BOLD fMRI of cerebrovascular reactivity in the middle cerebral artery territory: A 100 volunteers’ study

Boudiaf, Naïla; Attyé, Arnaud; Warnking, Jan; Troprés, Irène; Lamalle, Laurent; Pietras, J.; Krainik, Alexandre

doi:10.1016/j.neurad.2015.04.004

“…TCD is relatively inexpensive and widely available, while it does not provide additional information about brain parenchyma and is technically impossible in some cases due to lack of acoustic windows. In the present study, we accurately evaluated CVR for ischemic-stroke patients by multimodal imaging methods (MRI, CT, or SPECT), and explored the recurrence of ischemic stroke after treatment; thus, we can develop a new method for accurate diagnosis and treatment of ischemic stroke [9,19,20]. Our approach possesses a number of novel features compared with other relevant trials.…”

Section: Discussionmentioning

confidence: 99%

“…One approach attempts direct CBF measurements of the brain tissue with flow-sensitive imaging techniques such as positron-emission tomography (PET), nuclear medicine (NM) techniques, computed tomography (CT) perfusion, or magnetic resonance imaging (MRI) perfusion before and after a vasodilatory stimulus. The second approach involves transcranial Doppler (TCD) measurement of flow velocities (typically in the middle cerebral artery (MCA)) distal to a lesion both before and after a vasodilatory stimulus, with the increase flow velocity considered a surrogate for CVR [9][10][11][12]. We intend to precisely evaluate the change of CVR before and after surgical or medical treatments by multimodal image including MRI, CT, and single-photon-emission computed tomography (SPECT), so that we can make strategies for individualized accurate diagnosis and treatment for the ischemic stroke [3,13].…”

Section: Introductionmentioning

confidence: 99%

Measurement of cerebrovascular reserve by multimodal imaging for cerebral arterial occlusion or stenosis patients: protocol of a prospective, randomized, controlled clinical study

Xiao

¹

,

Ke

²

,

Wan

³

et al. 2020

Trials

1

0

View full text Add to dashboard Cite

Background: Cerebrovascular reactivity (CVR) is the change in cerebral blood flow in response to a vaso-active stimulus, and may assist the treatment strategy of ischemic stroke. However, previous studies reported that a therapeutic strategy for stroke mainly depends on the degree of vascular stenosis with steady-state vascular parameters (e.g., cerebral blood flow and CVR). Hence, measurement of CVR by multimodal imaging techniques may improve the treatment of ischemic stroke. Methods/design: This is a prospective, randomized, controlled clinical trial that aimed to examine the capability of multimodal imaging techniques for the evaluation of CVR to improve treatment of patients with ischemic stroke. A total of 66 eligible patients will be recruited from Renji Hospital, Shanghai Jiaotong University School of Medicine. The patients will be categorized based on CVR into two subgroups as follows: CVR > 10% group and CVR < 10% group. The patients will be randomly assigned to medical management, percutaneous transluminal angioplasty and stenting, and intracranial and extra-cranial bypass groups in a 1:1:1 ratio. The primary endpoint is all adverse events and ipsilateral stroke recurrence at 6, 12, and 24 months after management. The secondary outcomes include the CVR, the National Institute of Health stroke scale and the Modified Rankin Scale at 6, 12, and 24 months. Discussion: Measurement of cerebrovascular reserve by multimodal image is recommended by most recent studies to guide the treatment of ischemic stroke, and thus its efficacy and evaluation accuracy need to be established in randomized controlled settings. This prospective, parallel, randomized, controlled registry study, together with other ongoing studies, should present more evidence for optimal individualized accurate treatment of ischemic stroke.

show abstract

“…TCD is relatively inexpensive and widely available, while it does not provide additional information about brain parenchyma and is technically impossible in some cases due to lack of acoustic windows. In the present study, we accurately evaluated CVR for ischemic stroke patients by multimodal imaging methods (MRI, CT or SPECT), and explored the recurrence of ischemic stroke after treatment, thus, we could develop a new method for accurate diagnosis and treatment of ischemic stroke [9,19,20]. Our approach possesses a number of novel features compared with other relevant trials.…”

Section: Discussionmentioning

confidence: 99%

“…One approach attempts direct CBF measurements of the brain tissue with flow sensitive imaging techniques such as positron-emission tomography (PET), nuclear medicine (NM) techniques, CT perfusion, or MR perfusion before and after a vasodilatory stimulus. The second approach involves transcranial Doppler (TCD) measurement of flow velocities (typically in the middle cerebral artery) distal to a lesion both before and after a vasodilatory stimulus, with the increase flow velocity 4 considered a surrogate for CVR [9][10][11][12]. we intend to precisely evaluate the change of CVR before and after surgery or medicine treatments by multimodal image including MR, CT and SPECT, so that we can make strategies of individualized accurate diagnosis and treatment for the ischemic stroke [3,13].…”

mentioning

confidence: 99%

Measurement of cerebrovascular reserve by multimodal imaging for cerebral arterial occlusion or stenosis patients: protocol of a prospective, randomized, controlled clinical trial

Xiao

¹

,

ke

²

,

yong

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background Cerebrovascular reactivity (CVR), index of cerebral hemodynamics, might guide the treatment of ischemic stroke. However, the previous studies that the therapeutic strategy of stroke mainly depends on the degree of vascular stenosis with steady-state vascular parameters, such as cerebral blood flow, and CVR factors are not under consideration. Measurement of CVR by multimodal image might improve the prognosis for ischemic stroke. Methods/design The study is a prospective, randomized, paralleled controlled clinical trial to examine the multimodal image evaluation for CVR. A total of 66 eligible patients will be recruited from Renji hospital, Shanghai Jiaotong University School of Medicine. The patients will be categorized based on CVR into two subgroups as follows: CVR>10% group and CVR<10% group. And the patients will be randomly assigned to medical management, percutaneous transluminal angioplasty and stenting, and intracranial and extra-cranial bypass groups in a 1:1:1 ratio. The primary end point is all adverse events and ipsilateral stroke recurrence at 6, 12, 24 months after the management. The secondary outcomes include the CVR, the National Institute of Health stroke scale and the Modified Rankin Scale at 6, 12, 24 months. Discussion Measurement of cerebrovascular reserve by multimodal image is recommended by most recent studies to guide the treatment of ischemic stroke, and thus its efficacy and evaluation accuracy need to be established in randomized controlled settings. This prospective, randomized, paralleled controlled registry study, together with other ongoing studies, will present more evidence for optimal individualized accurate treatment of ischemic stroke.

show abstract

“…CVR denotes the ability of cerebral vessels to dilate or constrict in response to challenges or defined as the change in CBF in response to a vasoactive stimulus such as an increase in the arterial partial pressure of CO2 (PaCO2) [7,8]. There are two typical methods to measure CVR: one is to directly reflect CVR by image, such as PET, SPECT, CT and MRI; Another method is to indirectly reflect CVR by TCD [9][10][11][12]. we intend to precisely evaluate the change of CVR before and after surgery or medicine treatments by multimodal image including MR, CT and SPECT, so that we can make strategies of individualized accurate diagnosis and treatment for the ischemic stroke [3,13].…”

Section: Introductionmentioning

confidence: 99%

Measurement of cerebrovascular reserve by multimodal image for cerebral arterial occlusion or stenosis patients: study protocol of a randomized paralleled controlled trial

Xiao

¹

,

ke

²

,

yong

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background Cerebrovascular reactivity (CVR), index of cerebral hemodynamics, might guide the treatment of ischemic stroke. However, the previous studies that the therapeutic strategy of stroke mainly depends on the degree of vascular stenosis with steady-state vascular parameters, such as cerebral blood flow, and CVR factors are not under consideration. Measurement of CVR by multimodal image might improve the prognosis for ischemic stroke. Methods/design The study is a prospective, randomized, paralleled controlled clinical trial to examine the multimodal image evaluation for CVR. A total of 66 eligible patients will be recruited from Renji hospital, Shanghai Jiaotong University School of Medicine. The patients will be categorized based on CVR into two subgroups as follows: CVR>10% group and CVR<10% group. And the patients will be randomly assigned to medical management, percutaneous transluminal angioplasty and stenting, and intracranial and extra-cranial bypass groups in a 1:1:1 ratio. The primary end point is all adverse events and ipsilateral stroke recurrence at 6, 12, 24 months after the management. The secondary outcomes include the CVR, the National Institute of Health stroke scale and the Modified Rankin Scale at 6, 12, 24 months. Discussion Measurement of cerebrovascular reserve by multimodal image is recommended by most recent studies to guide the treatment of ischemic stroke, and thus its efficacy and evaluation accuracy need to be established in randomized controlled settings. This prospective, randomized, paralleled controlled registry study, together with other ongoing studies, will present more evidence for optimal individualized accurate treatment of ischemic stroke.

show abstract

BOLD fMRI of cerebrovascular reactivity in the middle cerebral artery territory: A 100 volunteers’ study

Cited by 10 publications

References 46 publications

Measurement of cerebrovascular reserve by multimodal imaging for cerebral arterial occlusion or stenosis patients: protocol of a prospective, randomized, controlled clinical study

Measurement of cerebrovascular reserve by multimodal imaging for cerebral arterial occlusion or stenosis patients: protocol of a prospective, randomized, controlled clinical study

Measurement of cerebrovascular reserve by multimodal imaging for cerebral arterial occlusion or stenosis patients: protocol of a prospective, randomized, controlled clinical trial

Measurement of cerebrovascular reserve by multimodal image for cerebral arterial occlusion or stenosis patients: study protocol of a randomized paralleled controlled trial

Contact Info

Product

Resources

About