Using arterial spin labeling to measure cerebrovascular reactivity in Moyamoya disease: Insights from simultaneous PET/MRI

Zhao, Mengjing; Fan, Audrey P.; Chen, David Yen-Ting; Ishii, Yôsuke; Khalighi, Mohammad Mehdi; Moseley, Michael E.; Zaharchuk, Greg

doi:10.1177/0271678x221083471

Cited by 18 publications

(33 citation statements)

References 69 publications

(95 reference statements)

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“…In this study, we encoded seven different PLD times with the application of seven effective label durations. Many studies on cerebrovascular disease have utilized multi-delay ASL approaches to correct CBF values for arrival time [56][57][58]. It was demonstrated that the multi-delay ASL technique holds an advantage for clinical applications, particularly for patients with arterial transit time abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Cerebral perfusion variance in new daily persistent headache and chronic migraine: an arterial spin-labeled MR imaging study

et al. 2022

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Background and purpose New daily persistent headache (NDPH) and chronic migraine (CM) are two different types of headaches that might involve vascular dysregulation. There is still a lack of clarity about altered brain perfusion in NDPH and CM. This study aimed to investigate the cerebral perfusion variances of NDPH and CM using multi-delay pseudo-continuous arterial spin-labeled magnetic resonance imaging (pCASL-MRI). Methods Fifteen patients with NDPH, 18 patients with CM, and 15 age- and sex-matched healthy controls (HCs) were included. All participants underwent 3D multi-delay pCASL-MRI to obtain cerebral perfusion data, including arrival-time-corrected cerebral blood flow (CBF) and arterial cerebral blood volume (aCBV). The automated anatomical labeling atlas 3 (AAL3) was used to parcellate 170 brain regions. The CBF and aCBV values in each brain region were compared among the three groups. Correlation analyses between cerebral perfusion parameters and clinical variables were performed. Results Compared with HC participants, patients with NDPH were found to have decreased CBF and aCBV values in multiple regions in the right hemisphere, including the right posterior orbital gyrus (OFCpost.R), right middle occipital gyrus (MOG.R), and ventral anterior nucleus of right thalamus (tVA.R), while patients with CM showed increased CBF and aCBV values presenting in the ventral lateral nucleus of left thalamus (tVL.L) and right thalamus (tVL.R) compared with HCs (all p < 0.05). In patients with NDPH, after age and sex adjustment, the increased aCBV values of IFGorb. R were positively correlated with GAD-7 scores; and the increased CBF and aCBV values of tVA.R were positively correlated with disease duration. Conclusion The multi-delay pCASL technique can detect cerebral perfusion variation in patients with NDPH and CM. The cerebral perfusion changes may suggest different variations between NDPH and CM, which might provide hemodynamic evidence of these two types of primary headaches.

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Section: Discussionmentioning

confidence: 99%

Cerebral perfusion variance in new daily persistent headache and chronic migraine: an arterial spin-labeled MR imaging study

et al. 2022

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“…Studies have shown a significant CVR impairment in patients with MMD, based on ASL MRI and PET measurements following the injection of vasodilator acetazolamide ( Deckers et al, 2021 ; Zhao et al, 2022 ). These studies showed that the CBF of patients with MMD did not increase after the injection of acetazolamide, suggesting that the cerebral vessels were already at maximal vasodilation to compensate for CBF reduction.…”

Section: Vascular Smooth Muscle Cell Dysfunction and Cerebrovascular ...mentioning

confidence: 99%

Vascular smooth muscle cell dysfunction in neurodegeneration

Hayes

Pinto²,

Sparks³

et al. 2022

Front. Neurosci.

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Vascular smooth muscle cells (VSMCs) are the key moderators of cerebrovascular dynamics in response to the brain’s oxygen and nutrient demands. Crucially, VSMCs may provide a sensitive biomarker for neurodegenerative pathologies where vasculature is compromised. An increasing body of research suggests that VSMCs have remarkable plasticity and their pathophysiology may play a key role in the complex process of neurodegeneration. Furthermore, extrinsic risk factors, including environmental conditions and traumatic events can impact vascular function through changes in VSMC morphology. VSMC dysfunction can be characterised at the molecular level both preclinically, and clinically ex vivo. However the identification of VSMC dysfunction in living individuals is important to understand changes in vascular function at the onset and progression of neurological disorders such as dementia, Alzheimer’s disease, and Parkinson’s disease. A promising technique to identify changes in the state of cerebral smooth muscle is cerebrovascular reactivity (CVR) which reflects the intrinsic dynamic response of blood vessels in the brain to vasoactive stimuli in order to modulate regional cerebral blood flow (CBF). In this work, we review the role of VSMCs in the most common neurodegenerative disorders and identify physiological systems that may contribute to VSMC dysfunction. The evidence collected here identifies VSMC dysfunction as a strong candidate for novel therapeutics to combat the development and progression of neurodegeneration, and highlights the need for more research on the role of VSMCs and cerebrovascular dynamics in healthy and diseased states.

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“…Even where they have been compared to SPECT and PET, their predictive value regarding the clinical course of the disease have not yet been prospectively verified. [82][83][84][85]…”

Section: Paediatric Patientsmentioning

confidence: 99%

European Stroke Organisation (ESO) Guidelines on Moyamoya angiopathy Endorsed by Vascular European Reference Network (VASCERN)

Bersano

Khan²,

Gimeno

et al. 2023

European Stroke Journal

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The European Stroke Organisation (ESO) guidelines on Moyamoya Angiopathy (MMA), developed according to ESO standard operating procedure and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology, were compiled to assist clinicians in managing patients with MMA in their decision making. A working group involving neurologists, neurosurgeons, a geneticist and methodologists identified nine relevant clinical questions, performed systematic literature reviews and, whenever possible, meta-analyses. Quality assessment of the available evidence was made with specific recommendations. In the absence of sufficient evidence to provide recommendations, Expert Consensus Statements were formulated. Based on low quality evidence from one RCT, we recommend direct bypass surgery in adult patients with haemorrhagic presentation. For ischaemic adult patients and children, we suggest revascularization surgery using direct or combined technique rather than indirect, in the presence of haemodynamic impairment and with an interval of 6–12 weeks between the last cerebrovascular event and surgery. In the absence of robust trial, an Expert Consensus was reached recommending long-term antiplatelet therapy in non-haemorrhagic MMA, as it may reduce risk of embolic stroke. We also agreed on the utility of performing pre- and post- operative haemodynamic and posterior cerebral artery assessment. There were insufficient data to recommend systematic variant screening of RNF213 p.R4810K. Additionally, we suggest that long-term MMA neuroimaging follow up may guide therapeutic decision making by assessing the disease progression. We believe that this guideline, which is the first comprehensive European guideline on MMA management using GRADE methods will assist clinicians to choose the most effective management strategy for MMA.

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Using arterial spin labeling to measure cerebrovascular reactivity in Moyamoya disease: Insights from simultaneous PET/MRI

Cited by 18 publications

References 69 publications

Cerebral perfusion variance in new daily persistent headache and chronic migraine: an arterial spin-labeled MR imaging study

Cerebral perfusion variance in new daily persistent headache and chronic migraine: an arterial spin-labeled MR imaging study

Vascular smooth muscle cell dysfunction in neurodegeneration

European Stroke Organisation (ESO) Guidelines on Moyamoya angiopathy Endorsed by Vascular European Reference Network (VASCERN)

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