Non‐Invasive Assessment of Damping of Blood Flow Velocity Pulsatility in Cerebral Arteries With <scp>MRI</scp>

Arts, Tine; Onkenhout, Laurien; Amier, Raquel P.; Geest, Rob J. van der; Harten, Thijs van; Kappelle, Jaap; Kuipers, Sanne; Osch, M.J.P. van; Bavel, E. T. van; Biessels, Geert Jan; Zwanenburg, Jaco J.M.

doi:10.1002/jmri.27989

Cited by 17 publications

(20 citation statements)

References 37 publications

(108 reference statements)

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“…Therefore, given the current understanding of the disease, 28 decreased blood flow velocity in CADASIL is likely attributable to decreased total blood flow in the perforating arteries. Of note, flow velocity and pulsatility index in the perforating arteries are not independent of effects up‐ and downstream in the vascular tree 29 . Increased pulsatility index of perforating artery flow velocity may therefore reflect changes in upstream vessels (generating a more pulsatile perfusion pressure), enhanced stiffness of the pial or perforating arteries themselves, or changes in the downstream vascular bed including abnormal microvascular compliance.…”

Section: Discussionmentioning

confidence: 98%

CADASIL Affects Multiple Aspects of Cerebral Small Vessel Function on 7T‐MRI

Brink

Kopczak²,

Arts

et al. 2022

Annals of Neurology

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the SVDs@target group Objective: Cerebral small vessel diseases (cSVDs) are a major cause of stroke and dementia. We used cutting-edge 7T-MRI techniques in patients with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL), to establish which aspects of cerebral small vessel function are affected by this monogenic form of cSVD. Methods: We recruited 23 CADASIL patients (age 51.1 AE 10.1 years, 52% women) and 13 age-and sex-matched controls (46.1 AE 12.6, 46% women). Small vessel function measures included: basal ganglia and centrum semiovale perforating artery blood flow velocity and pulsatility, vascular reactivity to a visual stimulus in the occipital cortex and reactivity to hypercapnia in the cortex, subcortical gray matter, white matter, and white matter hyperintensities. Results: Compared with controls, CADASIL patients showed lower blood flow velocity and higher pulsatility index within perforating arteries of the centrum semiovale (mean difference À 0.09 cm/s, p = 0.03 and 0.20, p = 0.009) and basal ganglia (mean difference À 0.98 cm/s, p = 0.003 and 0.17, p = 0.06). Small vessel reactivity to a short visual stimulus was decreased (blood-oxygen-level dependent [BOLD] mean difference À0.21%, p = 0.04) in patients, while reactivity to hypercapnia was preserved in the cortex, subcortical gray matter, and normal appearing white matter. Among patients, reactivity to hypercapnia was decreased in white matter hyperintensities compared to normal appearing white matter (BOLD mean difference À0.29%, p = 0.02). Interpretation: Multiple aspects of cerebral small vessel function on 7T-MRI were abnormal in CADASIL patients, indicative of increased arteriolar stiffness and regional abnormalities in reactivity, locally also in relation to white matter injury. These observations provide novel markers of cSVD for mechanistic and intervention studies.

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Section: Discussionmentioning

confidence: 98%

CADASIL Affects Multiple Aspects of Cerebral Small Vessel Function on 7T‐MRI

Brink

Kopczak²,

Arts

et al. 2022

Annals of Neurology

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“…However, focal measurements in regions of particular interest could be advantageous in future SVD studies. Indeed, 2D phase contrast MRI at 7T allows for pulsatility 33 and damping 34 measurements in perforating arteries of the basal ganglia and semioval center, regions of particular interest in SVD. This approach showed higher pulsatility in patients with SVD‐related stroke 35 .…”

Section: Discussionmentioning

confidence: 99%

5‐Year Associations among Cerebral Arterial Pulsatility, Perivascular Space Dilation, and White Matter Lesions

Vikner

Karalija

Eklund

et al. 2022

Annals of Neurology

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High cerebral arterial pulsatility index (PI), white matter lesions (WMLs), enlarged perivascular spaces (PVSs), and lacunar infarcts are common findings in the elderly population, and considered indicators of small vessel disease (SVD). Here, we investigate the potential temporal ordering among these variables, with emphasis on determining whether high PI is an early or delayed manifestation of SVD. Methods: In a population-based cohort, 4D flow MRI data for cerebral arterial pulsatility was collected for 159 participants at baseline (age 64-68), and for 122 participants at follow-up 5 years later. Structural MRI was used for WML and PVS segmentation, and lacune identification. Linear mixed-effects (LME) models were used to model longitudinal changes testing for pairwise associations, and latent change score (LCS) models to model multiple relationships among variables simultaneously. Results: Longitudinal 5-year increases were found for WML, PVS, and PI. Cerebral arterial PI at baseline did not predict changes in WML or PVS volume. However, WML and PVS volume at baseline predicted 5-year increases in PI. This was shown for PI increases in relation to baseline WML and PVS volumes using LME models (R ≥ 0.24; p < 0.02 and R ≥ 0.23; p < 0.03, respectively) and LCS models (β = 0.28; p = 0.015 and β = 0.28; p = 0.009, respectively). Lacunes at baseline were unrelated to PI. Interpretation: In healthy older adults, indicators of SVD are related in a lead-lag fashion, in which the expression of WML and PVS precedes increases in cerebral arterial PI. Hence, we propose that elevated PI is a relatively late manifestation, rather than a risk factor, for cerebral SVD.

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“…WM masks and lacunar infarcts in these regions were delineated from 3T MRI T1-weighted and FLAIR images using the Quantib Brain Segmentation Tool and the FMRIB Software Library (FSL version 6.0.1, Oxford, UK)(Sup. Table 1 ) [16] . The lacunar infarct masks were dilated with a 3 × 3 mm kernel.…”

Section: Methodsmentioning

confidence: 99%