In vivo mapping of cerebrovascular oscillations in the 0.05-0.15 Hz remains difficult.Oscillations in the cerebrospinal fluid (CSF) represent a possible avenue for noninvasively tracking these oscillations using resting-state functional MRI (rs-fMRI), and have been used to correct for vascular oscillations in rs-fMRI functional connectivity. However, the relationship between low-frequency CSF and vascular oscillations remains unclear. In this study, we investigate this relationship using fast simultaneous rs-fMRI and photoplethysmogram (PPG), examining the 0.1 Hz PPG signal, heart-rate variability (HRV), pulse-intensity ratio (PIR), and the second derivative of the PPG (SDPPG). The main findings of this study are: (a) signals in different CSF regions are not equivalent in their associations with vascular and tissue rs-fMRI signals; (b) the PPG signal is maximally coherent with the arterial and CSF signals at the cardiac frequency, but coherent with brain tissue at 0.2 Hz; (c) PIR is maximally coherent with the CSF signal near 0.03 Hz; and (d) PPGrelated vascular oscillations only contribute to 15% of the CSF (and arterial) signal in rs-fMRI. These findings caution against averaging all CSF regions when extracting physiological nuisance regressors in rs-fMRI applications, and indicate the drivers of the CSF signal are more than simply cardiac. Our study is an initial attempt at the refinement and standardization of how the CSF signal in rs-fMRI can be used and interpreted. It also paves the way for using rs-fMRI in the CSF as a potential tool for tracking cerebrovascular health through, for instance, the potential relationship between PIR and the CSF signal.

Slow and rhythmic spontaneous oscillations of cerebral blood flow are well known to have diagnostic utility, notably frequencies of 0.008-0.03 Hz (B-waves) and 0.05-0.15Hz (Mayer waves or M waves). However, intracranial measurements of these oscillations have been difficult. Oscillations in the cerebrospinal fluid (CSF), which are influenced by the cardiac pulse wave, represent a possible avenue for non-invasively tracking these oscillations using resting-state functional MRI (rs-fMRI), and have been used to correct for vascular oscillations in rs-fMRI functional connectivity calculations. However, the relationship between low-frequency CSF and vascular oscillations is unclear. In this study, we investigate this relationship using fast simultaneous multi-slice rs-fMRI coupled with fingertip photoplethysmography (PPG). We not only extract B-wave and M-wave range spectral power from the PPG signal, but also derive the pulse-intensity ratio (PIR, a surrogate of slow blood-pressure oscillations), the second-derivative of the PPG (SDPPG, a surrogate of arterial stiffness) and heart-rate variability (HRV). The main findings of this study are: (1) signals in different CSF regions (ROIs) are not equivalent in their vascular contributions or in their associations with vascular and tissue rs-fMRI signals; (2) the PPG signal contains the highest signal contribution from the M-wave range, while PIR contains the highest signal contribution from the B-wave range; (3) in the low-frequency range, PIR is more strongly associated with rs-fMRI signal in the CSF than PPG itself, and than HRV and SDPPG; (4) PPG-related vascular oscillations only contribute to < 20% of the CSF signal in rs-fMRI, insufficient support for the assumption that low-frequency CSF signal fluctuations directly reflect vascular oscillations. These findings caution the use of CSF as a monolithic region for extracting physiological nuisance regressors in rs-fMRI applications. They also pave the way for using rs-fMRI in the CSF as a potential tool for tracking cerebrovascular health through, for instance the strong relationship between PIR and the CSF signal.

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