Functional MRI of human brain during breath holding by BOLD and FAIR techniques

Detection and Mitigation of Neurovascular Uncoupling in Brain Gliomas

Functional magnetic resonance imaging (fMRI) with blood oxygen level-dependent (BOLD) technique is useful for preoperative mapping of brain functional networks in tumor patients, providing reliable in vivo detection of eloquent cortex to help reduce the risk of postsurgical morbidity. BOLD task-based fMRI (tb-fMRI) is the most often used noninvasive method that can reliably map cortical networks, including those associated with sensorimotor, language, and visual functions. BOLD resting-state fMRI (rs-fMRI) is emerging as a promising ancillary tool for visualization of diverse functional networks. Although fMRI is a powerful tool that can be used as an adjunct for brain tumor surgery planning, it has some constraints that should be taken into consideration for proper clinical interpretation. BOLD fMRI interpretation may be limited by neurovascular uncoupling (NVU) induced by brain tumors. Cerebrovascular reactivity (CVR) mapping obtained using breath-hold methods is an effective method for evaluating NVU potential.

fMRI studies evaluating central respiratory control in humans

A plethora of neural centers in the central nervous system control the fundamental respiratory pattern. This control is ensured by neurons that act as pacemakers, modulating activity through chemical control driven by changes in the O₂/CO₂ balance. Most of the respiratory neural centers are located in the brainstem, but difficult to localize on magnetic resonance imaging (MRI) due to their small size, lack of visually-detectable borders with neighboring areas, and significant physiological noise hampering detection of its activity with functional MRI (fMRI). Yet, several approaches make it possible to study the normal response to different abnormal stimuli or conditions such as CO₂ inhalation, induced hypercapnia, volitional apnea, induced hypoxia etc. This review provides a comprehensive overview of the majority of available studies on central respiratory control in humans.

Hemodynamic and oxygen-metabolic responses of the awake mouse brain to hypercapnia revealed by multi-parametric photoacoustic microscopy

A widely used cerebrovascular stimulus and common pathophysiologic condition, hypercapnia is of great interest in brain research. However, it remains controversial how hypercapnia affects brain hemodynamics and energy metabolism. By using multi-parametric photoacoustic microscopy, the multifaceted responses of the awake mouse brain to different levels of hypercapnia are investigated. Our results show significant and vessel type-dependent increases of the vessel diameter and blood flow in response to the hypercapnic challenges, along with a decrease in oxygen extraction fraction due to elevated venous blood oxygenation. Interestingly, the increased blood flow and decreased oxygen extraction are not commensurate with each other, which leads to reduced cerebral oxygen metabolism. Further, time-lapse imaging over 2-hour chronic hypercapnic challenges reveals that the structural, functional, and metabolic changes induced by severe hypercapnia (10% CO2) are not only more pronounced but more enduring than those induced by mild hypercapnia (5% CO2), indicating that the extent of brain's compensatory response to chronic hypercapnia is inversely related to the severity of the challenge. Offering quantitative, dynamic, and CO2 level-dependent insights into the hemodynamic and metabolic responses of the brain to hypercapnia, these findings might provide useful guidance to the application of hypercapnia in brain research.

Cerebrovascular Reactivity Mapping Without Gas Challenges: A Methodological Guide

Cerebrovascular reactivity (CVR) is defined as the ability of vessels to alter their caliber in response to vasoactive factors, by means of dilating or constricting, in order to increase or decrease regional cerebral blood flow (CBF). Importantly, CVR may provide a sensitive biomarker for pathologies where vasculature is compromised. Furthermore, the spatiotemporal dynamics of CVR observed in healthy subjects, reflecting regional differences in cerebral vascular tone and response, may also be important in functional MRI studies based on neurovascular coupling mechanisms. Assessment of CVR is usually based on the use of a vasoactive stimulus combined with a CBF measurement technique. Although transcranial Doppler ultrasound has been frequently used to obtain global flow velocity measurements, MRI techniques are being increasingly employed for obtaining CBF maps. For the vasoactive stimulus, vasodilatory hypercapnia is usually induced through the manipulation of respiratory gases, including the inhalation of increased concentrations of carbon dioxide. However, most of these methods require an additional apparatus and complex setups, which not only may not be well-tolerated by some populations but are also not widely available. For these reasons, strategies based on voluntary breathing fluctuations without the need for external gas challenges have been proposed. These include the task-based methodologies of breath holding and paced deep breathing, as well as a new generation of methods based on spontaneous breathing fluctuations during resting-state. Despite the multitude of alternatives to gas challenges, existing literature lacks definitive conclusions regarding the best practices for the vasoactive modulation and associated analysis protocols. In this work, we perform an extensive review of CVR mapping techniques based on MRI and CO2 variations without gas challenges, focusing on the methodological aspects of the breathing protocols and corresponding data analysis. Finally, we outline a set of practical guidelines based on generally accepted practices and available data, extending previous reports and encouraging the wider application of CVR mapping methodologies in both clinical and academic MRI settings.

The Problem of Neurovascular Uncoupling

Neurovascular uncoupling (NVU) is one of the most important confounds of blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMR imaging) in the setting of focal brain lesions such as brain tumors. This article reviews the assessment of NVU related to focal brain lesions with emphasis on the use of cerebrovascular reactivity mapping measurement methods and resting state BOLD fMR imaging metrics in the detection of NVU, as well as the use of amplitude of low-frequency fluctuation metrics to mitigate the effects of NVU on clinical fMR imaging activation.

APOE gene-dependent BOLD responses to a breath-hold across the adult lifespan

Age and apolipoprotein E (APOE) e4 genotype are two of the strongest known risk factors for sporadic Alzheimer's disease (AD). Neuroimaging has shown hemodynamic response changes with age, in asymptomatic carriers of the APOE e4 allele, and in AD. In this study, we aimed to characterize and differentiate age- and APOE gene-specific hemodynamic changes to breath-hold and visual stimulation. A further aim was to study whether these responses were modulated by 3-day intake of nitrate, a nitric oxide (NO) source. The study was designed as a randomized, double-blinded, placebo-controlled crossover study, and the study cohort comprised 41 APOE e4 carriers (e3/e4 or e4/e4 genotype) and 40 non-carriers (e3/e3 genotype) aged 30-70 years at enrollment. The participants underwent two scanning sessions, each preceded by ingestion of sodium nitrate or sodium chloride (control). During functional magnetic resonance imaging (fMRI) sessions, participants performed two concurrent tasks; a breath-hold task to probe cerebrovascular reactivity and a visual stimulation task to evoke functional hyperemia, respectively. We found that the blood oxygenation level dependent (BOLD) hemodynamic response to breath-hold was altered in APOE e4 carriers relative to non-carriers. Mid-aged (50-60 years of age) e4 carriers exhibited a significantly increased peak time relative to mid-aged e3 carriers, and peak time for younger (30-40 years of age) e4 carriers was significantly shorter than that of mid-aged e4 carriers. The response width was significantly increased for e4 carriers. The response peak magnitude significantly decreased with age. For the visual stimulation task, we found age-related changes, with reduced response magnitude with age but no significant effect of APOE allele type. We found no effect of nitrate ingestion on BOLD responses evoked by the breath-hold and visual stimulation tasks. The APOE gene-dependent response to breath-hold may reflect NO-independent differences in vascular function.

Improving the Assessment of Breath-Holding Induced Cerebral Vascular Reactivity Using a Multiband Multi-echo ASL/BOLD Sequence

Breath holding (BH) is a viable vasodilatory stimulus for calculating functional MRI-derived cerebral vascular reactivity (CVR). The BH technique suffers from reduced repeatability compared with gas inhalation techniques; however, extra equipment is needed to perform gas inhalation techniques, and this equipment is not available at all institutions. This study aimed to determine the sensitivity and repeatability of BH activation and CVR using a multiband multi-echo simultaneous arterial spin labelling/blood oxygenation level dependent (ASL/BOLD) sequence. Whole-brain images were acquired in 14 volunteers. Ten subjects returned for repeat imaging. Each subject performed four cycles of 16 s BH on expiration interleaved with paced breathing. Following standard preprocessing, the echoes were combined using a T2*-weighted approach. BOLD and ASL BH activation was computed, and CVR was then determined as the percent signal change related to the activation. The "M" parameter from the Davis Model was also computed by incorporating the ASL signal. Our results showed higher BH activation strength, volume, and repeatability for the combined multi-echo (MEC) data compared with the single-echo data. MEC CVR also had higher repeatability, sensitivity, specificity, and reliability compared with the single-echo BOLD data. These data support the usefulness of an MBME ASL/BOLD acquisition for BH CVR and M measurements.

Challenges and techniques for presurgical brain mapping with functional MRI

Functional magnetic resonance imaging (fMRI) is increasingly used for preoperative counseling and planning, and intraoperative guidance for tumor resection in the eloquent cortex. Although there have been improvements in image resolution and artifact correction, there are still limitations of this modality. In this review, we discuss clinical fMRI's applications, limitations and potential solutions. These limitations depend on the following parameters: foundations of fMRI, physiologic effects of the disease, distinctions between clinical and research fMRI, and the design of the fMRI study. We also compare fMRI to other brain mapping modalities which should be considered as alternatives or adjuncts when appropriate, and discuss intraoperative use and validation of fMRI. These concepts direct the clinical application of fMRI in neurosurgical patients.

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fMRI is increasingly used for presurgical brain mapping for surgical planning.

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Understanding of the limitations of fMRI is critical for its clinical use.

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Clinical fMRI's challenges and potential solutions are discussed.

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Intraoperative use and validation of fMRI are discussed.

Measuring vascular reactivity with resting-state blood oxygenation level-dependent (BOLD) signal fluctuations: A potential alternative to the breath-holding challenge?

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 (P_aCO₂) 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.

Methods for cleaning the BOLD fMRI signal

Blood oxygen-level-dependent functional magnetic resonance imaging (BOLD fMRI) has rapidly become a popular technique for the investigation of brain function in healthy individuals, patients as well as in animal studies. However, the BOLD signal arises from a complex mixture of neuronal, metabolic and vascular processes, being therefore an indirect measure of neuronal activity, which is further severely corrupted by multiple non-neuronal fluctuations of instrumental, physiological or subject-specific origin. This review aims to provide a comprehensive summary of existing methods for cleaning the BOLD fMRI signal. The description is given from a methodological point of view, focusing on the operation of the different techniques in addition to pointing out the advantages and limitations in their application. Since motion-related and physiological noise fluctuations are two of the main noise components of the signal, techniques targeting their removal are primarily addressed, including both data-driven approaches and using external recordings. Data-driven approaches, which are less specific in the assumed model and can simultaneously reduce multiple noise fluctuations, are mainly based on data decomposition techniques such as principal and independent component analysis. Importantly, the usefulness of strategies that benefit from the information available in the phase component of the signal, or in multiple signal echoes is also highlighted. The use of global signal regression for denoising is also addressed. Finally, practical recommendations regarding the optimization of the preprocessing pipeline for the purpose of denoising and future venues of research are indicated. Through the review, we summarize the importance of signal denoising as an essential step in the analysis pipeline of task-based and resting state fMRI studies.

Cerebrovascular reactivity measured by functional magnetic resonance imaging during breath-hold challenge: A systematic review

Cerebrovascular reactivity (CVR) is the cerebral hemodynamic response to a vasoactive substance. Breath-hold (BH) induced CVR has the advantage of being non-invasive and easy to implement during magnetic resonance imaging (MRI). We systematically reviewed the literature regarding MRI measurement of BH induced CVR. The literature was searched using MEDLINE with the search terms breath-hold; and MRI or cerebrovascular reactivity. The search yielded 2244 results and 54 articles were included. Between-group comparisons have found that CVR was higher among healthy controls than patients with various pathologies (e.g. sleep apnea, diabetes, hypertension etc.). However, counter-intuitive findings have also been reported, including higher CVR among smokers, sedentary individuals, and patients with schizophrenia vs.

CONTROLS

Methodological studies have highlighted important measurement characteristics (e.g. normalizing signal to end-tidal CO₂), and comparisons of BH induced CVR to non-BH methods. Future studies are warranted to address questions about group differences, treatment response, disease progression, and other salient clinical themes. Standardization of CVR and BH designs is needed to fully exploit the potential of this practical non-invasive method.

Gradient-echo EPI using a high-degree shim insert coil at 7 T: Implications for BOLD fMRI

Purpose

To quantitatively assess the effects of high degree and order (1^st–4^th+) relative to 1^st–2^nd degree B₀ shimming at 7 Tesla (T) on gradient‐echo echo planar imaging (GE‐EPI) and blood‐oxygen‐level dependent (BOLD) activation.

Methods

Simulations and GE‐EPI were performed at (2mm)³ and (3mm)³ resolution, evaluating the temporal signal‐to‐noise ratio (tSNR), transverse relaxivity ( R2*), BOLD % signal change and activated pixel counts in a breath‐hold task.

Results

Comparing the 1^st–4^th+ degree with 1^st–2^nd degree shimmed B₀ maps generated spatially varying regions of Δ|B0|=|B01−2|−|B01−4+|. As binned in 10‐Hz intervals, the two center Δ|B₀| (±10 Hz) bins maintained the B₀ offset of 48.6% of gray‐matter pixels. In the positive Δ|B₀| bins greater than 10 Hz, the 1^st–4^th+degree shimming improved the B₀ offset in 41.1%; in negative Δ|B₀| bins less than −10 Hz, the offset worsened in 10.2% of the pixels. In the positive Δ|B₀| bins, we found variable but significant increases in BOLD sensitivity; the negative Δ|B₀| bins showed significant decreases. In the breath‐hold studies, positive bins showed significantly increased activated pixel numbers (+5–29%), whereas negative bins showed −18 to 0% decline.

Conclusion

1^st–4^th+ degree shimming maintained B₀ homogeneity over central brain regions while improving most of the other regions, including the inferior frontal lobe. Magn Reson Med 78:1734–1745, 2017. © 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Vascular autorescaling of fMRI (VasA fMRI) improves sensitivity of population studies: A pilot study

The blood oxygenation level-dependent (BOLD) signal is widely used for functional magnetic resonance imaging (fMRI) of brain function in health and disease. The statistical power of fMRI group studies is significantly hampered by high inter-subject variance due to differences in baseline vascular physiology. Several methods have been proposed to account for physiological vascularization differences between subjects and hence improve the sensitivity in group studies. However, these methods require the acquisition of additional reference scans (such as a full resting-state fMRI session or ASL-based calibrated BOLD). We present a vascular autorescaling (VasA) method, which does not require any additional reference scans. VasA is based on the observation that slow oscillations (<0.1Hz) in arterial blood CO2 levels occur naturally due to changes in respiration patterns. These oscillations yield fMRI signal changes whose amplitudes reflect the blood oxygenation levels and underlying local vascularization and vascular responsivity. VasA estimates proxies of the amplitude of these CO2-driven oscillations directly from the residuals of task-related fMRI data without the need for reference scans. The estimates are used to scale the amplitude of task-related fMRI responses, to account for vascular differences. The VasA maps compared well to cerebrovascular reactivity (CVR) maps and cerebral blood volume maps based on vascular space occupancy (VASO) measurements in four volunteers, speaking to the physiological vascular basis of VasA. VasA was validated in a wide variety of tasks in 138 volunteers. VasA increased t-scores by up to 30% in specific brain areas such as the visual cortex. The number of activated voxels was increased by up to 200% in brain areas such as the orbital frontal cortex while still controlling the nominal false-positive rate. VasA fMRI outperformed previously proposed rescaling approaches based on resting-state fMRI data and can be readily applied to any task-related fMRI data set, even retrospectively.

Effects of thoracic pressure changes on MRI signals in the brain

Cerebrovascular stressors, such as breath holding or CO2 inhalation, cause global magnetic resonance imaging (MRI) signal changes. In this study, we show that intrathoracic pressure changes cause rapid MRI signal alterations that have similar spatial patterns to the changes associated with breath holding or CO2 inhalation. Nine subjects performed the Valsalva maneuver during functional MRI data collection. Expiratory pressures ranged from 10 to 40 mm Hg. Breath holds ending on either inhalation or exhalation were also collected. The maximal and minimal functional MRI (fMRI) signal scaled with thoracic pressure load, and the overall amplitude of responses to the Valsalva varied, depending on brain tissue. Additionally, a Valsalva effort as short as 5 seconds yielded signal changes similar in spatial distribution and magnitude to a 20-second breath hold, suggesting potential applications of the Valsalva maneuver for calibrated fMRI experiments.

Greater BOLD response to working memory in endurance-trained adults revealed by breath-hold calibration

BACKGROUND

Cardiorespiratory fitness is associated with increased frontal and parietal activation during executive function tasks. While these findings suggest fitness-related enhancement of neuronal response, the utility of functional magnetic resonance imaging (fMRI) may be limited by potential fitness-related differences in global vascular reactivity. The aim of this study was to determine if highly fit adults display differential activation during working memory after calibration for vascular reactivity relative to their sedentary counterparts.

METHODS

Thirty-two endurance-trained and 24 sedentary adults, aged 40-65 years, completed a 2-Back verbal working memory task and a breath-hold challenge during fMRI. Group differences in blood oxygen level-dependent (BOLD) response during working memory were examined across the whole brain and in a priori regions of interest (ROI) before and after breath-hold calibration using non-parametric permutation testing. Multiple regression was used to explore the association between cardiorespiratory fitness (VO2 max), age, and calibrated 2-Back-related activation within the one a priori ROI with significant group effects.

RESULTS

In comparison to the endurance-trained group, the sedentary group exhibited greater BOLD signal changes in response to the breath-hold task. After, but not before calibration, the endurance-trained group displayed significantly higher 2-Back-related activation in the right middle frontal gyrus (P = 0.049). Older age predicted lower 2-Back-related activation (ß = -0.308, P = 0.031), whereas fitness predicted higher activation (ß = 0.372, P = 0.021) in this region.

CONCLUSIONS

Breath-hold calibration increased detection of working memory-related BOLD response differences between sedentary and endurance-trained adults. Moreover, cardiorespiratory fitness appeared to mitigate age-related changes in BOLD during working memory in this region.

The impact of vascular factors on language localization in the superior temporal sulcus

The left superior temporal sulcus (STS) has been shown in numerous functional imaging studies to be a critical region for language processing, as it is reliably activated when language comprehension is compared with acoustically matched control conditions. Studies in non-human primates have demonstrated several subdivisions in the STS, yet the precise region(s) within the STS that are important for language remain unclear, in large part because the presence of draining veins in the sulcus makes it difficult to determine whether neural activity is localized to the dorsal or ventral bank of the sulcus. We used functional MRI to localize language regions, and then acquired several additional sequences in order to account for the impact of vascular factors. A breath-holding task was used to induce hypercapnia in order to normalize voxel-wise differences in blood oxygen level-dependent (BOLD) responsivity, and veins were identified on susceptibility-weighted and T2*-weighted BOLD images, and masked out. We found that the precise locations of language areas in individual participants were strongly influenced by vascular factors, but that these vascular effects could be ameliorated by hypercapnic normalization and vein masking. After these corrections were applied, the majority of regions activated by language processing were localized to the dorsal bank of the STS.

Olfactory Hallucinations without Clinical Motor Activity: A Comparison of Unirhinal with Birhinal Phantosmia

Olfactory hallucinations without subsequent myoclonic activity have not been well characterized or understood. Herein we describe, in a retrospective study, two major forms of olfactory hallucinations labeled phantosmias: one, unirhinal, the other, birhinal. To describe these disorders we performed several procedures to elucidate similarities and differences between these processes. From 1272, patients evaluated for taste and smell dysfunction at The Taste and Smell Clinic, Washington, DC with clinical history, neurological and otolaryngological examinations, evaluations of taste and smell function, EEG and neuroradiological studies 40 exhibited cyclic unirhinal phantosmia (CUP) usually without hyposmia whereas 88 exhibited non-cyclic birhinal phantosmia with associated symptomology (BPAS) with hyposmia. Patients with CUP developed phantosmia spontaneously or after laughing, coughing or shouting initially with spontaneous inhibition and subsequently with Valsalva maneuvers, sleep or nasal water inhalation; they had frequent EEG changes usually ipsilateral sharp waves. Patients with BPAS developed phantosmia secondary to several clinical events usually after hyposmia onset with few EEG changes; their phantosmia could not be initiated or inhibited by any physiological maneuver. CUP is uncommonly encountered and represents a newly defined clinical syndrome. BPAS is commonly encountered, has been observed previously but has not been clearly defined. Mechanisms responsible for phantosmia in each group were related to decreased gamma-aminobutyric acid (GABA) activity in specific brain regions. Treatment which activated brain GABA inhibited phantosmia in both groups.

Vascular space occupancy MRI during breathholding at 3 Tesla

PURPOSE

To evaluate the vasodilatory response of normal human brain and meningiomas under repeated breathholding challenges using vascular space occupancy (VASO) MRI at 3 Tesla (T).

MATERIALS AND METHODS

Five normal volunteers and five patients with meningiomas were recruited for this study. For the normal group, VASO MRI during repeated breathholds of different duration (5 to 30 s) was acquired. Patients performed a 15-s breathhold paradigm for VASO MRI. The maximum signal change and full-width at half-maximum (FWHM) were determined by curve fitting.

RESULTS

Significant VASO signal decreases in the gray matter could be detected for a breathhold period as short as 5 s. The fractional activation volume vs. breathhold duration reached a plateau around 34.21 ± 3.39% at 15 s. In the patient group, there were significant VASO signal decreases in normal gray matters and also in small areas of three large-sized meningiomas.

CONCLUSION

The 3T VASO MRI detected significant signal decreases in the gray matter, but not in the white matter, during short periods of breathholding. The fractional activation volume reached the plateau at 15-s breathhold, which is recommended for clinical application.

Assessing Cerebrovascular Reactivity in Carotid Steno-Occlusive Disease Using MRI BOLD and ASL Techniques

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.

Task-related BOLD responses and resting-state functional connectivity during physiological clamping of end-tidal CO(2)

Carbon dioxide (CO(2)), a potent vasodilator, is known to have a significant impact on the blood-oxygen level dependent (BOLD) signal. With the growing interest in studying synchronized BOLD fluctuations during the resting state, the extent to which the apparent synchrony is due to variations in the end-tidal pressure of CO(2) (PETCO(2)) is an important consideration. CO(2)-related fluctuations in BOLD signal may also represent a potential confound when studying task-related responses, especially if breathing depth and rate are affected by the task. While previous studies of the above issues have explored retrospective correction of BOLD fluctuations related to arterial PCO(2), here we demonstrate an alternative approach based on physiological clamping of the arterial CO(2) level to a near-constant value. We present data comparing resting-state functional connectivity within the default-mode-network (DMN), as well as task-related BOLD responses, acquired in two conditions in each subject: 1) while subject's PETCO(2) was allowed to vary spontaneously; and 2) while controlling subject's PETCO(2) within a narrow range. Strong task-related responses and areas of maximal signal correlation in the DMN were not significantly altered by suppressing fluctuations in PETCO(2). Controlling PETCO(2) did, however, improve the performance of retrospective physiological noise correction techniques, allowing detection of additional regions of task-related response and resting-state connectivity in highly vascularized regions such as occipital cortex. While these results serve to further rule out systemic physiological fluctuations as a significant source of apparent resting-state network connectivity, they also demonstrate that fluctuations in arterial CO(2) are one of the factors limiting sensitivity in task-based and resting-state fMRI, particularly in regions of high vascular density. This must be considered when comparing subject groups who might exhibit differences in respiratory physiology or breathing patterns.

An improved method for mapping cerebrovascular reserve using concurrent fMRI and near-infrared spectroscopy with Regressor Interpolation at Progressive Time Delays (RIPTiDe)

Cerebrovascular reserve (CVR) reflects the compensatory dilatory capacity of cerebral vasculature to a dilatory stimulus. Blood oxygen-level dependent (BOLD) fMRI has been proven to be an effective imaging technique to obtain CVR maps when subjects perform CO(2) inhalation or a breath-holding (BH) task. Here we propose a novel way to process the fMRI data obtained during a blocked BH task by using simultaneously collected near-infrared spectroscopy (NIRS) data as regressors to estimate the vascular contribution to the BOLD signal. Six healthy subjects underwent a 6min 30s resting state (RS) fMRI scan, followed by a scan of the same duration with a blocked BH task (5 breath holds with 20s durations separated by ~50s of regular breathing). NIRS data were recorded from a probe over the subjects' right prefrontal area. For each scan, the time course of changes in total hemoglobin (Δ[tHb]) was calculated from the NIRS data, time shifted by various amounts, and resampled to the fMRI acquisition rate. Each shifted time course was used as regressor in a general linear model analysis. The maximum parameter estimate across all time shifts was calculated at all voxels in both the BH and RS scans, and then converted into signal percentage changes. The ratio of these signal changes generates a CVR map of the BH response, normalized to the resting state. The NIRS regressor method makes no assumptions about the shape (or presence) of the BH response, and allows direct, quantitative comparison of the vascular BOLD response to BH to the baseline map obtained in the resting state.

Robustly measuring vascular reactivity differences with breath-hold: normalising stimulus-evoked and resting state BOLD fMRI data

Inter-subject differences in local cerebral blood flow (CBF) and cerebral blood volume (CBV) contribute to differences in BOLD signal reactivity and, therefore, unmodelled variance in group level fMRI analyses. A simple way of elevating blood CO(2) concentrations to characterise subject differences in vascular reactivity is through breath-holds but two aspects of this measure are often neglected: (1) breath-holds are usually modelled as blocks even though CO(2) accumulates over time and (2) increases in CO(2) differ between subjects. This study demonstrates that the BOLD breath-hold response is best modelled by convolving the end-tidal CO(2) trace with a standard haemodynamic response function and including its temporal derivative. Inclusion of the BOLD breath-hold response as a voxel-dependent covariate in a group level analysis increases the spatial extent of activation in stimulus evoked and resting state datasets. By expressing the BOLD breath-hold response as a percentage signal increase with respect to an absolute change in the partial pressure of CO(2) (expressed in mmHg), the spatial extent of stimulus-evoked activation is further improved. This demonstrates that individual end-tidal CO(2) increases to breath-hold should be accounted for to provide an accurate measure of vascular reactivity resulting in more statistically active voxels in group level analyses.

Relative utility for hemispheric lateralization of different clinical fMRI activation tasks within a comprehensive language paradigm battery in brain tumor patients as assessed by both threshold-dependent and threshold-independent analysis methods

The aim of this study was to compare the relative effectiveness of 6 different commonly used language fMRI activation paradigms, including receptive and expressive, as well as semantic and phonological tasks, for hemispheric lateralization in brain tumor patients utilizing both threshold-dependent and threshold-independent approaches. We studied 46 right-handed patients with primary intra-axial brain tumors with BOLD fMRI on a 3-T MRI system. A linear fit of the laterality indices (LIs) as a function of the t-value (which varied from 2.0 to 6.5) was calculated and the slope (M) taken as measure of LI variability in the threshold-dependent LI approach; for the threshold-independent approach, the LIs were determined by comparing the integrated T-score weighted distributions of all positively task-correlated voxels of the left and the right hemispheric regions of interest. We demonstrated that silent word generation (SWG) and rhyming (R) were the two expressive tasks that provided the best hemispheric language lateralization in this group, based on concordant threshold-dependent and threshold-independent analyses. Furthermore, R (mean LI value=61.91, M=7.9±1.5) had a higher mean LI value and was less threshold-dependent than SWG (mean LI=52.97, M=11.40±0.64) for LI determination. SWG and R were able to provide effective language lateralization even in the subgroup of patients with lesions located in the left hemisphere and in the frontal or parietal lobes. The receptive language paradigms examined in this study (passive listening [PL], listening comprehension [LC], and reading comprehension [RC]) were less effective than SWG and R for language lateralization.

Combining spatial priors and anatomical information for fMRI detection

In this paper, we analyze Markov Random Field (MRF) as a spatial regularizer in fMRI detection. The low signal-to-noise ratio (SNR) in fMRI images presents a serious challenge for detection algorithms, making regularization necessary to achieve good detection accuracy. Gaussian smoothing, traditionally employed to boost SNR, often produces over-smoothed activation maps. Recently, the use of MRF priors has been suggested as an alternative regularization approach. However, solving for an optimal configuration of the MRF is NP-hard in general. In this work, we investigate fast inference algorithms based on the Mean Field approximation in application to MRF priors for fMRI detection. Furthermore, we propose a novel way to incorporate anatomical information into the MRF-based detection framework and into the traditional smoothing methods. Intuitively speaking, the anatomical evidence increases the likelihood of activation in the gray matter and improves spatial coherency of the resulting activation maps within each tissue type. Validation using the receiver operating characteristic (ROC) analysis and the confusion matrix analysis on simulated data illustrates substantial improvement in detection accuracy using the anatomically guided MRF spatial regularizer. We further demonstrate the potential benefits of the proposed method in real fMRI signals of reduced length. The anatomically guided MRF regularizer enables significant reduction of the scan length while maintaining the quality of the resulting activation maps.

Neural and vascular variability and the fMRI-BOLD response in normal aging

Neural, vascular and structural variables contributing to the blood oxygen level-dependent (BOLD) signal response variability were investigated in younger and older humans. Twelve younger healthy human subjects (six male and six female; mean age: 24 years; range: 19-27 years) and 12 older healthy subjects (five male and seven female; mean age: 58 years; range: 55-71 years) with no history of head trauma and neurological disease were scanned. Functional magnetic resonance imaging measurements using the BOLD contrast were made when participants performed a motor, cognitive or a breath hold (BH) task. Activation volume and the BOLD response amplitude were estimated for the younger and older at both group and subject levels. Mean activation volume was reduced by 45%, 40% and 38% in the elderly group during the motor, cognitive and BH tasks, respectively, compared to the younger. Reduction in activation volume was substantially higher compared to the reduction in the gray matter volume of 14% in the older compared to the younger. A significantly larger variability in the intersubject BOLD signal change occurred during the motor task, compared to the cognitive task. BH-induced BOLD signal change between subjects was significantly less-variable in the motor task-activated areas in the younger compared to older whereas such a difference between age groups was not observed during the cognitive task. Hemodynamic scaling using the BH signal substantially reduced the BOLD signal variability during the motor task compared to the cognitive task. The results indicate that the origin of the BOLD signal variability between subjects was predominantly vascular during the motor task while being principally a consequence of neural variability during the cognitive task. Thus, in addition to gray matter differences, the type of task performed can have different vascular variability weighting that can influence age-related differences in brain functional response.

fMRI in the presence of task-correlated breathing variations

Variations in the subject's heart rate and breathing pattern have been shown to result in significant fMRI signal changes, mediated in part by non-neuronal physiological mechanisms such as global changes in levels of arterial CO(2). When these physiological changes are correlated with a task, as may happen in response to emotional stimuli or tasks that change levels of arousal, a concern arises that non-neuronal physiologically-induced signal changes may be misinterpreted as reflecting task-related neuronal activation. The purpose of this study is to provide information that can help in determining whether task activation maps are influenced by task-correlated physiological noise, particularly task-correlated breathing changes. We also compare different strategies to reduce the influence of physiological noise. Two paradigms are investigated--1) a lexical decision task where some subjects showed task-related breathing changes, and 2) a task where subjects were instructed to hold their breath during the presentation of contrast-reversing checkerboard, an extreme case of task-correlated physiological noise. Consistent with previous literature, we find that MRI signal changes correlated with variations in breathing depth and rate have a characteristic spatial and temporal profile that is different from the typical activation-induced BOLD response. The delineation of activation in the presence of task correlated breathing changes was improved either by independent component analysis, or by including specific nuisance regressors in a regression analysis. The difference in the spatial and temporal characteristics of physiological-induced and neuronal-induced fluctuations exploited by these strategies suggests that activation can be studied even in the presence of task-correlated physiological changes.

Relationship between respiration, end-tidal CO2, and BOLD signals in resting-state fMRI

A significant component of BOLD fMRI physiological noise is caused by variations in the depth and rate of respiration. It has previously been demonstrated that a breath-to-breath metric of respiratory variation (respiratory volume per time; RVT), computed from pneumatic belt measurements of chest expansion, has a strong linear relationship with resting-state BOLD signals across the brain. RVT is believed to capture breathing-induced changes in arterial CO(2), which is a cerebral vasodilator; indeed, separate studies have found that spontaneous fluctuations in end-tidal CO(2) (PETCO(2)) are correlated with BOLD signal time series. The present study quantifies the degree to which RVT and PETCO(2) measurements relate to one another and explain common aspects of the resting-state BOLD signal. It is found that RVT (particularly when convolved with a particular impulse response, the "respiration response function") is highly correlated with PETCO(2), and that both explain remarkably similar spatial and temporal BOLD signal variance across the brain. In addition, end-tidal O(2) is shown to be largely redundant with PETCO(2). Finally, the latency at which PETCO(2) and respiration belt measures are correlated with the time series of individual voxels is found to vary across the brain and may reveal properties of intrinsic vascular response delays.

Reproducibility of BOLD signal change induced by breath holding

Blood oxygen level dependent (BOLD) contrast is influenced by some physiological factors such as blood flow and blood volume that can be a source of variability in fMRI analysis. Previous studies proposed to use the cerebrovascular response data to normalize or calibrate BOLD maps in order to reduce variability of fMRI data both among brain areas in single subject analysis and across subjects. Breath holding is one of the most widely used methods to investigate the vascular reactivity. However, little is known about the robustness and reproducibility of this procedure. In this study we investigated three different breath holding periods. Subjects were asked to hold their breath for 9, 15 or 21 s in three separate runs and the fMRI protocol was repeated after 15 to 20 days. Our data show that the BOLD response to breath holding after inspiration results in a complex shape due to physiological factors that influence the signal variation with a timing that is highly reproducible. Nevertheless, the reproducibility of the magnitude of the cerebrovascular response to CO(2), expressed as amplitude of BOLD signal and number of responding voxels, strongly depends on duration of breath holding periods. Breath holding period of 9 s results in high variability of the magnitude of the response while longer breath holding durations produce more robust and reproducible BOLD responses.

Cholinergic enhancement reduces spatial spread of visual responses in human early visual cortex

Animal studies have shown that acetylcholine decreases excitatory receptive field size and spread of excitation in early visual cortex. These effects are thought to be due to facilitation of thalamocortical synaptic transmission and/or suppression of intracortical connections. We have used functional magnetic resonance imaging (fMRI) to measure the spatial spread of responses to visual stimulation in human early visual cortex. The cholinesterase inhibitor donepezil was administered to normal healthy human subjects to increase synaptic levels of acetylcholine in the brain. Cholinergic enhancement with donepezil decreased the spatial spread of excitatory fMRI responses in visual cortex, consistent with a role of acetylcholine in reducing excitatory receptive field size of cortical neurons. Donepezil also reduced response amplitude in visual cortex, but the cholinergic effects on spatial spread were not a direct result of reduced amplitude. These findings demonstrate that acetylcholine regulates spatial integration in human visual cortex.

The impact of global signal regression on resting state correlations: are anti-correlated networks introduced?

Low-frequency fluctuations in fMRI signal have been used to map several consistent resting state networks in the brain. Using the posterior cingulate cortex as a seed region, functional connectivity analyses have found not only positive correlations in the default mode network but negative correlations in another resting state network related to attentional processes. The interpretation is that the human brain is intrinsically organized into dynamic, anti-correlated functional networks. Global variations of the BOLD signal are often considered nuisance effects and are commonly removed using a general linear model (GLM) technique. This global signal regression method has been shown to introduce negative activation measures in standard fMRI analyses. The topic of this paper is whether such a correction technique could be the cause of anti-correlated resting state networks in functional connectivity analyses. Here we show that, after global signal regression, correlation values to a seed voxel must sum to a negative value. Simulations also show that small phase differences between regions can lead to spurious negative correlation values. A combination breath holding and visual task demonstrates that the relative phase of global and local signals can affect connectivity measures and that, experimentally, global signal regression leads to bell-shaped correlation value distributions, centred on zero. Finally, analyses of negatively correlated networks in resting state data show that global signal regression is most likely the cause of anti-correlations. These results call into question the interpretation of negatively correlated regions in the brain when using global signal regression as an initial processing step.

The effect of respiration variations on independent component analysis results of resting state functional connectivity

The analysis of functional connectivity in fMRI can be severely affected by cardiac and respiratory fluctuations. While some of these artifactual signal changes can be reduced by physiological noise correction routines, signal fluctuations induced by slower breath-to-breath changes in the depth and rate of breathing are typically not removed. These slower respiration-induced signal changes occur at low frequencies and spatial locations similar to the fluctuations used to infer functional connectivity, and have been shown to significantly affect seed-ROI or seed-voxel based functional connectivity analysis, particularly in the default mode network. In this study, we investigate the effect of respiration variations on functional connectivity maps derived from independent component analysis (ICA) of resting-state data. Regions of the default mode network were identified by deactivations during a lexical decision task. Variations in respiration were measured independently and correlated with the MRI time series data. ICA appears to separate the default mode network and the respiration-related changes in most cases. In some cases, however, the component automatically identified as the default mode network was the same as the component identified as respiration-related. Furthermore, in most cases the time series associated with the default mode network component was still significantly correlated with changes in respiration volume per time, suggesting that current methods of ICA may not completely separate respiration from the default mode network. An independent measure of the respiration provides valuable information to help distinguish the default mode network from respiration-related signal changes, and to assess the degree of residual respiration related effects.

Detection and scaling of task-induced fMRI-BOLD response using resting state fluctuations

This study evaluated a calibration technique for scaling the fMRI-BOLD response during a simple motor task. A novel scaling parameter, resting state physiological fluctuation amplitude (RSFA), was tested using previously established scaling factors such as breath hold or 5% CO(2). RSFA was hypothesized to contain vascular reactivity information present in the resting state fMRI signal. Subjects were scanned under various stimulus conditions: (a) rest while breathing room air, (b) bilateral fingertapping, (c) breath holding and (d) moderate hypercapnia (breathing 5% CO(2)+air). In all subjects who breathed 5% CO(2), RSFA correlated highly with the BOLD response amplitude during 5% CO(2) inhalation. Also, RSFA correlated highly with the amplitude of the BOLD response elicited by breath hold. RSFA was therefore used as a hemodynamic scaling factor to calibrate both the amplitude and spatial extent of the fMRI-BOLD response during the motor task (fingertapping). Results revealed that amplitude scaling using RSFA was similar to that using breath hold or 5% CO(2), where the spatial extent of activation diminished by 20-37% over all subjects. Spatial extent of activation changed significantly after scaling and only 30-40% of the activated area overlapped with the unscaled activation. RSFA-scaled task-induced fMRI-BOLD response in both amplitude and spatial extent was comparable to that obtained using breath hold or 5% CO(2). We conclude that RSFA may be used to hemodynamically scale the fMRI-BOLD response and does not require the use of a hypercapnic challenge (which may not be purely non-neural), which can be difficult to implement in special populations.

Paced respiration with end-expiration technique offers superior BOLD signal repeatability for breath-hold studies

As a simple, non-invasive method of blood oxygenation level-dependent (BOLD) signal calibration, the breath-hold task offers considerable potential for the quantification of neuronal activity from functional magnetic resonance imaging (fMRI) measurements. With an aim to improve the precision of this calibration method, the impact of respiratory rate control on the BOLD signal achieved with the breath-hold task was investigated. In addition to self-paced breathing, three different computer-paced breathing rates were imposed during the periods between end-expiration breath-hold blocks. The resulting BOLD signal timecourses and statistical activation maps were compared in eleven healthy human subjects. Results indicate that computer-paced respiration produces a larger peak BOLD signal increase with breath-hold than self-paced breathing, in addition to lower variability between trials. This is due to the more significant post-breath-hold signal undershoot present in self-paced runs, a characteristic which confounds the definition of baseline and is difficult to accurately model. Interestingly, the specific respiratory rate imposed between breath-hold periods generally does not have a statistically significant impact on the BOLD signal change. This result can be explained by previous reports of humans adjusting their inhalation depth to compensate for changes in rate, with the end-goal of maintaining homeostatic ventilation. The advantage of using end-expiration relative to end-inspiration breath-hold is apparent in view of the high repeatability of the BOLD signal in the present study, which does not suffer from the previously reported high variability associated with uncontrolled inspiration depth when using the end-inspiration technique.

Quantitative evaluation of hemodynamic response after hypercapnia among different brain territories by fMRI

The brain vascular system has an autoregulatory mechanism that maintains blood perfusion within normal limits at the capillary level. Partially due to its clinical importance, it is of interest to better understand the mechanisms involved in vascular regulation. Therefore, using functional magnetic resonance imaging (fMRI), we quantitatively investigated hemodynamic response characteristics of regions supplied by the main cerebral arteries, during two breath holding tests (BHT): after inspiration and after expiration. We used an auto-regressive method capable of estimating four signal parameters: onset delay, full width at half maximum (FWHM), time-to-peak and amplitude. The onset delay was significantly longer for the posterior cerebral artery (PCA) than for middle cerebral artery (MCA) and anterior arteries (ACA). FWHM and time-to-peak were larger in the ACA territory, indicating a slower blood flow in this region. Differences were also observed in the amplitude among the three areas, where MCA and PCA territories showed the smallest and the highest amplitudes, respectively. Moreover, differences were found in amplitude and onset when BHT was performed after inspiration as compared to BHT after expiration. Time-to-peak and FWHM showed no statistical differences between these two challenges. Such results are related to regional anatomical specificities and biochemical mechanisms responsible for vasodilation, such as those related to vascularity and vessel sizes.

Quantitative aspects of brain perfusion dynamic induced by BOLD fMRI

The increase of relative cerebral blood flow (rCBF) may contribute for a change in blood oxygenation level dependent signal (BOLD). The main purpose of this study is to investigate some aspects of perfusional alterations in the human brain in response to a uniform stimulation: hypercapnia induced by breath holding. It was observed that the BOLD signal increased globally during hypercapnia and that it is correlated with the time of breath holding. This signal increase shows a clear distinction between gray and white matter, being greater in the grey matter.

The respiration response function: the temporal dynamics of fMRI signal fluctuations related to changes in respiration

Changes in the subject's breathing rate or depth, such as a breath-hold challenge, can cause significant MRI signal changes. However, the response function that best models breath-holding-induced signal changes, as well as those resulting from a wider range of breathing variations including those occurring during rest, has not yet been determined. Respiration related signal changes appear to be slower than neuronally induced BOLD signal changes and are not modeled accurately using the typical hemodynamic response functions used in fMRI. In this study, we derive a new response function to model the average MRI signal changes induced by variations in the respiration volume (breath-to-breath changes in the respiration depth and rate). This was done by averaging the response to a series of single deep breaths performed once every 40 s amongst otherwise constant breathing. The new "respiration response function" consists of an early overshoot followed by a later undershoot (peaking at approximately 16 s), and accurately models the MRI signal changes resulting from breath-holding as well as cued depth and rate changes.

Multimodal investigation of fMRI and fNIRS derived breath hold BOLD signals with an expanded balloon model

Multimodal investigation of blood oxygenation level-dependent (BOLD) signals, using both functional near-infrared spectroscopy (fNIRS) and functional magnetic resonance imaging (fMRI), may give further insight to the underlying physiological principles and the detailed transient dynamics of the vascular response. Utilizing a breath hold task (BHT), we measured deoxy-hemoglobin (HbR) and oxy-hemoglobin (HbO) changes via fNIRS and blood oxygen level dependent (BOLD) changes by fMRI. Measurements were taken in four volunteers asynchronously and carefully aligned for comparative analysis. In order to describe the main stimulus in BHT, partial pressure of carbon dioxide (PaCO(2)) parameter was integrated into the balloon model as the driving function of cerebral blood flow (CBF) which led to the development of an expanded balloon model (EBM). During BHT, the increase in HbR was observed later than the BOLD peak and coincided temporally with its post-stimulus undershoot. Further investigation of these transients with a PaCO(2) integrated balloon model suggests that post-stimulus undershoot measured by fMRI is dominated by slow return of cerebral blood volume (CBV). This was confirmed by fNIRS measurements. In addition, the BOLD signal decreased with the increase of the initial level of PaCO(2) derived from EBM, indicating an effect of basal CBF level on the BOLD signal. In conclusion, a multimodal approach with an appropriate biophysical model gave a comprehensive description of the hemodynamic response during BHT.

Reducing vascular variability of fMRI data across aging populations using a breathholding task

The magnitude and shape of blood oxygen level-dependent (BOLD) responses in functional MRI (fMRI) studies vary across brain regions, subjects, and populations. This variability may be secondary to neural activity or vasculature differences, thus complicating interpretations of BOLD signal changes in fMRI experiments. We compare the BOLD responses to neural activity and a vascular challenge and test a method to dissociate these influences in 26 younger subjects (ages 18-36) and 24 older subjects (ages 51-78). Each subject performed a visuomotor saccade task (a vascular response to neural activity) and a breathholding task (vascular dilation induced by hypercapnia) during separate runs in the same scanning session. For the saccade task, signal magnitude showed a significant decrease with aging in FEF, SEF, and V1, and a delayed time-to-peak with aging in V1. The signal magnitudes from the saccade and hypercapnia tasks showed significant linear regressions within subjects and across individuals and populations. These two tasks had weaker, but sometimes significant linear regressions for time-to-peak and coherence phase measures. The significant magnitude decrease with aging in V1 remained after dividing the saccade task magnitude by the hypercapnia task magnitude, implying that the signal decrease is neural in origin. These findings may lead to a method to identify vascular reactivity-induced differences in the BOLD response across populations and the development of methods to account for the influence of these vasculature differences in a simple, noninvasive manner.

Applications and limitations of whole-brain MAGIC VASO functional imaging

This work extends the multiple acquisitions with global inversion cycling vascular space occupancy (MAGIC VASO) method to human whole-brain functional magnetic resonance imaging (fMRI) at 3.0 Tesla and demonstrates the need to consider the dynamic contribution of cerebrospinal fluid (CSF) to the relative VASO signal change (DeltaVASO/VASO). Simulations were performed to determine the optimal slice number between global inversions, and correction factors were obtained to account for incomplete blood nulling in particular slices. The necessity of an accurate estimate of resting cerebral blood volume (CBV(rest)) is discussed in the context of DeltaCBV/CBV calculations. A three-compartment model is proposed to include both the resting and changing fractional CSF contribution (x(c,rest) and Deltax(c), respectively) to DeltaVASO/VASO. A MAGIC VASO sequence that provides whole-brain coverage is demonstrated using a paradigm comprised of visual, motor, and auditory stimulation. Activated regions are quantitatively compared in the corresponding blood oxygenation level-dependent (BOLD) images. Estimates of the minimum DeltaCBV/CBV resulting from motor and visual stimulation were comparable to previous findings at 17 +/- 8% (N = 8) and 19 +/- 9% (N = 6), respectively. The absence of VASO activation for auditory stimulation and evidence of activation-induced decreases in CSF volume fraction around the insula and superior temporal gyrus support the possibility of a Deltax(c) contribution to the VASO signal. Without specific knowledge of the CSF components (x(c,rest) and Deltax(c)), inference of DeltaCBV/CBV from DeltaVASO/VASO is severely limited.

Controlled inspiration depth reduces variance in breath-holding-induced BOLD signal

Recent studies have shown that blood oxygen level dependent (BOLD) response amplitude during short periods of breath holding (BH) measured by functional magnetic resonance imaging (fMRI) can be an effective metric for intersubject calibration procedures. However, inconsistency in the depth of inspiration during the BH scan may account for a portion of BOLD variation observed in such scans, and it is likely to reduce the effectiveness of the calibration measurement. While modulation of BOLD signal has been correlated with end-tidal CO2 and other measures of breathing, fluctuations in performance of BH have not been studied in the context of their impact on BOLD signal. Here, we studied the degree to which inspiration depth corresponds to BOLD signal change and tested the effectiveness of a method designed to control inspiration level through visual cues during the BH task paradigm. We observed reliable differences in BOLD signal amplitude corresponding to the depth of inspiration. It was determined that variance in BOLD signal response to BH could be significantly reduced when subjects were given visual feedback during task inspiration periods. The implications of these findings for routine BH studies of BOLD-derived neurovascular response are discussed.

False activation in the brain ventricles related to task-correlated breathing in fMRI speech and motor paradigms

OBJECT

We demonstrate, and show how to eliminate, a task-correlated breathing activation artefact created while performing exercise tasks during a gap in functional magnetic resonance imaging (fMRI).

MATERIALS AND METHODS

Two studies are presented. The first was intended to isolate a reliable fMRI paradigm for intense handgrip contractions. A gapped acquisition was used to reduce motion artefact, where the contraction was performed during a gap, and image acquisition was between contractions. The second study involved naming regular words (REGs) and nonwords (NWs), where a gap is required for the analysis of participants' overt speech.

RESULTS

For study 1, brain ventricle activation was present when breathing responses were task-correlated, and was only eliminated by removing the gap from the sequence. For study 2, NWs were associated with activation artefact in the ventricles, and slower reaction time (RT), reflecting a strategy whereby breathing falls in synchrony with image acquisition. REGs showed the expected RT distribution and frequency effect (reflecting lexical access), with no ventricle activation, and consequently no synchrony with image acquisition.

CONCLUSION

The gapped paradigm increased the likelihood of breathing correlated T2* signal changes in brain ventricles. FMRI researchers should examine the brain ventricles for activation artefact as they are likely associated with false activations in other brain regions.

The influence of neuropathology on the FMRI signal: a measurement of brain or vein?

There is a rapidly growing literature using fMRI technology to investigate the various forms of behavioral impairment associated with brain injury and disease. Given this, surprisingly little work has been conducted to examine the influence of neuropathophysiological processes on the fMRI signal. This paper reviews the literature examining baseline alteration in cerebrovascular parameters associated with normal aging, brain injury, and brain disease. In addition, findings from three cases of individuals with severe brain trauma will be presented to show the influence of brain trauma on baseline cerebrovascular parameters measured by fMRI. The methods used here can be implemented by other investigators to accurately isolate specific hemodynamic changes that can influence the BOLD fMRI signal.

Hemodynamic scaling of fMRI-BOLD signal: validation of low-frequency spectral amplitude as a scalability factor

Functional magnetic resonance imaging blood-oxygenation-level-dependent (fMRI-BOLD) signal representing neural activity may be optimized by discriminating MR signal components related to neural activity and those related to intrinsic properties of the cortical vasculature. The objective of this study was to reduce the hemodynamic change independent of neural activity to obtain a scaled fMRI-BOLD response using two factors, namely, low-frequency spectral amplitude (LFSA) and breath-hold amplitude (BHA). Ten subjects (age range, 22-38 years) were scanned during four task conditions: (a) rest while breathing room air, (b) bilateral finger tapping while breathing room air, (c) rest during a partial inspirational breath-hold, and (d) rest during moderate hypercapnia (breathing 5% CO2, 20% O2 and 75% N2). In all subjects who breathed 5% CO2, regions with significant BOLD response during breath-hold correlated significantly with the percent signal increase during 5% CO2 inhalation. Finger-tapping-induced responses in the motor cortex were diminished to a similar extent after scaling using either LFSA or BHA. Inter- and intrasubject variation in the amplitude of the BOLD signal response reduced after hemodynamic scaling using LFSA or BHA. The results validated the hemodynamic amplitude scaling using LFSA with the earlier established BHA. LFSA free from motor-task contamination can be used to calibrate the fMRI-BOLD response in lieu of BHA or hypercapnia to minimize intra- and intersubject variation arising from vascular anatomy and vasodilative capacity.

The Effect of Flavanol-rich Cocoa on the fMRI Response to a Cognitive Task in Healthy Young People

Flavanols are the main flavonoids found in cocoa and chocolate, and can be especially abundant in certain cocoas. Research over the past decade has identified flavanols as showing diverse beneficial physiologic and antioxidant effects, particularly in context of vascular function. The present study employed functional magnetic resonance imaging based on blood oxygenation level-dependent (BOLD) contrast to explore the effect of flavanols on the human brain. Magnetic resonance imaging was used to measure BOLD responses to a cognitive task in 16 healthy young subjects. The data presented show an increase in the BOLD signal intensity in response to a cognitive task following ingestion of flavanol-rich cocoa (5 days of 150 mg of cocoa flavanols). This may arise either as a result of altered neuronal activity, or a change in vascular responsiveness, or both--the net effect then being dependent on which of the two effects is dominant. No significant effects were evident in behavioral reaction times, switch cost, and heart rate after consumption of this moderate dose of cocoa flavanols. A pilot study evaluated the relationship between cerebral blood flow and a single acute dose (450 mg flavanols) of flavanol-rich cocoa and showed that flavanol-rich cocoa can increase the cerebral blood flow to gray matter, suggesting the potential of cocoa flavanols for treatment of vascular impairment, including dementia and strokes, and thus for maintaining cardiovascular health.

Separating respiratory-variation-related fluctuations from neuronal-activity-related fluctuations in fMRI

Subtle changes in a subject's breathing rate or depth, which occur naturally during rest at low frequencies (<0.1 Hz), have been shown to be significantly correlated with fMRI signal changes throughout gray matter and near large vessels. The goal of this study was to investigate the impact of these low-frequency respiration variations on both task activation fMRI studies and resting-state functional connectivity analysis. Unlike MR signal changes correlated with the breathing motion ( approximately 0.3 Hz), BOLD signal changes correlated with across-breath variations in respiratory volume ( approximately 0.03 Hz) appear localized to blood vessels and regions with high blood volume, such as gray matter, similar to changes seen in response to a breath-hold challenge. In addition, the respiration-variation-induced signal changes were found to coincide with many of the areas identified as part of the 'default mode' network, a set of brain regions hypothesized to be more active at rest. Regions could therefore be classified as being part of a resting network based on their similar respiration-induced changes rather than their synchronized neuronal activity. Monitoring and removing these respiration variations led to a significant improvement in the identification of task-related activation and deactivation and only slight differences in regions correlated with the posterior cingulate at rest. Regressing out global signal changes or cueing the subject to breathe at a constant rate and depth resulted in an improved spatial overlap between deactivations and resting-state correlations among areas that showed deactivation.

Breath holding reveals differences in fMRI BOLD signal in children and adults

Application of fMRI to studies of cognitive development is of growing interest because of its sensitivity and non-invasive nature. However, interpretation of fMRI results in children is presently based on vascular dynamics that have been studied primarily in healthy adults. Comparison of the neurological basis of cognitive development is valid to the extent that the neurovascular responsiveness between children and adults is equal. The present study was designed to detect age-related vascular differences that may contribute to altered BOLD fMRI signal responsiveness. We examined BOLD signal changes in response to breath holding, a global, systemic state change in brain oxygenation. Children exhibited greater percent signal changes than adults in grey and white matter, and this was accompanied by an increase in noise. Consequently, the volume of activation exceeding statistical threshold was reduced in children. The reduced activation in children was well modeled by adding noise to adult data. These findings raise the possibility that developmental differences in fMRI findings between children and adults could, under some circumstances, reflect greater noise in the BOLD response in the brains of children than adults. BOLD responses varied across brain regions, but showed similar regional variation in children and adults.