Cerebrovascular Reactivity during Prolonged Breath-Hold in Experienced Freedivers

Keil, Vera C.; Eichhorn, Lars; Mutsaerts, Henk‐Jan; Träber, Frank; Block, Wolfgang; Mädler, Burkhard; Ven, K.C.C. van de; Siero, Jeroen C.W.; MacIntosh, Bradley J.; Petr, Jan; Fimmers, Rolf; Schild, Hans H.; Hattingen, Elke

doi:10.3174/ajnr.a5790

Cited by 7 publications

(6 citation statements)

References 37 publications

(45 reference statements)

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“…Even though no obvious signs of arterial delay artefacts were found, CBF in watershed areas of ICAS-patients may potentially be affected by delayed blood arrival. [54][55][56][57][58] We detected decreased CVR on the side of the stenosis in ICAS-patients (À15% compared with contralateral values and -29% compared with HCs in iWSA-GM), as predicted by the basic hemodynamic model and in agreement with other studies. 5,24 We also found decreased CVR in the contralateral hemisphere (-18% compared with HCs in iWSA-GM).…”

Section: Impaired Perfusion (Cbf Cvr and Rcbv)supporting

confidence: 91%

“… 23 Those delay effects are a generally known methodological issue of single-PLD pCASL. 54 – 56 We did not observe obvious signs of major delays in the label arrival by visual and quantitative inspection of our data. However, quantitative errors in the regions with potentially prolonged longer ATT, such as the watershed areas, cannot completely be excluded.…”

Section: Discussionmentioning

confidence: 50%

“…Even though no obvious signs of arterial delay artefacts were found, CBF in watershed areas of ICAS-patients may potentially be affected by delayed blood arrival. 54 – 58 …”

Section: Discussionmentioning

confidence: 99%

“…13 Sections of iWSAs in WM are expected to be located at the most distal arterial branches, where CPP is generally assumed to be the lowest. Additional influencing factors may also be due to delay effects in single-PLD pCASL [54][55][56] and delay effects in CVR-imaging. 64 Even though CBF evaluation by ASL is known to be challenging in WM due to a lower SNR 23 and partial volume effects, 65 a previous study showed its sensitivity to WM perfusion deficits, 66 which was also supported by our successful evaluations on a group level.…”

Section: Impaired Perfusion (Cbf Cvr and Rcbv)mentioning

confidence: 99%

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Hemodynamic impairments within individual watershed areas in asymptomatic carotid artery stenosis by multimodal MRI

Kaczmarz

Göttler

Petr

et al. 2020

J Cereb Blood Flow Metab

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Improved understanding of complex hemodynamic impairments in asymptomatic internal carotid artery stenosis (ICAS) is crucial to better assess stroke risks. Multimodal MRI is ideal for measuring brain hemodynamics and has the potential to improve diagnostics and treatment selections. We applied MRI-based perfusion and oxygenation-sensitive imaging in ICAS with the hypothesis that the sensitivity to hemodynamic impairments will improve within individual watershed areas (iWSA). We studied cerebral blood flow (CBF), cerebrovascular reactivity (CVR), relative cerebral blood volume (rCBV), relative oxygen extraction fraction (rOEF), oxygen extraction capacity (OEC) and capillary transit-time heterogeneity (CTH) in 29 patients with asymptomatic, unilateral ICAS (age 70.3 ± 7.0 y) and 30 age-matched healthy controls. In ICAS, we found significant impairments of CBF, CVR, rCBV, OEC, and CTH (strongest lateralization ΔCVR = –24%), but not of rOEF. Although the spatial overlap of compromised hemodynamic parameters within each patient varied in a complex manner, most pronounced changes of CBF, CVR and rCBV were detected within iWSAs (strongest effect ΔCVR = +117%). At the same time, CTH impairments were iWSA independent, indicating widespread dysfunction of capillary-level oxygen diffusivity. In summary, complementary MRI-based perfusion and oxygenation parameters offer deeper perspectives on complex microvascular impairments in individual patients. Furthermore, knowledge about iWSAs improves the sensitivity to hemodynamic impairments.

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Section: Impaired Perfusion (Cbf Cvr and Rcbv)supporting

confidence: 91%

Section: Discussionmentioning

confidence: 50%

“…Even though no obvious signs of arterial delay artefacts were found, CBF in watershed areas of ICAS-patients may potentially be affected by delayed blood arrival. 54 – 58 …”

Section: Discussionmentioning

confidence: 99%

Section: Impaired Perfusion (Cbf Cvr and Rcbv)mentioning

confidence: 99%

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Hemodynamic impairments within individual watershed areas in asymptomatic carotid artery stenosis by multimodal MRI

Kaczmarz

Göttler

Petr

et al. 2020

J Cereb Blood Flow Metab

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“…A hypercapnic state leads to reduction of ATT, making the ATT/PLD combination much more favorable for measuring CBF than in normal settings that lead to a higher increase in WM-CBF than in GM-CBF, showing the important role of a short ATT in CBF measurement in WM with ASL. 43 Similarly, a decrease in WM-CBF was not always explained by an increase in the sCoV. 19 This finding leads us to an assumption that despite needing to be interpreted with care, real WM-CBF differences can be observed in our data.…”

Section: Discussionmentioning

confidence: 52%

Arterial Spin-Labeling Parameters and Their Associations with Risk Factors, Cerebral Small-Vessel Disease, and Etiologic Subtypes of Cognitive Impairment and Dementia

Gyanwali

Tan

Petr

et al. 2022

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Cerebral small-vessel disease may alter cerebral blood flow (CBF) leading to brain changes and, hence, cognitive impairment and dementia. CBF and the spatial coefficient of variation can be measured quantitatively by arterial spinlabeling. We aimed to investigate the associations of demographics, vascular risk factors, location, and severity of cerebral small-vessel disease as well as the etiologic subtypes of cognitive impairment and dementia with CBF and the spatial coefficient of variation.MATERIALS AND METHODS: Three hundred ninety patients with a diagnosis of no cognitive impairment, cognitive impairment no dementia, vascular cognitive impairment no dementia, Alzheimer disease, and vascular dementia were recruited from the memory clinic. Cerebral microbleeds and lacunes were categorized into strictly lobar, strictly deep, and mixed-location and enlarged perivascular spaces into the centrum semiovale and basal ganglia. Total and region-specific white matter hyperintensity volumes were segmented using FreeSurfer. CBF (n ¼ 333) and the spatial coefficient of variation (n ¼ 390) were analyzed with ExploreASL from 2D-EPI pseudocontinuous arterial spin-labeling images in white matter (WM) and gray matter (GM). To analyze the effect of demographic and vascular risk factors as well as the location and severity of cerebral small-vessel disease markers on arterial spin-labeling parameters, we constructed linear regression models, whereas logistic regression models were used to determine the association between arterial spin-labeling parameters and cognitive impairment no dementia, vascular cognitive impairment no dementia, Alzheimer disease, and vascular dementia. RESULTS:Increasing age, male sex, hypertension, hyperlipidemia, history of heart disease, and smoking were associated with lower CBF and a higher spatial coefficient of variation. Higher numbers of lacunes and cerebral microbleeds were associated with lower CBF and a higher spatial coefficient of variation. Location-specific analysis showed mixed-location lacunes and cerebral microbleeds were associated with lower CBF. Higher total, anterior, and posterior white matter hyperintensity volumes were associated with a higher spatial coefficient of variation. No association was observed between enlarged perivascular spaces and arterial spin-labeling parameters. A higher spatial coefficient of variation was associated with the diagnosis of vascular cognitive impairment no dementia, Alzheimer's disease, and vascular dementia.CONCLUSIONS: Reduced CBF and an increased spatial coefficient of variation were associated with cerebral small-vessel disease, and more specifically lacunes, whereas cerebral microbleeds and white matter hyperintensities were associated with WM-CBF and GM spatial coefficient of variation. The spatial coefficient of variation was associated with cognitive impairment and dementia, suggesting that hypoperfusion might be the key underlying mechanism for vascular brain damage.ABBREVIATIONS: AD ¼ Alzheimer's disease; ASL ¼ art...

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The value of arterial spin labelling perfusion MRI in brain age prediction

Dijsselhof

Barboure

Stritt

et al. 2023

Human Brain Mapping

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Current structural MRI‐based brain age estimates and their difference from chronological age—the brain age gap (BAG)—are limited to late‐stage pathological brain‐tissue changes. The addition of physiological MRI features may detect early‐stage pathological brain alterations and improve brain age prediction. This study investigated the optimal combination of structural and physiological arterial spin labelling (ASL) image features and algorithms. Healthy participants (n = 341, age 59.7 ± 14.8 years) were scanned at baseline and after 1.7 ± 0.5 years follow‐up (n = 248, mean age 62.4 ± 13.3 years). From 3 T MRI, structural (T1w and FLAIR) volumetric ROI and physiological (ASL) cerebral blood flow (CBF) and spatial coefficient of variation ROI features were constructed. Multiple combinations of features and machine learning algorithms were evaluated using the Mean Absolute Error (MAE). From the best model, longitudinal BAG repeatability and feature importance were assessed. The ElasticNetCV algorithm using T1w + FLAIR+ASL performed best (MAE = 5.0 ± 0.3 years), and better compared with using T1w + FLAIR (MAE = 6.0 ± 0.4 years, p < .01). The three most important features were, in descending order, GM CBF, GM/ICV, and WM CBF. Average baseline and follow‐up BAGs were similar (−1.5 ± 6.3 and − 1.1 ± 6.4 years respectively, ICC = 0.85, 95% CI: 0.8–0.9, p = .16). The addition of ASL features to structural brain age, combined with the ElasticNetCV algorithm, improved brain age prediction the most, and performed best in a cross‐sectional and repeatability comparison. These findings encourage future studies to explore the value of ASL in brain age in various pathologies.

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Cerebrovascular Reactivity during Prolonged Breath-Hold in Experienced Freedivers

Cited by 7 publications

References 37 publications

Hemodynamic impairments within individual watershed areas in asymptomatic carotid artery stenosis by multimodal MRI

Hemodynamic impairments within individual watershed areas in asymptomatic carotid artery stenosis by multimodal MRI

Arterial Spin-Labeling Parameters and Their Associations with Risk Factors, Cerebral Small-Vessel Disease, and Etiologic Subtypes of Cognitive Impairment and Dementia

The value of arterial spin labelling perfusion MRI in brain age prediction

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