Cerebral Hemodynamic Impairment: Assessment with Resting-State Functional MR Imaging

Amemiya, Shonan; Kunimatsu, Akira; Saito, Nobuhito; Ohtomo, Kuni

doi:10.1148/radiol.13130982

Cited by 78 publications

(101 citation statements)

References 17 publications

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“…20,21 Some of the earliest studies on BOLD delay found spatial similarities between MTT lesions and BOLD delay lesions. 7,8 Our study shows that BOLD delay is related to both Tmax and MTT on a quantitative level. Although Tmax is the major predictor of BOLD delay, MTT predicts BOLD delay to some extent even when the influence of Tmax is adjusted for (Table 1).…”

Section: Discussionmentioning

confidence: 64%

Relationship Between Changes in the Temporal Dynamics of the Blood-Oxygen-Level-Dependent Signal and Hypoperfusion in Acute Ischemic Stroke

Khalil

Ostwaldt

Nierhaus

et al. 2017

Stroke

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Background and Purpose-Changes in the blood-oxygen-level-dependent (BOLD) signal provide a noninvasive measure of blood flow, but a detailed comparison with established perfusion parameters in acute stroke is lacking. We investigated the relationship between BOLD signal temporal delay and dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) in stroke patients. Methods-In 30 patients with acute (<24 hours) ischemic stroke, we performed Pearson correlation and multiple linear regression between DSC-MRI parameters (time to maximum [Tmax], mean transit time, cerebral blood flow, and cerebral blood volume) and BOLD-based parameters (BOLD delay and coefficient of BOLD variation). Prediction of severe hypoperfusion (Tmax >6 seconds) was assessed using receiver-operator characteristic (ROC) analysis. Results-Correlation was highest between Tmax and BOLD delay (venous sinus reference; time shift range 7; median r=0.60; interquartile range=0.49-0.71). Coefficient of BOLD variation correlated with cerebral blood volume (median r= 0.37; interquartile range=0.24-0.51). Mean R 2 for predicting BOLD delay by DSC-MRI was 0.54 (SD=0.2) and for predicting coefficient of BOLD variation was 0.37 (SD=0.17). BOLD delay (whole-brain reference, time shift range 3) had an area under the curve of 0.76 for predicting severe hypoperfusion (sensitivity=69.2%; specificity=80%), whereas BOLD delay (venous sinus reference, time shift range 3) had an area under the curve of 0.76 (sensitivity=67.3%; specificity=83.5%). Conclusions-BOLD delay is related to macrovascular delay and microvascular hypoperfusion, can identify severely hypoperfused tissue in acute stroke, and is a promising alternative to gadolinium contrast agent-based perfusion assessment in acute stroke. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00715533 and NCT02077582.

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Section: Discussionmentioning

confidence: 64%

Relationship Between Changes in the Temporal Dynamics of the Blood-Oxygen-Level-Dependent Signal and Hypoperfusion in Acute Ischemic Stroke

Khalil

Ostwaldt

Nierhaus

et al. 2017

Stroke

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“…Intact brain regions had altered temporal hemodynamic flow, which either led or lagged behind the mean time course of intact grey matter. This finding was replicated in the acute and chronic stages of stroke, and steno-occlusive vessels disease (Amemiya et al, 2014; Siegel et al, 2016). Hemodynamic changes could emerge for at least two possible reasons.…”

Section: Introductionmentioning

confidence: 63%

“…Recently, rs-fMRI data were used to identify temporal hemodynamic changes in post-stroke populations (and proved crucial for understanding the true basis of altered FC) (Amemiya et al, 2014; Lv et al, 2013; Siegel et al, 2016). Intact brain regions had altered temporal hemodynamic flow, which either led or lagged behind the mean time course of intact grey matter.…”

Section: Introductionmentioning

confidence: 99%

“…Hemodynamic changes could emerge for at least two possible reasons. First, some brain regions share a vascular supply and therefore, if a common vascular supply is compromised, intact regions' hemodynamic response could be affected (Amemiya et al, 2014; Lv et al, 2013; Siegel et al, 2016). Secondly, remote regions can have structural and/or functional connections with the affected regions (Bullmore and Sporns, 2009) which could affect their functional integrity even if they have different vascular supplies.…”

Section: Introductionmentioning

confidence: 99%

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Relating resting-state hemodynamic changes to the variable language profiles in post-stroke aphasia

Zhao

Ralph

Halai

2018

NeuroImage: Clinical

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Linking both structural lesions and the functional integrity of remaining brain tissue to patients' behavioural profile may be critical in discovering the limits of behavioural recovery post stroke. In the present study, we explored the relationship between temporal hemodynamic changes and language performance in chronic post-stroke aphasia. We collected detailed language and neuropsychological data for 66 patients with chronic (>1 year) post-stroke aphasia. We used principal component analysis to extract their core language-neuropsychological features. From resting-state fMRI scans in 35 patients, we calculated the lag in the time-course of the intact brain voxels in each patient. Finally, variation across the language-cognitive factors was related to both the patients' structural damage and the time-course changes in each patient's intact tissue. Phonological abilities were correlated with the structural integrity of the left superior temporal, angular gyrus, supramarginal gyrus and arcuate fasciculus regions and hemodynamic advance in the left intra-parietal sulcus. Speech fluency related to integrity of premotor regions, plus hemodynamic advance in the left middle/superior temporal gyrus, left middle occipital gyrus, and right angular gyrus. Semantic performance reflected a combination of medial ventral temporal lobe status and hemodynamic delay in the left posterior middle temporal gyrus. Finally, executive abilities correlated with hemodynamic delay in the left middle/inferior frontal gyrus, right rolandic operculum, bilateral supplementary motor areas/middle cingulum areas, and bilateral thalamus/caudate. Following stroke, patients' patterns of chronic language abilities reflects a combination of structural and functional integrity across a distributed network of brain regions. The correlation between hemodynamic changes and behaviours may have clinical importance.

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“…Further effort to obtain the signal component that is most relevant to CO 2 fluctuation was undertaken by identifying the frequency band (0.02–0.04 Hz) that shows the higher correlation with end-tidal CO 2 . A few studies have also been reported to use resting-state fMRI data to estimate blood transit time in the brain (Amemiya et al, 2014; Christen et al, 2015; Tong and Frederick, 2014). We have tried to obtain the voxel-wise delay following a previous study (Christen et al, 2015) and apply it in resting-state CVR mapping.…”

Section: Discussionmentioning

confidence: 99%

Cerebrovascular reactivity mapping without gas challenges

et al. 2017

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Cerebrovascular reactivity (CVR), the ability of cerebral vessels to dilate or constrict, has been shown to provide valuable information in the diagnosis and treatment evaluation of patients with various cerebrovascular conditions. CVR mapping is typically performed using hypercapnic gas inhalation as a vasoactive challenge while collecting BOLD images, but the inherent need of gas inhalation and the associated apparatus setup present a practical obstacle in applying it in routine clinical use. Therefore, we aimed to develop a new method to map CVR using resting-state BOLD data without the need of gas inhalation. This approach exploits the natural variation in respiration and measures its influence on BOLD MRI signal. In this work, we first identified a surrogate of the arterial CO2 fluctuation during spontaneous breathing from the global BOLD signal. Second, we tested the feasibility and reproducibility of the proposed approach to use the above-mentioned surrogate as a regressor to estimate voxel-wise CVR. Third, we validated the “resting-state CVR map” with a conventional CVR map obtained with hypercapnic gas inhalation in healthy volunteers. Finally, we tested the utility of this new approach in detecting abnormal CVR in a group of patients with Moyamoya disease, and again validated the results using the conventional gas inhalation method. Our results showed that global BOLD signal fluctuation in the frequency range of 0.02–0.04 Hz contains the most prominent contribution from natural variation in arterial CO2. The CVR map calculated using this signal as a regressor is reproducible across runs (ICC=0.91±0.06), and manifests a strong spatial correlation with results measured with a conventional hypercapnia-based method in healthy subjects (r=0.88, p<0.001). We also found that resting-state CVR was able to identify vasodilatory deficit in patients with steno-occlusive disease, the spatial pattern of which matches that obtained using the conventional gas method (r=0.71±0.18). These results suggest that CVR obtained with resting-state BOLD may be a useful alternative in detecting vascular deficits in clinical applications when gas challenge is not feasible.

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Cerebral Hemodynamic Impairment: Assessment with Resting-State Functional MR Imaging

Abstract: Resting-state functional MR imaging temporal-shift analysis can noninvasively demonstrate the extent and degree of perfusion delay in patients with hypoperfusion both with and without neurologic deficit.

Cited by 78 publications

References 17 publications

Relationship Between Changes in the Temporal Dynamics of the Blood-Oxygen-Level-Dependent Signal and Hypoperfusion in Acute Ischemic Stroke

Relationship Between Changes in the Temporal Dynamics of the Blood-Oxygen-Level-Dependent Signal and Hypoperfusion in Acute Ischemic Stroke

Relating resting-state hemodynamic changes to the variable language profiles in post-stroke aphasia

Cerebrovascular reactivity mapping without gas challenges

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