Impaired Cerebrovascular Reactivity Predicts Recurrent Symptoms in Patients with Carotid Artery Occlusion: A Hypercapnia BOLD fMRI Study

Goode, Stephen; Altaf, Nishath; Munshi, Sunil; MacSweeney, S.T.R.; Auer, Dorothee P.

doi:10.3174/ajnr.a4739

Cited by 9 publications

(5 citation statements)

References 40 publications

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“…Cerebral steno-occlusive diseases (e.g,. Moyamoya disease, carotid stenosis/occlusion) were the most commonly investigated diseases (72/235 studies, 31%), followed by dementia and cognitive impairments (9/235, 4%), normal ageing (8/235, 3%), small vessel disease (7/235, 3%), sport-related concussions 1786/541 51.4/44.9 -Lower CVR than healthy controls (Hartkamp et al, 2017;Liu et al, 2017a;De Vis et al, 2018;Duffin et al, 2018;Venkatraghavan et al, 2018;Waddle et al, 2019) -Longer delays than healthy controls (Hartkamp et al, 2012;Duffin et al, 2015;Liu et al, 2017b;Waddle et al, 2019) -Increased CVR (Han et al, 2011a;Mandell et al, 2011;Watchmaker et al, 2019) and smaller delays (Watchmaker et al, 2019) after surgical intervention Piepgras et al, 1994;Guckel et al, 1995;Ohnishi et al, 1996;Schreiber et al, 1998;Hamzei et al, 2003;Shiino et al, 2003;Griffiths et al, 2005;Ziyeh et al, 2005;Ma et al, 2007;Haller et al, 2008;Mandell et al, 2008bMandell et al, , 2011Chang et al, 2009Chang et al, , 2013Donahue et al, 2009Donahue et al, , 2013Donahue et al, , 2016Goode et al, 2009Goode et al, , 2016Calviere et al, 2010;Bokkers et al, 2011;Conklin et al, 2011;…”

Section: Pathologiesmentioning

confidence: 99%

Cerebrovascular Reactivity Measurement Using Magnetic Resonance Imaging: A Systematic Review

et al. 2021

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Cerebrovascular reactivity (CVR) magnetic resonance imaging (MRI) probes cerebral haemodynamic changes in response to a vasodilatory stimulus. CVR closely relates to the health of the vasculature and is therefore a key parameter for studying cerebrovascular diseases such as stroke, small vessel disease and dementias. MRI allows in vivo measurement of CVR but several different methods have been presented in the literature, differing in pulse sequence, hardware requirements, stimulus and image processing technique. We systematically reviewed publications measuring CVR using MRI up to June 2020, identifying 235 relevant papers. We summarised the acquisition methods, experimental parameters, hardware and CVR quantification approaches used, clinical populations investigated, and corresponding summary CVR measures. CVR was investigated in many pathologies such as steno-occlusive diseases, dementia and small vessel disease and is generally lower in patients than in healthy controls. Blood oxygen level dependent (BOLD) acquisitions with fixed inspired CO2 gas or end-tidal CO2 forcing stimulus are the most commonly used methods. General linear modelling of the MRI signal with end-tidal CO2 as the regressor is the most frequently used method to compute CVR. Our survey of CVR measurement approaches and applications will help researchers to identify good practice and provide objective information to inform the development of future consensus recommendations.

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Section: Pathologiesmentioning

confidence: 99%

Cerebrovascular Reactivity Measurement Using Magnetic Resonance Imaging: A Systematic Review

et al. 2021

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“…Utilizing TCD and SPECT with a breath-hold stimulus, it has been shown that superficial temporal artery (STA)-MCA bypass surgery performed in patients with severe steno-occlusive disease and impaired CVR results in a reduction in stroke recurrence (Low et al, 2015). Therefore, while management of ICAD patients remains controversial, CVR imaging may be of particular interest in this population in identifying those with severe disease who may benefit from aggressive interventions and recent work using hypercapnic BOLD MRI has shown that CVR may be prognostic for recurrent ischemic injury in patients with carotid occlusion (Goode et al, 2016). Future work will likely focus on identifying patients with ICAD at risk of failing standard-of-care AMM and triaging such patients for more aggressive therapies.…”

Section: Atherosclerotic Arterial Steno-occlusive Diseasementioning

confidence: 99%

Neuroimaging of vascular reserve in patients with cerebrovascular diseases

Juttukonda

Donahue

2019

NeuroImage

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Cerebrovascular reactivity, defined broadly as the ability of brain parenchyma to adjust cerebral blood flow in response to altered metabolic demand or a vasoactive stimulus, is being measured with increasing frequency and may have a use for portending new or recurrent stroke risk in patients with cerebrovascular disease. The purpose of this review is to outline (i) the physiological basis of variations in cerebrovascular reactivity, (ii) available approaches for measuring cerebrovascular reactivity in research and clinical settings, and (iii) clinically-relevant cerebrovascular reactivity findings in the context of patients with cerebrovascular disease, including atherosclerotic arterial steno-occlusion, non-atherosclerotic arterial steno-occlusion, anemia, and aging. Literature references summarizing safety considerations for these procedures and future directions for standardizing protocols and post-processing procedures across centers are presented in the specific context of major unmet needs in the setting of cerebrovascular disease.

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“… 6 Another study shows that impaired CVR predicted recurrent symptoms in patients with carotid artery occlusion, and those patients showed a higher risk of recurrent ischemic symptoms. 5 In addition, a study in children with a prior diagnosis of transient cerebral arteriopathy showed that impaired CVR was limited to infarct zone and adjacent white matter in most children. 4 Studies also indicated that CVR-CO 2 declined in people with Alzheimer’s disease, which was characterized by impaired cognitive function.…”

Section: Introductionmentioning

confidence: 99%

Effects of sevoflurane versus propofol on cerebrovascular reactivity to carbon dioxide during laparoscopic surgery

Wang¹,

Ni²,

Li³

et al. 2017

TCRM

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PurposeCerebrovascular reactivity to carbon dioxide (CVR-CO2) reflects cerebrovascular reserve capacity, which is important in many brain disorders, including cerebrovascular and Alzheimer’s diseases. Meanwhile, there is a relationship between CVR-CO2 and cognitive function. Therefore, the study is aimed at investigating the effects of sevoflurane versus propofol on CVR-CO2 during laparoscopic surgery, as well as the role of CVR-CO2 on cognitive function during perioperative period.Patients and methodsEighty-eight patients, aged 18–65 years undergoing elective laparoscopic cholecystectomy, were randomly assigned to group S and group P. The patients in group S were induced with propofol and maintained with sevoflurane. The patients in group P were induced and maintained with propofol (target-controlled infusion). Remifentanil was given to both groups. CVR-CO2 at baseline (before induction), before pneumoperitoneum and during pneumoperitoneum, as well as Mini-Mental State Examination scores at baseline and 24 hours after surgery were recorded.ResultsIn group S, CVR-CO2 before and during pneumoperitoneum increased significantly compared with baseline (P<0.05). In group P, CVR-CO2 before pneumoperitoneum increased significantly (P<0.05), but CVR-CO2 during pneumoperitoneum was not different compared with baseline. In either group, there was no significant correlation between mean blood pressure and CVR-CO2 during surgery, and there was no significant difference between Mini-Mental State Examination scores at baseline and 24 hours after surgery.ConclusionSevoflurane could maintain CVR-CO2 at a higher level during pneumoperitoneum in surgery. Therefore, in patients with impaired cerebrovascular reserve capacity, inhaled anesthetic could be a priority strategy for anesthesia maintenance to improve the compensatory vasodilation ability of cerebral small vessels.

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Impaired Cerebrovascular Reactivity Predicts Recurrent Symptoms in Patients with Carotid Artery Occlusion: A Hypercapnia BOLD fMRI Study

Cited by 9 publications

References 40 publications

Cerebrovascular Reactivity Measurement Using Magnetic Resonance Imaging: A Systematic Review

Cerebrovascular Reactivity Measurement Using Magnetic Resonance Imaging: A Systematic Review

Neuroimaging of vascular reserve in patients with cerebrovascular diseases

Effects of sevoflurane versus propofol on cerebrovascular reactivity to carbon dioxide during laparoscopic surgery

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