On the assessment of cerebrovascular reactivity using hypercapnia BOLD MRI

Uma S. Yezhuvath, Kelly Lewis-Amezcua, Rani Varghese, Guanghua Xiao, Hanzhang Lu

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Cerebrovascular reactivity (CVR) reflects the capacity of blood vessels to dilate and is an important marker for brain vascular reserve. It may provide a useful addition to the traditional baseline blood flow measurement when assessing vascular factors in brain disorders. Blood-oxygenation-level-dependent MRI under CO2 inhalation offers a non-invasive and quantitative means to estimate CVR in humans. In this study, we investigated several important methodological aspects of this technique with the goal of optimizing the experimental and data processing strategies for clinical use. Comparing 4 min of 5% CO2 inhalation (less comfortable) to a 1 min inhalation (more comfortable) duration, it was found that the CVR values were 0.31 ± 0.05%/mmHg (N=11) and 0.31 ± 0.08%/mmHg (N=9), respectively, showing no significant differences between the two breathing paradigms. Therefore, the 1 min paradigm is recommended for future application studies for patient comfort and tolerability. Furthermore, we have found that end-tidal CO2 recording was useful for accurate quantification of CVR because it provided both timing and amplitude information regarding the input function to the brain vascular system, which can be subject-dependent. Finally, we show that inter-subject variations in CVR are of physiologic origin and affect the whole brain in a similar fashion. Based on this, it is proposed that relative CVR (normalized against the CVR of the whole brain or a reference tissue) may be a more sensitive biomarker than absolute CVR in clinical applications as it minimizes inter-subject variations. With these technological optimizations, CVR mapping may become a useful method for studies of neurological and psychiatric diseases.

Original languageEnglish (US)
Pages (from-to)779-786
Number of pages8
JournalNMR in Biomedicine
Volume22
Issue number7
DOIs
StatePublished - 2009

Fingerprint

Hypercapnia
Magnetic resonance imaging
Inhalation
Blood Vessels
Brain
Cognitive Reserve
Brain Diseases
Blood
Psychiatry
Respiration
Biomarkers
Oxygenation
Blood vessels
Flow measurement
Tissue

Keywords

  • BOLD
  • Brain
  • Cerebrovascular reactivity
  • CVR
  • fMRI
  • Hypercapnia

ASJC Scopus subject areas

  • Spectroscopy
  • Molecular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

On the assessment of cerebrovascular reactivity using hypercapnia BOLD MRI. / Yezhuvath, Uma S.; Lewis-Amezcua, Kelly; Varghese, Rani; Xiao, Guanghua; Lu, Hanzhang.

In: NMR in Biomedicine, Vol. 22, No. 7, 2009, p. 779-786.

Research output: Contribution to journalArticle

Yezhuvath, US, Lewis-Amezcua, K, Varghese, R, Xiao, G & Lu, H 2009, 'On the assessment of cerebrovascular reactivity using hypercapnia BOLD MRI', NMR in Biomedicine, vol. 22, no. 7, pp. 779-786. https://doi.org/10.1002/nbm.1392
Yezhuvath, Uma S. ; Lewis-Amezcua, Kelly ; Varghese, Rani ; Xiao, Guanghua ; Lu, Hanzhang. / On the assessment of cerebrovascular reactivity using hypercapnia BOLD MRI. In: NMR in Biomedicine. 2009 ; Vol. 22, No. 7. pp. 779-786.
@article{fe1a640be08d424bb75dec84e2642a3f,
title = "On the assessment of cerebrovascular reactivity using hypercapnia BOLD MRI",
abstract = "Cerebrovascular reactivity (CVR) reflects the capacity of blood vessels to dilate and is an important marker for brain vascular reserve. It may provide a useful addition to the traditional baseline blood flow measurement when assessing vascular factors in brain disorders. Blood-oxygenation-level-dependent MRI under CO2 inhalation offers a non-invasive and quantitative means to estimate CVR in humans. In this study, we investigated several important methodological aspects of this technique with the goal of optimizing the experimental and data processing strategies for clinical use. Comparing 4 min of 5{\%} CO2 inhalation (less comfortable) to a 1 min inhalation (more comfortable) duration, it was found that the CVR values were 0.31 ± 0.05{\%}/mmHg (N=11) and 0.31 ± 0.08{\%}/mmHg (N=9), respectively, showing no significant differences between the two breathing paradigms. Therefore, the 1 min paradigm is recommended for future application studies for patient comfort and tolerability. Furthermore, we have found that end-tidal CO2 recording was useful for accurate quantification of CVR because it provided both timing and amplitude information regarding the input function to the brain vascular system, which can be subject-dependent. Finally, we show that inter-subject variations in CVR are of physiologic origin and affect the whole brain in a similar fashion. Based on this, it is proposed that relative CVR (normalized against the CVR of the whole brain or a reference tissue) may be a more sensitive biomarker than absolute CVR in clinical applications as it minimizes inter-subject variations. With these technological optimizations, CVR mapping may become a useful method for studies of neurological and psychiatric diseases.",
keywords = "BOLD, Brain, Cerebrovascular reactivity, CVR, fMRI, Hypercapnia",
author = "Yezhuvath, {Uma S.} and Kelly Lewis-Amezcua and Rani Varghese and Guanghua Xiao and Hanzhang Lu",
year = "2009",
doi = "10.1002/nbm.1392",
language = "English (US)",
volume = "22",
pages = "779--786",
journal = "NMR in Biomedicine",
issn = "0952-3480",
publisher = "John Wiley and Sons Ltd",
number = "7",

}

TY - JOUR

T1 - On the assessment of cerebrovascular reactivity using hypercapnia BOLD MRI

AU - Yezhuvath, Uma S.

AU - Lewis-Amezcua, Kelly

AU - Varghese, Rani

AU - Xiao, Guanghua

AU - Lu, Hanzhang

PY - 2009

Y1 - 2009

N2 - Cerebrovascular reactivity (CVR) reflects the capacity of blood vessels to dilate and is an important marker for brain vascular reserve. It may provide a useful addition to the traditional baseline blood flow measurement when assessing vascular factors in brain disorders. Blood-oxygenation-level-dependent MRI under CO2 inhalation offers a non-invasive and quantitative means to estimate CVR in humans. In this study, we investigated several important methodological aspects of this technique with the goal of optimizing the experimental and data processing strategies for clinical use. Comparing 4 min of 5% CO2 inhalation (less comfortable) to a 1 min inhalation (more comfortable) duration, it was found that the CVR values were 0.31 ± 0.05%/mmHg (N=11) and 0.31 ± 0.08%/mmHg (N=9), respectively, showing no significant differences between the two breathing paradigms. Therefore, the 1 min paradigm is recommended for future application studies for patient comfort and tolerability. Furthermore, we have found that end-tidal CO2 recording was useful for accurate quantification of CVR because it provided both timing and amplitude information regarding the input function to the brain vascular system, which can be subject-dependent. Finally, we show that inter-subject variations in CVR are of physiologic origin and affect the whole brain in a similar fashion. Based on this, it is proposed that relative CVR (normalized against the CVR of the whole brain or a reference tissue) may be a more sensitive biomarker than absolute CVR in clinical applications as it minimizes inter-subject variations. With these technological optimizations, CVR mapping may become a useful method for studies of neurological and psychiatric diseases.

AB - Cerebrovascular reactivity (CVR) reflects the capacity of blood vessels to dilate and is an important marker for brain vascular reserve. It may provide a useful addition to the traditional baseline blood flow measurement when assessing vascular factors in brain disorders. Blood-oxygenation-level-dependent MRI under CO2 inhalation offers a non-invasive and quantitative means to estimate CVR in humans. In this study, we investigated several important methodological aspects of this technique with the goal of optimizing the experimental and data processing strategies for clinical use. Comparing 4 min of 5% CO2 inhalation (less comfortable) to a 1 min inhalation (more comfortable) duration, it was found that the CVR values were 0.31 ± 0.05%/mmHg (N=11) and 0.31 ± 0.08%/mmHg (N=9), respectively, showing no significant differences between the two breathing paradigms. Therefore, the 1 min paradigm is recommended for future application studies for patient comfort and tolerability. Furthermore, we have found that end-tidal CO2 recording was useful for accurate quantification of CVR because it provided both timing and amplitude information regarding the input function to the brain vascular system, which can be subject-dependent. Finally, we show that inter-subject variations in CVR are of physiologic origin and affect the whole brain in a similar fashion. Based on this, it is proposed that relative CVR (normalized against the CVR of the whole brain or a reference tissue) may be a more sensitive biomarker than absolute CVR in clinical applications as it minimizes inter-subject variations. With these technological optimizations, CVR mapping may become a useful method for studies of neurological and psychiatric diseases.

KW - BOLD

KW - Brain

KW - Cerebrovascular reactivity

KW - CVR

KW - fMRI

KW - Hypercapnia

UR - http://www.scopus.com/inward/record.url?scp=70049114384&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70049114384&partnerID=8YFLogxK

U2 - 10.1002/nbm.1392

DO - 10.1002/nbm.1392

M3 - Article

C2 - 19388006

AN - SCOPUS:70049114384

VL - 22

SP - 779

EP - 786

JO - NMR in Biomedicine

JF - NMR in Biomedicine

SN - 0952-3480

IS - 7

ER -