of BOLD-CBV and the BOLD signal change per mmHg variation in end-tidal carbon dioxide (BOLD-CVR). The empirical measure of BOLD-CBV accounted for more between-subject variability in the motor task-induced BOLD responses than BOLD-CVR estimated from end-tidal carbon dioxide recordings. The new method can potentially increase the power of group fMRI studies by including a measure of vascular characteristics and has the strong practical advantage of not requiring experimental measurement of end-tidal carbon dioxide, unlike traditional methods to estimate BOLD-CVR. It also more closely represents a specific physiological characteristic of brain vasculature than BOLD-CVR, namely blood volume.
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Affiliation(s)
- Emma Biondetti
- Department of Neurosciences, Imaging, and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy.
| | - Antonio Maria Chiarelli
- Department of Neurosciences, Imaging, and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Michael Germuska
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Physics and Astronomy, Cardiff University, Cardiff, United Kingdom
| | - Ilona Lipp
- Department of Neurophysics, Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany; Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Alessandro Villani
- Department of Neurosciences, Imaging, and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Alessandra S Caporale
- Department of Neurosciences, Imaging, and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Eleonora Patitucci
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Kevin Murphy
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Physics and Astronomy, Cardiff University, Cardiff, United Kingdom
| | - Valentina Tomassini
- Department of Neurosciences, Imaging, and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK; MS Centre, Neurology Unit, 'SS. Annunziata' University Hospital, Chieti, Italy; Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK; Helen Durham Centre for Neuroinflammation, University Hospital of Wales, Cardiff, UK
| | - Richard G Wise
- Department of Neurosciences, Imaging, and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
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van Niftrik CHB, Hiller A, Sebök M, Halter M, Duffin J, Fisher JA, Mikulis DJ, Regli L, Piccirelli M, Fierstra J. Heterogeneous motor BOLD-fMRI responses in brain areas exhibiting negative BOLD cerebrovascular reactivity indicate that steal phenomenon does not always result from exhausted cerebrovascular reserve capacity. Magn Reson Imaging 2023; 103:124-130. [PMID: 37481092 DOI: 10.1016/j.mri.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/11/2023] [Accepted: 07/19/2023] [Indexed: 07/24/2023]
Abstract
INTRODUCTION Brain areas exhibiting negative blood oxygenation-level dependent cerebrovascular reactivity (BOLD-CVR) responses to carbon dioxide (CO2) are thought to suffer from a completely exhausted autoregulatory cerebrovascular reserve capacity and exhibit vascular steal phenomenon. If this assumption is correct, the presence of vascular steal phenomenon should subsequently result in an equal negative fMRI signal response during a motor-task based BOLD-fMRI study (increase in metabolism without an increase in cerebral blood flow due to exhausted reserve capacity) in otherwise functional brain tissue. To investigate this premise, the aim of this study was to further investigate motor-task based BOLD-fMRI signal responses in brain areas exhibiting negative BOLD-CVR. MATERIAL AND METHODS Seventy-one datasets of patients with cerebrovascular steno-occlusive disease without motor defects, who underwent a CO2-calibrated motor task-based BOLD-fMRI study with a fingertapping paradigm and a subsequent BOLD-CVR study with a precisely controlled CO2-challenge during the same MRI examination, were included. We compared BOLD-fMRI signal responses in the bilateral pre- and postcentral gyri - i.e. Region of Interest (ROI) with the corresponding BOLD-CVR in this ROI. The ROI was determined using a second level group analysis of the BOLD-fMRI task study of 42 healthy individuals undergoing the same study protocol. RESULTS An overall decrease in BOLD-CVR was associated with a decrease in BOLD-fMRI signal response within the ROI. For patients exhibiting negative BOLD-CVR, we found both positive and negative motor-task based BOLD-fMRI signal responses. CONCLUSION We show that the presence of negative BOLD-CVR responses to CO2 is associated with heterogeneous motor task-based BOLD-fMRI signal responses, where some patients show -more presumed- negative BOLD-fMRI signal responses, while other patient showed positive BOLD-fMRI signal responses. This finding may indicate that the autoregulatory vasodilatory reserve capacity does not always need to be completely exhausted for vascular steal phenomenon to occur.
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Affiliation(s)
- Christiaan Hendrik Bas van Niftrik
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Switzerland.
| | - Aimée Hiller
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Switzerland; Department of Abdominal and Transplant Surgery, University Hospital Zurich, University of Zurich. Switzerland
| | - Martina Sebök
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Switzerland
| | - Matthias Halter
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Switzerland
| | - James Duffin
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Joseph A Fisher
- Department of Anesthesia and Pain Management, University Health Network, Toronto, ON, Canada.; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - David J Mikulis
- Joint Department of Medical Imaging and the Functional Neuroimaging Laboratory, University Health Network, Toronto, ON, Canada
| | - Luca Regli
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Switzerland
| | - Marco Piccirelli
- Clinical Neuroscience Center, University Hospital Zurich, Switzerland; Department of Neuroradiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Jorn Fierstra
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Switzerland
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Stickland RC, Zvolanek KM, Moia S, Caballero-Gaudes C, Bright MG. Lag-Optimized Blood Oxygenation Level Dependent Cerebrovascular Reactivity Estimates Derived From Breathing Task Data Have a Stronger Relationship With Baseline Cerebral Blood Flow. Front Neurosci 2022; 16:910025. [PMID: 35801183 PMCID: PMC9254683 DOI: 10.3389/fnins.2022.910025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
Cerebrovascular reactivity (CVR), an important indicator of cerebrovascular health, is commonly studied with the Blood Oxygenation Level Dependent functional MRI (BOLD-fMRI) response to a vasoactive stimulus. Theoretical and empirical evidence suggests that baseline cerebral blood flow (CBF) modulates BOLD signal amplitude and may influence BOLD-CVR estimates. We address how acquisition and modeling choices affect the relationship between baseline cerebral blood flow (bCBF) and BOLD-CVR: whether BOLD-CVR is modeled with the inclusion of a breathing task, and whether BOLD-CVR amplitudes are optimized for hemodynamic lag effects. We assessed between-subject correlations of average GM values and within-subject spatial correlations across cortical regions. Our results suggest that a breathing task addition to a resting-state acquisition, alongside lag-optimization within BOLD-CVR modeling, can improve BOLD-CVR correlations with bCBF, both between- and within-subjects, likely because these CVR estimates are more physiologically accurate. We report positive correlations between bCBF and BOLD-CVR, both between- and within-subjects. The physiological explanation of this positive correlation is unclear; research with larger samples and tightly controlled vasoactive stimuli is needed. Insights into what drives variability in BOLD-CVR measurements and related measurements of cerebrovascular function are particularly relevant when interpreting results in populations with altered vascular and/or metabolic baselines or impaired cerebrovascular reserve.
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Affiliation(s)
- Rachael C. Stickland
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kristina M. Zvolanek
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, United States
| | - Stefano Moia
- Basque Center on Cognition, Brain and Language, Donostia, Spain
- University of the Basque Country EHU/UPV, Donostia, Spain
| | | | - Molly G. Bright
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, United States
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5
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Stadlbauer A, Kinfe TM, Zimmermann M, Eyüpoglu I, Brandner N, Buchfelder M, Zaiss M, Dörfler A, Brandner S. Association between tissue hypoxia, perfusion restrictions, and microvascular architecture alterations with lesion-induced impairment of neurovascular coupling. J Cereb Blood Flow Metab 2022; 42:526-539. [PMID: 32787542 PMCID: PMC8985434 DOI: 10.1177/0271678x20947546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Functional magnetic resonance imaging (fMRI) has been mainly utilized for the preoperative localization of eloquent cortical areas. However, lesion-induced impairment of neurovascular coupling (NVC) in the lesion border zone may lead to false-negative fMRI results. The purpose of this study was to determine physiological factors impacting the NVC. Twenty patients suffering from brain lesions were preoperatively examined using multimodal neuroimaging including fMRI, magnetoencephalography (MEG) during language or sensorimotor tasks (depending on lesion location), and a novel physiologic MRI approach for the combined quantification of oxygen metabolism, perfusion state, and microvascular architecture. Congruence of brain activity patterns between fMRI and MEG were found in 13 patients. In contrast, we observed missing fMRI activity in perilesional cortex that demonstrated MEG activity in seven patients, which was interpreted as lesion-induced impairment of NVC. In these brain regions with impaired NVC, physiologic MRI revealed significant brain tissue hypoxia, as well as significantly decreased macro- and microvascular perfusion and microvascular architecture. We demonstrated that perilesional hypoxia with reduced vascular perfusion and architecture is associated with lesion-induced impairment of NVC. Our physiologic MRI approach is a clinically applicable method for preoperative risk assessment for the presence of false-negative fMRI results and may prevent severe postoperative functional deficits.
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Affiliation(s)
- Andreas Stadlbauer
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany.,Institute of Medical Radiology, University Clinic of St. Pölten, St. Pölten, Austria
| | - Thomas M Kinfe
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany.,Division of Functional Neurosurgery and Stereotaxy, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
| | - Max Zimmermann
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany.,Department of Preclinical Imaging and Radiopharmacy, University of Tübingen, Tübingen, Germany
| | - Ilker Eyüpoglu
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
| | - Nadja Brandner
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
| | - Moritz Zaiss
- Department of Neuroradiology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Arnd Dörfler
- Department of Neuroradiology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Sebastian Brandner
- Department of Neurosurgery, Friedrich-Alexander University (FAU) of Erlangen-Nürnberg, Erlangen, Germany
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6
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Champagne AA, Coverdale NS, Allen MD, Tremblay JC, MacPherson REK, Pyke KE, Olver TD, Cook DJ. The physiological basis underlying functional connectivity differences in older adults: A multi-modal analysis of resting-state fMRI. Brain Imaging Behav 2022; 16:1575-1591. [PMID: 35092574 DOI: 10.1007/s11682-021-00570-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 09/27/2021] [Indexed: 11/02/2022]
Abstract
The purpose of this study was to determine if differences in functional connectivity strength (FCS) with age were confounded by vascular parameters including resting cerebral blood flow (CBF0), cerebrovascular reactivity (CVR), and BOLD-CBF coupling. Neuroimaging data were collected from 13 younger adults (24 ± 2 years) and 14 older adults (71 ± 4 years). A dual-echo resting state pseudo-continuous arterial spin labeling sequence was performed, as well as a BOLD breath-hold protocol. A group independent component analysis was used to identify networks, which were amalgamated into a region of interest (ROI). Within the ROI, FC strength (FCS) was computed for all voxels and compared across the groups. CBF0, CVR and BOLD-CBF coupling were examined within voxels where FCS was different between young and older adults. FCS was greater in old compared to young (P = 0.001). When the effect of CBF0, CVR and BOLD-CBF coupling on FCS was examined, BOLD-CBF coupling had a significant effect (P = 0.003) and group differences in FCS were not present once all vascular parameters were considered in the statistical model (P = 0.07). These findings indicate that future studies of FCS should consider vascular physiological markers in order to improve our understanding of aging processes on brain connectivity.
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Affiliation(s)
- Allen A Champagne
- Centre for Neuroscience Studies, Queen's University, Room 260, Kingston, ON, K7L 3N6, Canada
| | - Nicole S Coverdale
- Centre for Neuroscience Studies, Queen's University, Room 260, Kingston, ON, K7L 3N6, Canada
| | - Matti D Allen
- Department of Physical Medicine and Rehabilitation, Queen's University, Kingston, ON, Canada.,School of Kinesiology and Health Studies, Cardiovascular Stress Response Laboratory, Queen's University, Kingston, ON, K7L 3N6, Canada.,Department of Physical Medicine and Rehabilitation, Providence Care Hospital, 752 King St., Ontario, West Kingston, Canada
| | - Joshua C Tremblay
- School of Kinesiology and Health Studies, Cardiovascular Stress Response Laboratory, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Rebecca E K MacPherson
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St Catharines, ON, L2S 3A1, Canada
| | - Kyra E Pyke
- School of Kinesiology and Health Studies, Cardiovascular Stress Response Laboratory, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - T Dylan Olver
- Biomedical Sciences, Western College of Veterinarian Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan, S7N 5B4, Canada
| | - Douglas J Cook
- Centre for Neuroscience Studies, Queen's University, Room 260, Kingston, ON, K7L 3N6, Canada. .,Department of Surgery, Queen's University, Room 232, 18 Stuart St, Kingston, ON, K7L 3N6, Canada.
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7
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Fesharaki NJ, Mathew AB, Mathis JR, Huddleston WE, Reuss JL, Pillai JJ, DeYoe EA. Effects of Thresholding on Voxel-Wise Correspondence of Breath-Hold and Resting-State Maps of Cerebrovascular Reactivity. Front Neurosci 2021; 15:654957. [PMID: 34504411 PMCID: PMC8421787 DOI: 10.3389/fnins.2021.654957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/22/2021] [Indexed: 11/13/2022] Open
Abstract
Functional magnetic resonance imaging for presurgical brain mapping enables neurosurgeons to identify viable tissue near a site of operable pathology which might be at risk of surgery-induced damage. However, focal brain pathology (e.g., tumors) may selectively disrupt neurovascular coupling while leaving the underlying neurons functionally intact. Such neurovascular uncoupling can result in false negatives on brain activation maps thereby compromising their use for surgical planning. One way to detect potential neurovascular uncoupling is to map cerebrovascular reactivity using either an active breath-hold challenge or a passive resting-state scan. The equivalence of these two methods has yet to be fully established, especially at a voxel level of resolution. To quantitatively compare breath-hold and resting-state maps of cerebrovascular reactivity, we first identified threshold settings that optimized coverage of gray matter while minimizing false responses in white matter. When so optimized, the resting-state metric had moderately better gray matter coverage and specificity. We then assessed the spatial correspondence between the two metrics within cortical gray matter, again, across a wide range of thresholds. Optimal spatial correspondence was strongly dependent on threshold settings which if improperly set tended to produce statistically biased maps. When optimized, the two CVR maps did have moderately good correspondence with each other (mean accuracy of 73.6%). Our results show that while the breath-hold and resting-state maps may appear qualitatively similar they are not quantitatively identical at a voxel level of resolution.
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Affiliation(s)
- Nooshin J Fesharaki
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, United States.,Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Amy B Mathew
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Jedidiah R Mathis
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Wendy E Huddleston
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - James L Reuss
- Prism Clinical Imaging, Inc., Milwaukee, WI, United States
| | - Jay J Pillai
- Neuroradiology Division, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Edgar A DeYoe
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
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8
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Sleight E, Stringer MS, Marshall I, Wardlaw JM, Thrippleton MJ. Cerebrovascular Reactivity Measurement Using Magnetic Resonance Imaging: A Systematic Review. Front Physiol 2021; 12:643468. [PMID: 33716793 PMCID: PMC7947694 DOI: 10.3389/fphys.2021.643468] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/01/2021] [Indexed: 12/27/2022] Open
Abstract
Cerebrovascular reactivity (CVR) magnetic resonance imaging (MRI) probes cerebral haemodynamic changes in response to a vasodilatory stimulus. CVR closely relates to the health of the vasculature and is therefore a key parameter for studying cerebrovascular diseases such as stroke, small vessel disease and dementias. MRI allows in vivo measurement of CVR but several different methods have been presented in the literature, differing in pulse sequence, hardware requirements, stimulus and image processing technique. We systematically reviewed publications measuring CVR using MRI up to June 2020, identifying 235 relevant papers. We summarised the acquisition methods, experimental parameters, hardware and CVR quantification approaches used, clinical populations investigated, and corresponding summary CVR measures. CVR was investigated in many pathologies such as steno-occlusive diseases, dementia and small vessel disease and is generally lower in patients than in healthy controls. Blood oxygen level dependent (BOLD) acquisitions with fixed inspired CO2 gas or end-tidal CO2 forcing stimulus are the most commonly used methods. General linear modelling of the MRI signal with end-tidal CO2 as the regressor is the most frequently used method to compute CVR. Our survey of CVR measurement approaches and applications will help researchers to identify good practice and provide objective information to inform the development of future consensus recommendations.
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Affiliation(s)
- Emilie Sleight
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom,UK Dementia Research Institute, Edinburgh, United Kingdom
| | - Michael S. Stringer
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom,UK Dementia Research Institute, Edinburgh, United Kingdom,*Correspondence: Michael S. Stringer
| | - Ian Marshall
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom,UK Dementia Research Institute, Edinburgh, United Kingdom
| | - Joanna M. Wardlaw
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom,UK Dementia Research Institute, Edinburgh, United Kingdom
| | - Michael J. Thrippleton
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom,UK Dementia Research Institute, Edinburgh, United Kingdom
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9
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Berman BD, Groth CL, Shelton E, Sillau SH, Sutton B, Legget KT, Tregellas JR. Hemodynamic responses are abnormal in isolated cervical dystonia. J Neurosci Res 2020; 98:692-703. [PMID: 31692015 PMCID: PMC7015799 DOI: 10.1002/jnr.24547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/10/2019] [Accepted: 10/10/2019] [Indexed: 01/04/2023]
Abstract
Neuroimaging studies using functional magnetic resonance imaging (fMRI), which measures brain activity by detecting the changes in blood oxygenation levels, are advancing our understanding of the pathophysiology of dystonia. Neurobiological disturbances in dystonia, however, may affect neurovascular coupling and impact the interpretability of fMRI studies. We evaluated here whether the hemodynamic response patterns during a behaviorally matched motor task are altered in isolated cervical dystonia (CD). Twenty-five CD patients and 25 healthy controls (HCs) underwent fMRI scanning during a paced finger tapping task (nondystonic task in patients). Imaging data were analyzed using a constrained principal component analysis-a statistical method that combines regression analysis and principal component analysis and enables the extraction of task-related functional networks and determination of the spatial and temporal hemodynamic response patterns associated with the task performance. Data from three patients and two controls were removed due to excessive movement. No significant differences in demographics or motor performance were observed. Three task-associated functional brain networks were identified. During task performance, reduced hemodynamic responses were seen in a sensorimotor network and in a network that included key nodes of the default mode, executive control and visual networks. During rest, reductions in hemodynamic responses were seen in the cognitive/visual network. Lower hemodynamic responses within the primary sensorimotor network in patients were correlated with the increased dystonia severity. Pathophysiological disturbances in isolated CD, such as alterations in inhibitory signaling and dopaminergic neurotransmission, may impact neurovascular coupling. Not accounting for hemodynamic response differences in fMRI studies of dystonia could lead to inaccurate results and interpretations.
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Affiliation(s)
- Brian D. Berman
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO
- Neurology Section, Denver VA Medical Center, Aurora, CO, USA
| | - Christopher L. Groth
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Erica Shelton
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO
| | - Stefan H. Sillau
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO
| | - Brianne Sutton
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO
| | - Kristina T. Legget
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO
| | - Jason R. Tregellas
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO
- Research Service, Denver VA Medical Center, Aurora, CO USA
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10
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Champagne AA, Coverdale NS, Ross A, Chen Y, Murray CI, Dubowitz D, Cook DJ. Multi-modal normalization of resting-state using local physiology reduces changes in functional connectivity patterns observed in mTBI patients. Neuroimage Clin 2020; 26:102204. [PMID: 32058317 PMCID: PMC7013121 DOI: 10.1016/j.nicl.2020.102204] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 12/25/2022]
Abstract
Blood oxygenation level dependent (BOLD) resting-state functional magnetic resonance imaging (rs-fMRI) may serve as a sensitive marker to identify possible changes in the architecture of large-scale networks following mild traumatic brain injury (mTBI). Differences in functional connectivity (FC) measurements derived from BOLD rs-fMRI may however be confounded by changes in local cerebrovascular physiology and neurovascular coupling mechanisms, without changes in the underlying neuronally driven connectivity of networks. In this study, multi-modal neuroimaging data including BOLD rs-fMRI, baseline cerebral blood flow (CBF0) and cerebrovascular reactivity (CVR; acquired using a hypercapnic gas breathing challenge) were collected in 23 subjects with reported mTBI (14.6±14.9 months post-injury) and 27 age-matched healthy controls. Despite no group differences in CVR within the networks of interest (P > 0.05, corrected), significantly higher CBF0 was documented in the mTBI subjects (P < 0.05, corrected), relative to the controls. A normalization method designed to account for differences in CBF0 post-mTBI was introduced to evaluate the effects of such an approach on reported group differences in network connectivity. Inclusion of regional perfusion measurements in the computation of correlation coefficients within and across large-scale networks narrowed the differences in FC between the groups, suggesting that this approach may elucidate unique changes in connectivity post-mTBI while accounting for shared variance with CBF0. Altogether, our results provide a strong paradigm supporting the need to account for changes in physiological modulators of BOLD in order to expand our understanding of the effects of brain injury on large-scale FC of cortical networks.
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Affiliation(s)
- Allen A Champagne
- Centre for Neuroscience Studies, Room 260, Queen's University, Kingston ON K7L 3N6 Canada.
| | - Nicole S Coverdale
- Centre for Neuroscience Studies, Room 260, Queen's University, Kingston ON K7L 3N6 Canada.
| | - Andrew Ross
- Performance Phenomics, 180 John St., Toronto ON M5T 1 × 5 Canada.
| | - Yining Chen
- Centre for Neuroscience Studies, Room 260, Queen's University, Kingston ON K7L 3N6 Canada.
| | | | - David Dubowitz
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand.
| | - Douglas J Cook
- Centre for Neuroscience Studies, Room 260, Queen's University, Kingston ON K7L 3N6 Canada; Department of Surgery, Queen's University, Kingston, ON, Canada.
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11
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Co-localized impaired regional cerebrovascular reactivity in chronic concussion is associated with BOLD activation differences during a working memory task. Brain Imaging Behav 2020; 14:2438-2449. [PMID: 31903527 DOI: 10.1007/s11682-019-00194-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The purpose of this study was to quantify differences in blood oxygen level dependent (BOLD) activation on a working memory task, baseline cerebral blood flow (CBF0), and cerebrovascular reactivity (CVR) between participants with and without a history of concussion. A dual-echo pseudo-continuous arterial spin labelling (pCASL) sequence was performed on a group of 10 subjects with a previous concussion (126 ± 15 days prior) and on a control group (n = 10) during a visual working memory protocol. A separate dual-echo pCASL sequence was used to derive CVR and CBF0 measurements from a boxcar hypercapnic breathing protocol. Brain areas with significant activation differences on the working memory task between groups were identified and combined as an aggregate region of interest for CBF and CVR analyses. Areas of reduced BOLD activation during the working memory task in the concussed group included the ventral anterior cingulate cortex (ACC), the medial temporal gyrus (MTG), and the lateral occipital cortex in two loci. A single area of increased activation was located in the parietal operculum. Further analyses of CBF0 and CVR in these regions revealed reduced CVR in the concussed group in the MTG and ACC, while CBF0 did not differ. The differences in CVR between the two groups in these regions suggest that concussive injury may result in microvascular dysfunction. In turn, the decreased BOLD response during the task could be due to altered neurovascular coupling, rather than an impairment in neural activation alone. However, in other regions associated with working memory, unchanged CBF0 and CVR suggests that neural injury also persists after concussion. In the future, BOLD results should be normalized to CVR in order achieve a clearer understanding of the neural and vascular contributions to the differences in the signal.
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12
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Champagne AA, Coverdale NS, Germuska M, Cook DJ. Multi-parametric analysis reveals metabolic and vascular effects driving differences in BOLD-based cerebrovascular reactivity associated with a history of sport concussion. Brain Inj 2019; 33:1479-1489. [PMID: 31354054 PMCID: PMC7115911 DOI: 10.1080/02699052.2019.1644375] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 07/12/2019] [Indexed: 12/19/2022]
Abstract
Objective: Identify alterations in cerebrovascular reactivity (CVR) based on the history of sport-related concussion (SRC). Further explore possible mechanisms underlying differences in vascular physiology using hemodynamic parameters modeled using calibrated magnetic resonance imaging (MRI). Method: End-tidal targeting and dual-echo MRI were combined to probe hypercapnic and hyperoxic challenges in athletes with (n = 32) and without (n = 31) a history of SRC. Concurrent blood oxygenation level dependent (BOLD) and arterial spin labeling (ASL) data were used to compute BOLD-CVR, ASL-CVR, and other physiological parameters including resting oxygen extraction fraction (OEF0) and cerebral blood volume (CBV0). Multiple linear and logistic regressions were then used to identify dominant parameters driving group-differences in BOLD-CVR. Results: Robust evidence for elevated BOLD-CVR were found in athletes with SRC history spreading over parts of the cortical hemispheres. Follow-up analyses showed co-localized differences in ASL-CVR (representing modulation of cerebral blood flow) and hemodynamic factors representing static vascular (i.e., CBV0) and metabolic (i.e., OEF0) effects suggesting that group-based differences in BOLD-CVR may be driven by a mixed effect from factors with vascular and metabolic origins. Conclusion: These results emphasize that while BOLD-CVR offers promises as a surrogate non-specific biomarker for cerebrovascular health following SRC, multiple hemodynamic parameters can affect its relative measurements. Abbreviations: [dHb]: concentration of deoxyhemoglobin; AFNI: Analysis of Functional NeuroImages ( https://afni.nimh.nih.gov ); ASL: arterial spin labeling; BIG: position group: defensive and offensive linemen; BIG-SKILL: position group: full backs, linebackers, running backs, tight-ends; BOLD: blood oxygen level dependent; CBF: cerebral blood flow; CMRO2: cerebral metabolic rate of oxygen consumption; CTL: group of control subjects; CVR: cerebrovascular reactivity; fMRI: functional magnetic resonance imaging; FSL: FMRIB software library ( https://fsl.fmrib.ox.ac.uk/fsl/fslwiki/ ); HC: hypercapnia; HO: hyperoxia; HX: group with history of concussion; M: maximal theoretical BOLD signal upon complete removal of venous dHb; pCASL: pseudo-continuous arterial spin labeling; PETCO2: end-tidal carbon dioxide; PETO2: end-tidal oxygen; SCAT: sport-concussion assessment tool; SKILL: position group: defensive backs, kickers, quarterbacks, safeties, wide-receivers; SRC: sport-related concussion.
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Affiliation(s)
- Allen A. Champagne
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
| | | | - Michael Germuska
- Cardiff University Brain Research Imaging Center, Cardiff University, Cardiff, United Kingdom
| | - Douglas J. Cook
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
- Department of Surgery, Queen’s University, Kingston, ON, Canada
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13
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Reginold W, Sam K, Poublanc J, Fisher J, Crawley A, Mikulis DJ. The efficiency of the brain connectome is associated with cerebrovascular reactivity in persons with white matter hyperintensities. Hum Brain Mapp 2019; 40:3647-3656. [PMID: 31115127 DOI: 10.1002/hbm.24622] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 04/14/2019] [Accepted: 04/29/2019] [Indexed: 01/06/2023] Open
Abstract
The purpose of this study was to determine the relationship between the organization of the brain connectome and cerebrovascular reactivity (CVR) in persons with white matter hyperintensities. Diffusion tensor and CVR mapping 3T MRI scans were acquired in 31 participants with white matter hyperintensities. In each participant, the connectome was assessed by reconstructing all white matter tracts with tractography and segmenting the whole brain into multiple regions. Graph theory analysis was performed to quantify how effectively tracts connected brain regions by measuring the global and local efficiency of the connectome. CVR in white matter and gray matter was correlated with the global and local efficiency of the connectome, while adjusting for age, gender, and gray matter volume. For comparison, white matter hyperintensity volume was also correlated with global and local efficiency. White matter CVR was positively correlated with the global efficiency (coefficient: 23.3, p = .005) and local efficiency (coefficient: 2850, p = .004) of the connectome. Gray matter CVR was positively correlated with the global efficiency (coefficient: 21.3, p < .001) and local efficiency (coefficient: 2670, p < .001) of the connectome. White matter hyperintensity volume was negatively correlated with global efficiency (coefficient: -0.0002, p = .003) and local efficiency (coefficient: -0.024, p = .003) of the connectome. The association between CVR and the brain connectome suggests that impaired cerebrovascular function may be part of the pathophysiology of the disruption of the brain connectome in persons with white matter hyperintensities.
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Affiliation(s)
- William Reginold
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.,Division of Neuroradiology, Joint Department of Medical Imaging at the University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Kevin Sam
- Russell H. Morgan Department of Radiology & Radiologic Science, The John Hopkins University School of Medicine, Baltimore, Maryland
| | - Julien Poublanc
- Division of Neuroradiology, Joint Department of Medical Imaging at the University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Joe Fisher
- Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada
| | - Adrian Crawley
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.,Division of Neuroradiology, Joint Department of Medical Imaging at the University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada
| | - David J Mikulis
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.,Division of Neuroradiology, Joint Department of Medical Imaging at the University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada
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14
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van Niftrik CHB, Piccirelli M, Muscas G, Sebök M, Fisher JA, Bozinov O, Stippich C, Valavanis A, Regli L, Fierstra J. The voxel-wise analysis of false negative fMRI activation in regions of provoked impaired cerebrovascular reactivity. PLoS One 2019; 14:e0215294. [PMID: 31059517 PMCID: PMC6502350 DOI: 10.1371/journal.pone.0215294] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/30/2019] [Indexed: 12/30/2022] Open
Abstract
Task-evoked Blood-oxygenation-level-dependent (BOLD-fMRI) signal activation is widely used to interrogate eloquence of brain areas. However, data interpretation can be improved, especially in regions with absent BOLD-fMRI signal activation. Absent BOLD-fMRI signal activation may actually represent false-negative activation due to impaired cerebrovascular reactivity (BOLD-CVR) of the vascular bed. The relationship between impaired BOLD-CVR and BOLD-fMRI signal activation may be better studied in healthy subjects where neurovascular coupling is known to be intact. Using a model-based prospective end-tidal carbon dioxide (CO2) targeting algorithm, we performed two controlled 3 tesla BOLD-CVR studies on 17 healthy subjects: 1: at the subjects’ individual resting end-tidal CO2 baseline. 2: Around +6.0 mmHg CO2 above the subjects’ individual resting baseline. Two BOLD-fMRI finger-tapping experiments were performed at similar normo- and hypercapnic levels. Relative BOLD fMRI signal activation and t-values were calculated for BOLD-CVR and BOLD-fMRI data. For each component of the cerebral motor-network (precentral gyrus, postcentral gyrus, supplementary motor area, cerebellum und fronto-operculum), the correlation between BOLD-CVR and BOLD-fMRI signal changes and t-values was investigated. Finally, a voxel-wise quantitative analysis of the impact of BOLD-CVR on BOLD-fMRI was performed. For the motor-network, the linear correlation coefficient between BOLD-CVR and BOLD-fMRI t-values were significant (p<0.01) and in the range 0.33–0.55, similar to the correlations between the CVR and fMRI Δ%signal (p<0.05; range 0.34–0.60). The linear relationship between CVR and fMRI is challenged by our voxel-wise analysis of Δ%signal and t-value change between normo- and hypercapnia. Our main finding is that BOLD fMRI signal activation maps are markedly dampened in the presence of impaired BOLD-CVR and highlights the importance of a complementary BOLD-CVR assessment in addition to a task-evoked BOLD fMRI to identify brain areas at risk for false-negative BOLD-fMRI signal activation.
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Affiliation(s)
- Christiaan Hendrik Bas van Niftrik
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- * E-mail:
| | - Marco Piccirelli
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Giovanni Muscas
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Neurosurgery, Careggi University Hospital, Florence, University of Florence, Florence, Italy
| | - Martina Sebök
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Joseph Arnold Fisher
- Department of Anesthesiology, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Oliver Bozinov
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christoph Stippich
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Antonios Valavanis
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Luca Regli
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jorn Fierstra
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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15
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Champagne AA, Coverdale NS, Nashed JY, Fernandez-Ruiz J, Cook DJ. Resting CMRO 2 fluctuations show persistent network hyper-connectivity following exposure to sub-concussive collisions. NEUROIMAGE-CLINICAL 2019; 22:101753. [PMID: 30884366 PMCID: PMC6424143 DOI: 10.1016/j.nicl.2019.101753] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 02/20/2019] [Accepted: 03/09/2019] [Indexed: 12/20/2022]
Abstract
Exposure to head impacts may alter brain connectivity within cortical hubs such as the default-mode network (DMN). However, studies have yet to consider the confounding effects of altered resting cerebral blood flow (CBF0) and cerebrovascular reactivity (CVR) on changes in connectivity following sub-concussive impacts. Here, 23 Canadian collegiate football players were followed during a season using calibrated resting-state MRI and helmet accelerometers to examine the interplay between the neural and vascular factors that determine functional connectivity (FC). Connectivity-based analyses using blood oxygen level dependent (BOLD) and cerebral metabolic rate of oxygen consumption (CMRO2) mapping were used to study the DMN longitudinally. Network-specific decreases in CBF0 were observed one month following the season, while impaired CVR was documented at both mid-season and one month following the season, compared to pre-season baseline. Alterations in CBF0 and BOLD-based CVR throughout the season suggest that neurophysiological markers may show different susceptibility timelines following head impacts. DMN connectivity was increased throughout the season, independent of changes in cerebrovascular physiology, suggesting that alterations in FC following sub-concussive impacts are robust and independent of changes in brain hemodynamics. No significant correlations between impact kinematics and DMN connectivity changes were documented in this study. Altogether, these findings create a strong paradigm for future studies to examine the underlying neural and vascular mechanisms associated with increases in network connectivity following repeated exposure to sub-concussive collisions, in an effort to improve management of head impacts in contact sports. Changes in brain physiology do not confound BOLD-based changes in DMN connectivity. Physiological markers may show different susceptibility timelines to head impacts. CMRO2-based mapping shows robust evidence for sensitivity of DMN to head impacts.
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Affiliation(s)
- Allen A Champagne
- Centre for Neuroscience Studies, Room 260, Queen's University, Kingston, ON K7L 3N6, Canada.
| | - Nicole S Coverdale
- Centre for Neuroscience Studies, Room 260, Queen's University, Kingston, ON K7L 3N6, Canada.
| | - Joseph Y Nashed
- Centre for Neuroscience Studies, Room 260, Queen's University, Kingston, ON K7L 3N6, Canada.
| | - Juan Fernandez-Ruiz
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Av. Universidad 3000, Coyoacán, Ciudad de México 04510, México.
| | - Douglas J Cook
- Centre for Neuroscience Studies, Room 260, Queen's University, Kingston, ON K7L 3N6, Canada; Department of Surgery, Queen's University, Room 232, 18 Stuart St, Kingston, ON K7L 3N6, Canada.
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16
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Smeets PAM, Dagher A, Hare TA, Kullmann S, van der Laan LN, Poldrack RA, Preissl H, Small D, Stice E, Veldhuizen MG. Good practice in food-related neuroimaging. Am J Clin Nutr 2019; 109:491-503. [PMID: 30834431 PMCID: PMC7945961 DOI: 10.1093/ajcn/nqy344] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/22/2017] [Accepted: 11/05/2018] [Indexed: 12/17/2022] Open
Abstract
The use of neuroimaging tools, especially functional magnetic resonance imaging, in nutritional research has increased substantially over the past 2 decades. Neuroimaging is a research tool with great potential impact on the field of nutrition, but to achieve that potential, appropriate use of techniques and interpretation of neuroimaging results is necessary. In this article, we present guidelines for good methodological practice in functional magnetic resonance imaging studies and flag specific limitations in the hope of helping researchers to make the most of neuroimaging tools and avoid potential pitfalls. We highlight specific considerations for food-related studies, such as how to adjust statistically for common confounders, like, for example, hunger state, menstrual phase, and BMI, as well as how to optimally match different types of food stimuli. Finally, we summarize current research needs and future directions, such as the use of prospective designs and more realistic paradigms for studying eating behavior.
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Affiliation(s)
- Paul A M Smeets
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, NL,Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands,Address correspondence to PAMS (e-mail: )
| | - Alain Dagher
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Todd A Hare
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, German Center for Diabetes Research, Tübingen, Germany
| | - Laura N van der Laan
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, German Center for Diabetes Research, Tübingen, Germany
| | - Dana Small
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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17
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van Niftrik CHB, Piccirelli M, Bozinov O, Maldaner N, Strittmatter C, Pangalu A, Valavanis A, Regli L, Fierstra J. Impact of baseline CO 2 on Blood-Oxygenation-Level-Dependent MRI measurements of cerebrovascular reactivity and task-evoked signal activation. Magn Reson Imaging 2018; 49:123-130. [DOI: 10.1016/j.mri.2018.02.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/30/2018] [Accepted: 02/12/2018] [Indexed: 12/25/2022]
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18
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McKetton L, Venkatraghavan L, Poublanc J, Sobczyk O, Crawley AP, Rosen C, Silver FL, Duffin J, Fisher JA, Mikulis DJ. Importance of Collateralization in Patients With Large Artery Intracranial Occlusive Disease: Long-Term Longitudinal Assessment of Cerebral Hemodynamic Function. Front Neurol 2018; 9:226. [PMID: 29681886 PMCID: PMC5897547 DOI: 10.3389/fneur.2018.00226] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 03/23/2018] [Indexed: 01/14/2023] Open
Abstract
Patients with large artery intracranial occlusive disease (LAICOD) are at risk for both acute ischemia and chronic hypoperfusion. Collateral circulation plays an important role in prognosis, and imaging plays an essential role in diagnosis, treatment planning, and prognosis of patients with LAICOD. In addition to standard structural imaging, assessment of cerebral hemodynamic function is important to determine the adequacy of collateral supply. Among the currently available methods of assessment of cerebral hemodynamic function, measurement of cerebrovascular reactivity (CVR) using blood oxygen level-dependent (BOLD) MRI and precisely controlled CO2 has shown to be a safe, reliable, reproducible, and clinically useful method for long-term assessment of patients. Here, we report a case of long-term follow-up in a 28-year-old Caucasian female presented to the neurology clinic with a history of TIAs and LAICOD of the right middle cerebral artery (MCA). Initial structural MRI showed a right MCA stenosis and a small right coronal radiate lacunar infarct. Her CVR study showed a large area of impaired CVR with a paradoxical decrease in BOLD signal with hypercapnia involving the right MCA territory indicating intracerebral steal. The patient was managed medically with anticoagulant and antiplatelet therapy and was followed-up for over 9 years with both structural and functional imaging. Cortical thickness (CT) measures were longitudinally assessed from a region of interest that was applied to subsequent time points in the cortical region exhibiting steal physiology and in the same region of the contralateral healthy hemisphere. In the long-term follow-up, the patient exhibited improvement in her CVR as demonstrated by the development of collaterals with negligible changes to CT. Management of patients with LAICOD remains challenging since no revascularization strategies have shown efficacy except in patients with moyamoya disease. Management is well defined for acute ischemia where the presence and the adequacy of the collateralization dictate the need for intervention. Long-term assessment in neurovascular uncoupling (i.e., chronic ischemia) may reveal improvements in CVR as the durability of compensatory collaterals improve, even in cases with no intervention. Thus, assessment of cerebrovascular hemodynamics using CVR measurements coupled with time-of-flight MR angiography can be useful in the clinical management of patients with LAICOD.
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Affiliation(s)
- Larissa McKetton
- Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada
| | | | - Julien Poublanc
- Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada
| | - Olivia Sobczyk
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Adrian P Crawley
- Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Casey Rosen
- Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada
| | - Frank L Silver
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - James Duffin
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Joseph A Fisher
- Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.,Department of Anaesthesia, University Health Network, Toronto, ON, Canada.,Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - David J Mikulis
- Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
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19
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Davis KD, Flor H, Greely HT, Iannetti GD, Mackey S, Ploner M, Pustilnik A, Tracey I, Treede RD, Wager TD. Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendations. Nat Rev Neurol 2017; 13:624-638. [PMID: 28884750 DOI: 10.1038/nrneurol.2017.122] [Citation(s) in RCA: 161] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Chronic pain is the greatest source of disability globally and claims related to chronic pain feature in many insurance and medico-legal cases. Brain imaging (for example, functional MRI, PET, EEG and magnetoencephalography) is widely considered to have potential for diagnosis, prognostication, and prediction of treatment outcome in patients with chronic pain. In this Consensus Statement, a presidential task force of the International Association for the Study of Pain examines the capabilities of brain imaging in the diagnosis of chronic pain, and the ethical and legal implications of its use in this way. The task force emphasizes that the use of brain imaging in this context is in a discovery phase, but has the potential to increase our understanding of the neural underpinnings of chronic pain, inform the development of therapeutic agents, and predict treatment outcomes for use in personalized pain management. The task force proposes standards of evidence that must be satisfied before any brain imaging measure can be considered suitable for clinical or legal purposes. The admissibility of such evidence in legal cases also strongly depends on laws that vary between jurisdictions. For these reasons, the task force concludes that the use of brain imaging findings to support or dispute a claim of chronic pain - effectively as a pain lie detector - is not warranted, but that imaging should be used to further our understanding of the mechanisms underlying pain.
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Affiliation(s)
- Karen D Davis
- Division of Brain, Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Room MP12-306, Toronto, Ontario M5T 2S8, Canada.,Department of Surgery, University of Toronto, 149 College Street, Toronto, Ontario M5T 1P5, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-Universität Heidelberg, J5, D-86169 Mannheim, Germany
| | - Henry T Greely
- Stanford Program in Neuroscience and Society, Center for Law and the Biosciences, Stanford Law School, Stanford University, Stanford, California 94305-8610, USA
| | - Gian Domenico Iannetti
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, UK
| | - Sean Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 1070 Arastradero, Suite 200, Palo Alto, California 94304, USA
| | - Markus Ploner
- Department of Neurology and TUM-Neuroimaging Center, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | - Amanda Pustilnik
- Center for Law, Brain &Behavior, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114, USA.,University of Maryland School of Law, 500 W. Baltimore Street, Baltimore, Maryland 21201, USA
| | - Irene Tracey
- Nuffield Department of Clinical Neurosciences, University of Oxford, West Wing, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Rolf-Detlef Treede
- Center for Biomedicine and Medical Technology Mannheim, Heidelberg University, Ludolf-Krehl-Str. 13-17, 68167 Mannheim, Germany
| | - Tor D Wager
- Department of Psychology and Neuroscience, Muezinger D244, 345 UCB, Boulder, Colorado 80309-0345, USA.,Institute of Cognitive Science, University of Colorado, 344 UCB, Boulder, Colorado 80309-0344, USA
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