Magnetic resonance imaging for assessment of cerebrovascular reactivity and its relationship to cognition: a systematic review

Catchlove, Sarah; Pipingas, Andrew; Hughes, Matthew; Macpherson, Helen

doi:10.1186/s12868-018-0421-4

Cited by 33 publications

(24 citation statements)

References 69 publications

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“…The literature on CVR and cognitive performance is inconclusive. 49 Higher middle cerebral artery pulsatility has previously been associated with WMH on TCD. 6 We have shown associations of venous sinus pulsatility with WMH and PVS 22 and now extend that finding to show association of more pulsatile blood flow with lower CVR.…”

Section: Discussionmentioning

confidence: 95%

Intracranial hemodynamic relationships in patients with cerebral small vessel disease

et al. 2020

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ObjectiveTo investigate cerebrovascular reactivity (CVR), blood flow, vascular and CSF pulsatility, and their independent relationship with cerebral small vessel disease (SVD) features in patients with minor ischemic stroke and MRI evidence of SVD.MethodsWe recruited patients with minor ischemic stroke and assessed CVR using blood oxygen level–dependent MRI during a hypercapnic challenge, cerebral blood flow (CBF), vascular and CSF pulsatility using phase-contrast MRI, and structural magnetic resonance brain imaging to quantify white matter hyperintensities (WMHs) and perivascular spaces (PVSs). We used multiple regression to identify parameters associated with SVD features, controlling for patient characteristics.ResultsFifty-three of 60 patients completed the study with a full data set (age 68.0% ± 8.8 years, 74% male, 75% hypertensive). After controlling for age, sex, and systolic blood pressure, lower white matter CVR was associated with higher WMH volume (−0.01%/mm Hg per log10 increase in WMH volume, p = 0.02), basal ganglia PVS (−0.01%/mm Hg per point increase in the PVS score, p = 0.02), and higher venous pulsatility (superior sagittal sinus −0.03%/mm Hg, p = 0.02, per unit increase in the pulsatility index) but not with CBF (p = 0.58). Lower foramen magnum CSF stroke volume was associated with worse white matter CVR (0.04%/mm Hg per mL increase in stroke volume, p = 0.04) and more severe basal ganglia PVS (p = 0.09).ConclusionsLower CVR, higher venous pulsatility, and lower foramen magnum CSF stroke volume indicate that dynamic vascular dysfunctions underpin PVS dysfunction and WMH development. Further exploration of microvascular dysfunction and CSF dynamics may uncover new mechanisms and intervention targets to reduce SVD lesion development, cognitive decline, and stroke.

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Section: Discussionmentioning

confidence: 95%

Intracranial hemodynamic relationships in patients with cerebral small vessel disease

et al. 2020

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“…Cerebrovascular reactivity to CO 2 is also depressed in populations at higher risk for cardiovascular disease and cerebral small-vessel disease, as well as in aging 45,55,56 . Importantly, lower cerebrovascular reactivity has been consistently associated with cognitive impairments 57 , and shown to be predictive of future cognitive decline 24 . Therefore, if the acute benefits demonstrated in the present study were to be sustained by continued intake of flavanol-rich foods (e.g., grapes, apples, cocoa, berries, tea), this may be particularly beneficial for populations at higher risk.…”

Section: Discussionmentioning

confidence: 99%

Dietary flavanols improve cerebral cortical oxygenation and cognition in healthy adults

Gratton

Weaver

Burley

et al. 2020

Sci Rep

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Cocoa flavanols protect humans against vascular disease, as evidenced by improvements in peripheral endothelial function, likely through nitric oxide signalling. Emerging evidence also suggests that flavanol-rich diets protect against cognitive aging, but mechanisms remain elusive. In a randomized double-blind within-subject acute study in healthy young adults, we link these two lines of research by showing, for the first time, that flavanol intake leads to faster and greater brain oxygenation responses to hypercapnia, as well as higher performance only when cognitive demand is high. Individual difference analyses further show that participants who benefit from flavanols intake during hypercapnia are also those who do so in the cognitive challenge. These data support the hypothesis that similar vascular mechanisms underlie both the peripheral and cerebral effects of flavanols. They further show the importance of studies combining physiological and graded cognitive challenges in young adults to investigate the actions of dietary flavanols on brain function.

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“… 66 While more exact methods of increasing PaCO 2 exist (eg, computer-controlled targeting of end-tidal CO 2 partial pressures), these are expensive and require specific equipment and are thus not as accessible. A recent review of MRI-based CVR studies by the authors 67 found that inhalation of a fixed concentration of CO 2 -enriched gas was the most commonly used vasoactive stimuli.…”

Section: Discussionmentioning

confidence: 99%

Regional Cerebrovascular Reactivity and Cognitive Performance in Healthy Aging

et al. 2018

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Cerebrovascular reactivity (CVR) reflects the response of brain blood vessels to vasoactive stimuli, such as neural activity. The current research assessed age-related changes in regional CVR to 5% CO2 inhalation in younger (n = 30, range: 21-45 years) and older (n = 29, range: 55-75 years) adults, and the contribution of regional CVR to cognitive performance using blood-oxygen-level dependent contrast imaging (BOLD) functional magnetic resonance imaging (fMRI) at 3T field strength. CVR was measured by inducing hypercapnia using a block-design paradigm under physiological monitoring. Memory and attention were assessed with a comprehensive computerized aging battery. MRI data analysis was conducted using MATLAB® and SPM12. Memory and attention performance was positively associated with CVR in the temporal cortices. Temporal lobe CVR influenced memory performance independently of age, gender, and education level. When analyzing age groups separately, CVR in the hippocampus contributed significantly to memory score in the older group and was also related to subjective memory complaints. No associations between CVR and cognition were observed in younger adults. Vascular responsiveness in the brain has consequences for cognition in cognitively healthy people. These findings may inform other areas of research concerned with vaso-protective approaches for prevention or treatment of neurocognitive decline.

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Magnetic resonance imaging for assessment of cerebrovascular reactivity and its relationship to cognition: a systematic review

Cited by 33 publications

References 69 publications

Intracranial hemodynamic relationships in patients with cerebral small vessel disease

Intracranial hemodynamic relationships in patients with cerebral small vessel disease

Dietary flavanols improve cerebral cortical oxygenation and cognition in healthy adults

Regional Cerebrovascular Reactivity and Cognitive Performance in Healthy Aging

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