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Caldwell HG, Hoiland RL, Bain AR, Howe CA, Carr JMJR, Gibbons TD, Durrer CG, Tymko MM, Stacey BS, Bailey DM, Sekhon MS, MacLeod DB, Ainslie PN. Evidence for direct CO 2-mediated alterations in cerebral oxidative metabolism in humans. Acta Physiol (Oxf) 2024:e14197. [PMID: 38958262 DOI: 10.1111/apha.14197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024]
Abstract
AIM How the cerebral metabolic rates of oxygen and glucose utilization (CMRO2 and CMRGlc, respectively) are affected by alterations in arterial PCO2 (PaCO2) is equivocal and therefore was the primary question of this study. METHODS This retrospective analysis involved pooled data from four separate studies, involving 41 healthy adults (35 males/6 females). Participants completed stepwise steady-state alterations in PaCO2 ranging between 30 and 60 mmHg. The CMRO2 and CMRGlc were assessed via the Fick approach (CBF × arterial-internal jugular venous difference of oxygen or glucose content, respectively) utilizing duplex ultrasound of the internal carotid artery and vertebral artery to calculate cerebral blood flow (CBF). RESULTS The CMRO2 was altered by 0.5 mL × min-1 (95% CI: -0.6 to -0.3) per mmHg change in PaCO2 (p < 0.001) which corresponded to a 9.8% (95% CI: -13.2 to -6.5) change in CMRO2 with a 9 mmHg change in PaCO2 (inclusive of hypo- and hypercapnia). The CMRGlc was reduced by 7.7% (95% CI: -15.4 to -0.08, p = 0.045; i.e., reduction in net glucose uptake) and the oxidative glucose index (ratio of oxygen to glucose uptake) was reduced by 5.6% (95% CI: -11.2 to 0.06, p = 0.049) with a + 9 mmHg increase in PaCO2. CONCLUSION Collectively, the CMRO2 is altered by approximately 1% per mmHg change in PaCO2. Further, glucose is incompletely oxidized during hypercapnia, indicating reductions in CMRO2 are either met by compensatory increases in nonoxidative glucose metabolism or explained by a reduction in total energy production.
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Affiliation(s)
- Hannah G Caldwell
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Ryan L Hoiland
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
- Department of Anesthesiology, Pharmacology and Therapeutics, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Collaborative Entity for REsearching Brain Ischemia (CEREBRI), University of British Columbia, Vancouver, British Columbia, Canada
| | - Anthony R Bain
- Department of Kinesiology, Faculty of Human Kinetics, University of Windsor, Windsor, Ontario, Canada
| | - Connor A Howe
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Jay M J R Carr
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Travis D Gibbons
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Cody G Durrer
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
| | - Michael M Tymko
- Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Human Cerebrovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - Benjamin S Stacey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Damian M Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Mypinder S Sekhon
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
- Collaborative Entity for REsearching Brain Ischemia (CEREBRI), University of British Columbia, Vancouver, British Columbia, Canada
- Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - David B MacLeod
- Human Pharmacology and Physiology Lab, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
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Wehrli FW. Recent Advances in MR Imaging-based Quantification of Brain Oxygen Metabolism. Magn Reson Med Sci 2024; 23:377-403. [PMID: 38866481 PMCID: PMC11234951 DOI: 10.2463/mrms.rev.2024-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
The metabolic rate of oxygen (MRO2) is fundamental to tissue metabolism. Determination of MRO2 demands knowledge of the arterio-venous difference in hemoglobin-bound oxygen concentration, typically expressed as oxygen extraction fraction (OEF), and blood flow rate (BFR). MRI is uniquely suited for measurement of both these quantities, yielding MRO2 in absolute physiologic units of µmol O2 min-1/100 g tissue. Two approaches are discussed, both relying on hemoglobin magnetism. Emphasis will be on cerebral oxygen metabolism expressed in terms of the cerebral MRO2 (CMRO2), but translation of the relevant technologies to other organs, including kidney and placenta will be touched upon as well. The first class of methods exploits the blood's bulk magnetic susceptibility, which can be derived from field maps. The second is based on measurement of blood water T2, which is modulated by diffusion and exchange in the local-induced fields within and surrounding erythrocytes. Some whole-organ methods achieve temporal resolution adequate to permit time-series studies of brain energetics, for instance, during sleep in the scanner with concurrent electroencephalogram (EEG) sleep stage monitoring. Conversely, trading temporal for spatial resolution has led to techniques for spatially resolved approaches based on quantitative blood oxygen level dependent (BOLD) or calibrated BOLD models, allowing regional assessment of vascular-metabolic parameters, both also exploiting deoxyhemoglobin paramagnetism like their whole-organ counterparts.
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Affiliation(s)
- Felix W Wehrli
- Laboratory for Structural, Physiologic and Functional Imaging (LSPFI), Department of Radiology, Perelman School of Medicine, University Pennsylvania, Philadelphia, Pennsylvania, USA
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3
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Lee H, Xu J, Fernandez-Seara MA, Wehrli FW. Validation of a new 3D quantitative BOLD based cerebral oxygen extraction mapping. J Cereb Blood Flow Metab 2024; 44:1184-1198. [PMID: 38289876 PMCID: PMC11179617 DOI: 10.1177/0271678x231220332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 02/01/2024]
Abstract
Quantitative BOLD (qBOLD) MRI allows evaluation of oxidative metabolism of the brain based purely on an endogenous contrast mechanism. The method quantifies deoxygenated blood volume (DBV) and hemoglobin oxygen saturation level of venous blood (Yv), yielding oxygen extraction fraction (OEF), and along with a separate measurement of cerebral blood flow, cerebral metabolic rate of oxygen (CMRO2) maps. Here, we evaluated our recently reported 3D qBOLD method that rectifies a number of deficiencies in prior qBOLD approaches in terms of repeat reproducibility and sensitivity to hypercapnia on the metabolic parameters, and in comparison to dual-gas calibrated BOLD (cBOLD) MRI for determining resting-state oxygen metabolism. Results suggested no significant difference between test-retest qBOLD scans in either DBV and OEF. Exposure to hypercapnia yielded group averages of 38 and 28% for OEF and 151 and 146 µmol/min/100 g for CMRO2 in gray matter at baseline and hypercapnia, respectively. The decrease of OEF during hypercapnia was significant (p ≪ 0.01), whereas CMRO2 did not change significantly (p = 0.25). Finally, baseline OEF (37 vs. 39%) and CMRO2 (153 vs. 145 µmol/min/100 g) in gray matter using qBOLD and dual-gas cBOLD were found to be in good agreement with literature values, and were not significantly different from each other (p > 0.1).
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Affiliation(s)
- Hyunyeol Lee
- School of Electronic and Electrical Engineering, Kyungpook National University, Daegu, Republic of Korea
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jing Xu
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Maria A Fernandez-Seara
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Felix W Wehrli
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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4
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Luchkanych AMS, Morse CJ, Boyes NG, Khan MR, Marshall RA, Morton JS, Tomczak CR, Olver TD. Cerebral sympatholysis: experiments on in vivo cerebrovascular regulation and ex vivo cerebral vasomotor control. Am J Physiol Heart Circ Physiol 2024; 326:H1105-H1116. [PMID: 38391313 DOI: 10.1152/ajpheart.00714.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/13/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024]
Abstract
Whether cerebral sympathetic-mediated vasomotor control can be modulated by local brain activity remains unknown. This study tested the hypothesis that the application or removal of a cognitive task during a cold pressor test (CPT) would attenuate and restore decreases in cerebrovascular conductance (CVC), respectively. Middle cerebral artery blood velocity (transcranial Doppler) and mean arterial pressure (finger photoplethysmography) were examined in healthy adults (n = 16; 8 females and 8 males) who completed a control CPT, followed by a CPT coupled with a cognitive task administered either 1) 30 s after the onset of the CPT and for the duration of the CPT or 2) at the onset of the CPT and terminated 30 s before the end of the CPT (condition order was counterbalanced). The major finding was that the CPT decreased the index of CVC, and such decreases were abolished when a cognitive task was completed concurrently and restored when the cognitive task was removed. As a secondary experiment, vasomotor interactions between sympathetic transduction pathways (α1-adrenergic and Y1-peptidergic) and compounds implicated in cerebral blood flow control [adenosine, and adenosine triphosphate (ATP)] were explored in isolated porcine cerebral arteries (wire myography). The data reveal α1-receptor agonism potentiated vasorelaxation modestly in response to adenosine, and preexposure to ATP attenuated contractile responses to α1-agonism. Overall, the data suggest a cognitive task attenuates decreases in CVC during sympathoexcitation, possibly related to an interaction between purinergic and α1-adrenergic signaling pathways.NEW & NOTEWORTHY The present study demonstrates that the cerebrovascular conductance index decreases during sympathoexcitation and this response can be positively and negatively modulated by the application or withdrawal of a nonexercise cognitive task. Furthermore, isolated vessel experiments reveal that cerebral α1-adrenergic agonism potentiates adenosine-mediated vasorelaxation and ATP attenuates α1-adrenergic-mediated vasocontraction.
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Affiliation(s)
- Adam M S Luchkanych
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Cameron J Morse
- Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Natasha G Boyes
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - M Rafique Khan
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Rory A Marshall
- Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Jude S Morton
- Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Corey R Tomczak
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - T Dylan Olver
- Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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5
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Toader AE, Fukuda M, Vazquez AL. Evaluation of calibrated and uncalibrated optical imaging approaches for relative cerebral oxygen metabolism measurements in awake mice. Physiol Meas 2024; 45:045007. [PMID: 38569522 DOI: 10.1088/1361-6579/ad3a2d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 04/03/2024] [Indexed: 04/05/2024]
Abstract
Objective. The continuous delivery of oxygen is critical to sustain brain function, and therefore, measuring brain oxygen consumption can provide vital physiological insight. In this work, we examine the impact of calibration and cerebral blood flow (CBF) measurements on the computation of the relative changes in the cerebral metabolic rate of oxygen consumption (rCMRO2) from hemoglobin-sensitive intrinsic optical imaging data. Using these data, we calculate rCMRO2, and calibrate the model using an isometabolic stimulus.Approach. We used awake head-fixed rodents to obtain hemoglobin-sensitive optical imaging data to test different calibrated and uncalibrated rCMRO2models. Hypercapnia was used for calibration and whisker stimulation was used to test the impact of calibration.Main results. We found that typical uncalibrated models can provide reasonable estimates of rCMRO2with differences as small as 7%-9% compared to their calibrated models. However, calibrated models showed lower variability and less dependence on baseline hemoglobin concentrations. Lastly, we found that supplying the model with measurements of CBF significantly reduced error and variability in rCMRO2change calculations.Significance. The effect of calibration on rCMRO2calculations remains understudied, and we systematically evaluated different rCMRO2calculation scenarios that consider including different measurement combinations. This study provides a quantitative comparison of these scenarios to evaluate trade-offs that can be vital to the design of blood oxygenation sensitive imaging experiments for rCMRO2calculation.
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Affiliation(s)
- A E Toader
- Departments of Radiology, University of Pittsburgh, Pittsburgh PA 15217, United States of America
| | - M Fukuda
- Departments of Radiology, University of Pittsburgh, Pittsburgh PA 15217, United States of America
| | - A L Vazquez
- Departments of Radiology, University of Pittsburgh, Pittsburgh PA 15217, United States of America
- Bioengineering, University of Pittsburgh, Pittsburgh PA 15217, United States of America
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6
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Le TT, Im GH, Lee CH, Choi SH, Kim SG. Mapping cerebral perfusion in mice under various anesthesia levels using highly sensitive BOLD MRI with transient hypoxia. SCIENCE ADVANCES 2024; 10:eadm7605. [PMID: 38416820 PMCID: PMC10901365 DOI: 10.1126/sciadv.adm7605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/24/2024] [Indexed: 03/01/2024]
Abstract
Cerebral perfusion is critical for the early detection of neurological diseases and for effectively monitoring disease progression and treatment responses. Mouse models are widely used in brain research, often under anesthesia, which can affect vascular physiology. However, the impact of anesthesia on regional cerebral blood volume and flow in mice has not been thoroughly investigated. In this study, we have developed a whole-brain perfusion MRI approach by using a 5-second nitrogen gas stimulus under inhalational anesthetics to induce transient BOLD dynamic susceptibility contrast (DSC). This method proved to be highly sensitive, repeatable within each imaging session, and across four weekly sessions. Relative cerebral blood volumes measured by BOLD DSC agree well with those by contrast agents. Quantitative cerebral blood volume and flow metrics were successfully measured in mice under dexmedetomidine and various isoflurane doses using both total vasculature-sensitive gradient-echo and microvasculature-sensitive spin-echo BOLD MRI. Dexmedetomidine reduces cerebral perfusion, while isoflurane increases cerebral perfusion in a dose-dependent manner.
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Affiliation(s)
- Thuy Thi Le
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, Republic of Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Republic of Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea
| | - Geun Ho Im
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, Republic of Korea
| | - Chan Hee Lee
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, Republic of Korea
| | - Sang Han Choi
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, Republic of Korea
| | - Seong-Gi Kim
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, Republic of Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Republic of Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea
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7
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Yun SD, Küppers F, Shah NJ. Submillimeter fMRI Acquisition Techniques for Detection of Laminar and Columnar Level Brain Activation. J Magn Reson Imaging 2024; 59:747-766. [PMID: 37589385 DOI: 10.1002/jmri.28911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 08/18/2023] Open
Abstract
Since the first demonstration in the early 1990s, functional MRI (fMRI) has emerged as one of the most powerful, noninvasive neuroimaging tools to probe brain functions. Subsequently, fMRI techniques have advanced remarkably, enabling the acquisition of functional signals with a submillimeter voxel size. This innovation has opened the possibility of investigating subcortical neural activities with respect to the cortical depths or cortical columns. For this purpose, numerous previous works have endeavored to design suitable functional contrast mechanisms and dedicated imaging techniques. Depending on the choice of the functional contrast, functional signals can be detected with high sensitivity or with improved spatial specificity to the actual activation site, and the pertaining issues have been discussed in a number of earlier works. This review paper primarily aims to provide an overview of the subcortical fMRI techniques that allow the acquisition of functional signals with a submillimeter resolution. Here, the advantages and disadvantages of the imaging techniques will be described and compared. We also summarize supplementary imaging techniques that assist in the analysis of the subcortical brain activation for more accurate mapping with reduced geometric deformation. This review suggests that there is no single universally accepted method as the gold standard for subcortical fMRI. Instead, the functional contrast and the corresponding readout imaging technique should be carefully determined depending on the purpose of the study. Due to the technical limitations of current fMRI techniques, most subcortical fMRI studies have only targeted partial brain regions. As a future prospect, the spatiotemporal resolution of fMRI will be pushed to satisfy the community's need for a deeper understanding of whole-brain functions and the underlying connectivity in order to achieve the ultimate goal of a time-resolved and layer-specific spatial scale. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Seong Dae Yun
- Institute of Neuroscience and Medicine 4, INM-4, Forschungszentrum Jülich, Jülich, Germany
| | - Fabian Küppers
- Institute of Neuroscience and Medicine 4, INM-4, Forschungszentrum Jülich, Jülich, Germany
- RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine 11, INM-11, JARA, Forschungszentrum Jülich, Jülich, Germany
| | - N Jon Shah
- Institute of Neuroscience and Medicine 4, INM-4, Forschungszentrum Jülich, Jülich, Germany
- Institute of Neuroscience and Medicine 11, INM-11, JARA, Forschungszentrum Jülich, Jülich, Germany
- JARA - BRAIN - Translational Medicine, Aachen, Germany
- Department of Neurology, RWTH Aachen University, Aachen, Germany
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8
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Choi MH, Kim KB, Kim YJ, Kim JS, Kim HS, Yi JH, Chung SC. Changes in the BOLD signal of S1 and BA3 per finger/phalanx as a response to high-frequency vibratory stimulation. Somatosens Mot Res 2024; 41:48-55. [PMID: 36721377 DOI: 10.1080/08990220.2023.2173165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/23/2023] [Indexed: 02/02/2023]
Abstract
PURPOSE AND METHOD The purpose of this study was to determine the changes in the Blood Oxygen Level Dependent signal of Primary somatosensory area (S1) and Brodmann area 3 (BA3) per finger and phalanx in comparison to the activation voxel when 250 Hz vibratory stimulation with high sensitivity for the Pacinian corpuscle was given to the four fingers and three phalanges. RESULTS The result of analyzing the activation voxel showed a significant difference for S1 per finger and phalanx, but for BA3, no significant difference was observed despite a similar trend to S1. In contrast, the activation intensity (BOLD) displayed a significant difference for S1 per finger and phalanx and for BA3, where the activation voxel had no significant variation. In addition, while the result of S1 did not indicate whether the index or the little fingers had the highest sensitivity based on the BOLD signal per finger, the result of BA3 marked the strongest BOLD signal for the little finger as a response to 250 Hz vibratory stimulation. The activation intensity per phalanx was the highest for the intermediate phalanx for S1 and BA3, which was in line with a previous study comparing the activation voxel. CONCLUSIONS The method based on the intensity of the nerve activation is presumed to have high sensitivity as the signal intensity is monitored within a specific, defined area. Thus, for the extraction of brain activation patterns of micro-domains, such as BA3, monitoring the BOLD signal that reflects the nerve activation intensity more sensitively is likely to be advantageous.
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Affiliation(s)
- Mi-Hyun Choi
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, School of ICT Convergence Engineering, College of Science & Technology, Konkuk University, Chungju, South Korea
| | - Kyu-Beom Kim
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, School of ICT Convergence Engineering, College of Science & Technology, Konkuk University, Chungju, South Korea
| | - Ye-Jin Kim
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, School of ICT Convergence Engineering, College of Science & Technology, Konkuk University, Chungju, South Korea
| | - Ji-Su Kim
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, School of ICT Convergence Engineering, College of Science & Technology, Konkuk University, Chungju, South Korea
| | - Hyung-Sik Kim
- Department of Mechatronics Engineering, School of ICT Convergence Engineering, College of Science & Technology, Konkuk University, Chungju, South Korea
| | - Jeong-Han Yi
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, School of ICT Convergence Engineering, College of Science & Technology, Konkuk University, Chungju, South Korea
| | - Soon-Cheol Chung
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, School of ICT Convergence Engineering, College of Science & Technology, Konkuk University, Chungju, South Korea
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9
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Buxton RB. Thermodynamic limitations on brain oxygen metabolism: physiological implications. J Physiol 2024; 602:683-712. [PMID: 38349000 DOI: 10.1113/jp284358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/03/2024] [Indexed: 02/20/2024] Open
Abstract
Recent thermodynamic modelling indicates that maintaining the brain tissue ratio of O2 to CO2 (abbreviated tissue O2 /CO2 ) is critical for preserving the entropy increase available from oxidative metabolism of glucose, with a fall of that available entropy leading to a reduction of the phosphorylation potential and impairment of brain energy metabolism. This provides a novel perspective for understanding physiological responses under different conditions in terms of preserving tissue O2 /CO2 . To enable estimation of tissue O2 /CO2 in the human brain, a detailed mathematical model of O2 and CO2 transport was developed, and applied to reported physiological responses to different challenges, asking: how well is tissue O2 /CO2 preserved? Reported experimental results for increased neural activity, hypercapnia and hypoxia due to high altitude are consistent with preserving tissue O2 /CO2 . The results highlight two physiological mechanisms that control tissue O2 /CO2 : cerebral blood flow, which modulates tissue O2 ; and ventilation rate, which modulates tissue CO2 . The hypoxia modelling focused on humans at high altitude, including acclimatized lowlanders and Tibetan and Andean adapted populations, with a primary finding that decreasing CO2 by increasing ventilation rate is more effective for preserving tissue O2 /CO2 than increasing blood haemoglobin content to maintain O2 delivery to tissue. This work focused on the function served by particular physiological responses, and the underlying mechanisms require further investigation. The modelling provides a new framework and perspective for understanding how blood flow and other physiological factors support energy metabolism in the brain under a wide range of conditions. KEY POINTS: Thermodynamic modelling indicates that preserving the O2 /CO2 ratio in brain tissue is critical for preserving the entropy change available from oxidative metabolism of glucose and the phosphorylation potential underlying energy metabolism. A detailed model of O2 and CO2 transport was developed to allow estimation of the tissue O2 /CO2 ratio in the human brain in different physiological states. Reported experimental results during hypoxia, hypercapnia and increased oxygen metabolic rate in response to increased neural activity are consistent with maintaining brain tissue O2 /CO2 ratio. The hypoxia modelling of high-altitude acclimatization and adaptation in humans demonstrates the critical role of reducing CO2 with increased ventilation for preserving tissue O2 /CO2 . Preservation of tissue O2 /CO2 provides a novel perspective for understanding the function of observed physiological responses under different conditions in terms of preserving brain energy metabolism, although the mechanisms underlying these functions are not well understood.
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Affiliation(s)
- Richard B Buxton
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California, San Diego, California, USA
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10
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Mikulis DJ. Cerebrovascular Reserve Imaging: Problems and Solutions. Magn Reson Imaging Clin N Am 2024; 32:93-109. [PMID: 38007286 DOI: 10.1016/j.mric.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
The current standard of practice for assessing patients with cerebrovascular steno-occlusive disease is based on measuring resting blood flow metrics using MR imaging and CT perfusion imaging. However, the reliability of these methods decreases as the degree and number of stenoses increase. The reason for this is that measures of adequate baseline blood flow in highly collateralized circulations do not account for possible shortfalls in recruitable blood flow or increased metabolic demand. The following offers a clinically tested solution for this purpose using cerebrovascular reactivity methodology that applies a quantifiable vasodilatory stimulus improving reproducibility and repeatability essential for optimizing patient management.
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Affiliation(s)
- David J Mikulis
- The Krembil Brain Institute, Institute of Medcial Science, Department of Medical Imaging, The University of Toronto, The University Health Network, The Toronto Western Hospital, 399 Bathurst Street, Room 3MC-431, Toronto, ON M5T 2S8, Canada.
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11
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Highton D, Caldwell M, Tachtsidis I, Elwell CE, Smith M, Cooper CE. The influence of carbon dioxide on cerebral metabolism and oxygen consumption: combining multimodal monitoring with dynamic systems modelling. Biol Open 2024; 13:bio060087. [PMID: 38180242 PMCID: PMC10810564 DOI: 10.1242/bio.060087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/22/2023] [Indexed: 01/06/2024] Open
Abstract
Hypercapnia increases cerebral blood flow. The effects on cerebral metabolism remain incompletely understood although studies show an oxidation of cytochrome c oxidase, Complex IV of the mitochondrial respiratory chain. Systems modelling was combined with previously published non-invasive measurements of cerebral tissue oxygenation, cerebral blood flow, and cytochrome c oxidase redox state to evaluate any metabolic effects of hypercapnia. Cerebral tissue oxygen saturation and cytochrome oxidase redox state were measured with broadband near infrared spectroscopy and cerebral blood flow velocity with transcranial Doppler ultrasound. Data collected during 5-min hypercapnia in awake human volunteers were analysed using a Fick model to determine changes in brain oxygen consumption and a mathematical model of cerebral hemodynamics and metabolism (BrainSignals) to inform on mechanisms. Either a decrease in metabolic substrate supply or an increase in metabolic demand modelled the cytochrome oxidation in hypercapnia. However, only the decrease in substrate supply explained both the enzyme redox state changes and the Fick-calculated drop in brain oxygen consumption. These modelled outputs are consistent with previous reports of CO2 inhibition of mitochondrial succinate dehydrogenase and isocitrate dehydrogenase. Hypercapnia may have physiologically significant effects suppressing oxidative metabolism in humans and perturbing mitochondrial signalling pathways in health and disease.
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Affiliation(s)
- David Highton
- Neurocritical Care Unit, University College London Hospitals, National Hospital for Neurology & Neurosurgery, London WC1N 3BG, UK
- Princess Alexandra Hospital Southside Clinical Unit, University of Queensland, Brisbane QLD 4102, Australia
| | - Matthew Caldwell
- Department of Medical Physics and Biomedical Engineering, University College London, Malet Place Engineering Building, London WC1E 6BT, UK
| | - Ilias Tachtsidis
- Department of Medical Physics and Biomedical Engineering, University College London, Malet Place Engineering Building, London WC1E 6BT, UK
| | - Clare E. Elwell
- Department of Medical Physics and Biomedical Engineering, University College London, Malet Place Engineering Building, London WC1E 6BT, UK
| | - Martin Smith
- Neurocritical Care Unit, University College London Hospitals, National Hospital for Neurology & Neurosurgery, London WC1N 3BG, UK
- Department of Medical Physics and Biomedical Engineering, University College London, Malet Place Engineering Building, London WC1E 6BT, UK
| | - Chris E. Cooper
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, UK
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12
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Biondetti E, Chiarelli AM, Germuska M, Lipp I, Villani A, Caporale AS, Patitucci E, Murphy K, Tomassini V, Wise RG. Breath-hold BOLD fMRI without CO 2 sampling enables estimation of venous cerebral blood volume: potential use in normalization of stimulus-evoked BOLD fMRI data. Neuroimage 2024; 285:120492. [PMID: 38070840 DOI: 10.1016/j.neuroimage.2023.120492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 10/30/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024] Open
Abstract
BOLD fMRI signal has been used in conjunction with vasodilatory stimulation as a marker of cerebrovascular reactivity (CVR): the relative change in cerebral blood flow (CBF) arising from a unit change in the vasodilatory stimulus. Using numerical simulations, we demonstrate that the variability in the relative BOLD signal change induced by vasodilation is strongly influenced by the variability in deoxyhemoglobin-containing cerebral blood volume (CBV), as this source of variability is likely to be more prominent than that of CVR. It may, therefore, be more appropriate to describe the relative BOLD signal change induced by an isometabolic vasodilation as a proxy of deoxygenated CBV (CBVdHb) rather than CVR. With this in mind, a new method was implemented to map a marker of CBVdHb, termed BOLD-CBV, based on the normalization of voxel-wise BOLD signal variation by an estimate of the intravascular venous BOLD signal from voxels filled with venous blood. The intravascular venous BOLD signal variation, recorded during repeated breath-holding, was extracted from the superior sagittal sinus in a cohort of 27 healthy volunteers and used as a regressor across the whole brain, yielding maps of BOLD-CBV. In the same cohort, we demonstrated the potential use of BOLD-CBV for the normalization of stimulus-evoked BOLD fMRI by comparing group-level BOLD fMRI responses to a visuomotor learning task with and without the inclusion of voxel-wise vascular covariates of BOLD-CBV and the BOLD signal change per mmHg variation in end-tidal carbon dioxide (BOLD-CVR). The empirical measure of BOLD-CBV accounted for more between-subject variability in the motor task-induced BOLD responses than BOLD-CVR estimated from end-tidal carbon dioxide recordings. The new method can potentially increase the power of group fMRI studies by including a measure of vascular characteristics and has the strong practical advantage of not requiring experimental measurement of end-tidal carbon dioxide, unlike traditional methods to estimate BOLD-CVR. It also more closely represents a specific physiological characteristic of brain vasculature than BOLD-CVR, namely blood volume.
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Affiliation(s)
- Emma Biondetti
- Department of Neurosciences, Imaging, and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy.
| | - Antonio Maria Chiarelli
- Department of Neurosciences, Imaging, and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Michael Germuska
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Physics and Astronomy, Cardiff University, Cardiff, United Kingdom
| | - Ilona Lipp
- Department of Neurophysics, Max Planck Institute for Human Cognitive & Brain Sciences, Leipzig, Germany; Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Alessandro Villani
- Department of Neurosciences, Imaging, and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Alessandra S Caporale
- Department of Neurosciences, Imaging, and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Eleonora Patitucci
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
| | - Kevin Murphy
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Physics and Astronomy, Cardiff University, Cardiff, United Kingdom
| | - Valentina Tomassini
- Department of Neurosciences, Imaging, and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK; MS Centre, Neurology Unit, 'SS. Annunziata' University Hospital, Chieti, Italy; Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK; Helen Durham Centre for Neuroinflammation, University Hospital of Wales, Cardiff, UK
| | - Richard G Wise
- Department of Neurosciences, Imaging, and Clinical Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy; Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
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Grijalva C, Mullins VA, Michael BR, Hale D, Wu L, Toosizadeh N, Chilton FH, Laksari K. Neuroimaging, wearable sensors, and blood-based biomarkers reveal hyperacute changes in the brain after sub-concussive impacts. BRAIN MULTIPHYSICS 2023; 5:100086. [PMID: 38292249 PMCID: PMC10827333 DOI: 10.1016/j.brain.2023.100086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Impacts in mixed martial arts (MMA) have been studied mainly in regard to the long-term effects of concussions. However, repetitive sub-concussive head impacts at the hyperacute phase (minutes after impact), are not understood. The head experiences rapid acceleration similar to a concussion, but without clinical symptoms. We utilize portable neuroimaging technology - transcranial Doppler (TCD) ultrasound and functional near infrared spectroscopy (fNIRS) - to estimate the extent of pre- and post-differences following contact and non-contact sparring sessions in nine MMA athletes. In addition, the extent of changes in neurofilament light (NfL) protein biomarker concentrations, and neurocognitive/balance parameters were determined following impacts. Athletes were instrumented with sensor-based mouth guards to record head kinematics. TCD and fNIRS results demonstrated significantly increased blood flow velocity (p = 0.01) as well as prefrontal (p = 0.01) and motor cortex (p = 0.04) oxygenation, only following the contact sparring sessions. This increase after contact was correlated with the cumulative angular acceleration experienced during impacts (p = 0.01). In addition, the NfL biomarker demonstrated positive correlations with angular acceleration (p = 0.03), and maximum principal and fiber strain (p = 0.01). On average athletes experienced 23.9 ± 2.9 g peak linear acceleration, 10.29 ± 1.1 rad/s peak angular velocity, and 1,502.3 ± 532.3 rad/s2 angular acceleration. Balance parameters were significantly increased following contact sparring for medial-lateral (ML) center of mass (COM) sway, and ML ankle angle (p = 0.01), illustrating worsened balance. These combined results reveal significant changes in brain hemodynamics and neurophysiological parameters that occur immediately after sub-concussive impacts and suggest that the physical impact to the head plays an important role in these changes.
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Affiliation(s)
- Carissa Grijalva
- University of Arizona, Department of Biomedical Engineering, Tucson, AZ, United States
| | - Veronica A. Mullins
- University of Arizona, School of Nutritional Sciences and Wellness, Tucson, AZ, United States
| | - Bryce R. Michael
- University of Arizona, School of Nutritional Sciences and Wellness, Tucson, AZ, United States
| | - Dallin Hale
- University of Arizona, Department of Physiology, Tucson, AZ, United States
| | - Lyndia Wu
- Univerisity of British Columbia, Department of Mechanical Engineering, Vancouver, BC, Canada
| | - Nima Toosizadeh
- University of Arizona, Department of Biomedical Engineering, Tucson, AZ, United States
- University of Arizona, Department of Medicine, Arizona Center for Aging, Tucson, AZ, United States
| | - Floyd H. Chilton
- University of Arizona, School of Nutritional Sciences and Wellness, Tucson, AZ, United States
| | - Kaveh Laksari
- University of Arizona, Department of Biomedical Engineering, Tucson, AZ, United States
- University of Arizona, Department of Aerospace and Mechanical Engineering, Tucson, AZ, United States
- University of California Riverside, Department of Mechanical Engineering, Riverside, CA, United States
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14
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Bohraus Y, Merkle H, Logothetis NK, Goense J. Laminar differences in functional oxygen metabolism in monkey visual cortex measured with calibrated fMRI. Cell Rep 2023; 42:113341. [PMID: 37897728 DOI: 10.1016/j.celrep.2023.113341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/23/2023] [Accepted: 10/10/2023] [Indexed: 10/30/2023] Open
Abstract
Blood-oxygenation-level-dependent functional magnetic resonance imaging (BOLD fMRI) of cortical layers relies on the hemodynamic response and is biased toward large veins on the cortical surface. Functional changes in the cerebral metabolic rate of oxygen (ΔCMRO2) may reflect neural cortical function better than BOLD fMRI, but it is unknown whether the calibrated BOLD model for functional CMRO2 measurement remains valid at high resolution. Here, we measure laminar ΔCMRO2 elicited by visual stimulation in macaque primary visual cortex (V1) and find that ΔCMRO2 peaks in the middle of the cortex, in agreement with autoradiographic measures of metabolism. ΔCMRO2 values in gray matter are similar as found previously. Reductions in CMRO2 are associated with veins at the cortical surface, suggesting that techniques for vein removal may improve the accuracy of the model at very high resolution. However, our results show feasibility of laminar ΔCMRO2 measurement, providing a physiologically meaningful metric of laminar functional metabolism.
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Affiliation(s)
- Yvette Bohraus
- Department of Physiology of Cognitive Processes, Max-Planck Institute for Biological Cybernetics, 72076 Tübingen, Germany
| | | | - Nikos K Logothetis
- Department of Physiology of Cognitive Processes, Max-Planck Institute for Biological Cybernetics, 72076 Tübingen, Germany; Department of Physiology of Cognitive Processes, International Center for Primate Brain Research, Songjiang District, Shanghai 201602, China; Centre for Imaging Sciences, University of Manchester, Manchester M13 9PT, UK
| | - Jozien Goense
- Department of Physiology of Cognitive Processes, Max-Planck Institute for Biological Cybernetics, 72076 Tübingen, Germany; Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana-Champaign, Urbana, IL 61801, USA; Department of Psychology, University of Illinois, Urbana-Champaign, Champaign, IL 61820, USA; Department of Bioengineering, University of Illinois, Urbana-Champaign, Urbana, IL 61801, USA; Neuroscience Program, University of Illinois, Urbana-Champaign, Urbana, IL 61801, USA.
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Woodward OB, Driver I, Schwarz ST, Hart E, Wise R. Assessment of brainstem function and haemodynamics by MRI: challenges and clinical prospects. Br J Radiol 2023; 96:20220940. [PMID: 37721043 PMCID: PMC10607409 DOI: 10.1259/bjr.20220940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 04/25/2023] [Accepted: 05/24/2023] [Indexed: 09/19/2023] Open
Abstract
MRI offers techniques for non-invasively measuring a range of aspects of brain tissue function. Blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) is widely used to assess neural activity, based on the brain's haemodynamic response, while arterial spin labelling (ASL) MRI is a non-invasive method of quantitatively mapping cerebral perfusion. Both techniques can be applied to measure cerebrovascular reactivity (CVR), an important marker of the health of the cerebrovascular system. BOLD, ASL and CVR have been applied to study a variety of disease processes and are already used in certain clinical circumstances. The brainstem is a critical component of the central nervous system and is implicated in a variety of disease processes. However, its function is difficult to study using MRI because of its small size and susceptibility to physiological noise. In this article, we review the physical and biological underpinnings of BOLD and ASL and their application to measure CVR, discuss the challenges associated with applying them to the brainstem and the opportunities for brainstem MRI in the research and clinical settings. With further optimisation, functional MRI techniques could feasibly be used to assess brainstem haemodynamics and neural activity in the clinical setting.
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Affiliation(s)
- Owen Bleddyn Woodward
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, United Kingdom
| | - Ian Driver
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, United Kingdom
| | | | - Emma Hart
- University of Bristol, Bristol, United Kingdom
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van Niftrik CHB, Hiller A, Sebök M, Halter M, Duffin J, Fisher JA, Mikulis DJ, Regli L, Piccirelli M, Fierstra J. Heterogeneous motor BOLD-fMRI responses in brain areas exhibiting negative BOLD cerebrovascular reactivity indicate that steal phenomenon does not always result from exhausted cerebrovascular reserve capacity. Magn Reson Imaging 2023; 103:124-130. [PMID: 37481092 DOI: 10.1016/j.mri.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/11/2023] [Accepted: 07/19/2023] [Indexed: 07/24/2023]
Abstract
INTRODUCTION Brain areas exhibiting negative blood oxygenation-level dependent cerebrovascular reactivity (BOLD-CVR) responses to carbon dioxide (CO2) are thought to suffer from a completely exhausted autoregulatory cerebrovascular reserve capacity and exhibit vascular steal phenomenon. If this assumption is correct, the presence of vascular steal phenomenon should subsequently result in an equal negative fMRI signal response during a motor-task based BOLD-fMRI study (increase in metabolism without an increase in cerebral blood flow due to exhausted reserve capacity) in otherwise functional brain tissue. To investigate this premise, the aim of this study was to further investigate motor-task based BOLD-fMRI signal responses in brain areas exhibiting negative BOLD-CVR. MATERIAL AND METHODS Seventy-one datasets of patients with cerebrovascular steno-occlusive disease without motor defects, who underwent a CO2-calibrated motor task-based BOLD-fMRI study with a fingertapping paradigm and a subsequent BOLD-CVR study with a precisely controlled CO2-challenge during the same MRI examination, were included. We compared BOLD-fMRI signal responses in the bilateral pre- and postcentral gyri - i.e. Region of Interest (ROI) with the corresponding BOLD-CVR in this ROI. The ROI was determined using a second level group analysis of the BOLD-fMRI task study of 42 healthy individuals undergoing the same study protocol. RESULTS An overall decrease in BOLD-CVR was associated with a decrease in BOLD-fMRI signal response within the ROI. For patients exhibiting negative BOLD-CVR, we found both positive and negative motor-task based BOLD-fMRI signal responses. CONCLUSION We show that the presence of negative BOLD-CVR responses to CO2 is associated with heterogeneous motor task-based BOLD-fMRI signal responses, where some patients show -more presumed- negative BOLD-fMRI signal responses, while other patient showed positive BOLD-fMRI signal responses. This finding may indicate that the autoregulatory vasodilatory reserve capacity does not always need to be completely exhausted for vascular steal phenomenon to occur.
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Affiliation(s)
- Christiaan Hendrik Bas van Niftrik
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Switzerland.
| | - Aimée Hiller
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Switzerland; Department of Abdominal and Transplant Surgery, University Hospital Zurich, University of Zurich. Switzerland
| | - Martina Sebök
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Switzerland
| | - Matthias Halter
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Switzerland
| | - James Duffin
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Joseph A Fisher
- Department of Anesthesia and Pain Management, University Health Network, Toronto, ON, Canada.; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - David J Mikulis
- Joint Department of Medical Imaging and the Functional Neuroimaging Laboratory, University Health Network, Toronto, ON, Canada
| | - Luca Regli
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Switzerland
| | - Marco Piccirelli
- Clinical Neuroscience Center, University Hospital Zurich, Switzerland; Department of Neuroradiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Jorn Fierstra
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Switzerland
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17
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Tozzi A. Laws of taxation for multicellular organisms: The economics of sleep. Biosystems 2023; 232:105018. [PMID: 37666410 DOI: 10.1016/j.biosystems.2023.105018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 09/06/2023]
Abstract
In macro-public finance, the Ramsey rule (RR) concerns variable taxation to maximize social welfare and economic efficiency in a purely competitive monopolistic system. To extract tax revenue with the least loss of utility to the representative individual, RR dictates that optimal, proportionate taxes should be such as to diminish in the same proportion the production of each commodity taxed. The sources of supply that are inelastic, i.e., necessities/utilities, must be taxed more. We hypothesize that the Ramsey's economical approach might provide a general mechanism to investigate far-flung biological issues, such as preys/predators dynamics, food restriction in ecological niches, local changes in blood flow in rival or complementary organs of multicellular organisms. In particular, RR suggests a quantifiable relationship between the physiological decrease in cortical spike frequency occurring during sleep and energy consumption. Since small decreases in spike frequency during sleep are correlated with large decreases in the amount of consumed ATP, the brain could be considered an inelastic commodity which can be "taxed" more than other organs, allowing the whole organism to spare energy. Shedding light on the energy budget of the central nervous system, RR improves our knowledge of cerebral perfusion during sensory-evoked responses and tissue hypoxia caused by decreased blood flow, suggesting that energy from outside can be provided to counteract brain ischemia. In sum, the economical approach provided by Ramsey stands for a useful methodological tool that could be used in biological contexts to investigate the dynamical correlations among different organs in multicellular organisms.
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Affiliation(s)
- Arturo Tozzi
- Center for Nonlinear Science, Department of Physics, University of North Texas, 1155 Union Circle, #311427, Denton, TX, 76203-5017, USA.
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18
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Theriault JE, Shaffer C, Dienel GA, Sander CY, Hooker JM, Dickerson BC, Barrett LF, Quigley KS. A functional account of stimulation-based aerobic glycolysis and its role in interpreting BOLD signal intensity increases in neuroimaging experiments. Neurosci Biobehav Rev 2023; 153:105373. [PMID: 37634556 PMCID: PMC10591873 DOI: 10.1016/j.neubiorev.2023.105373] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/28/2023] [Accepted: 08/23/2023] [Indexed: 08/29/2023]
Abstract
In aerobic glycolysis, oxygen is abundant, and yet cells metabolize glucose without using it, decreasing their ATP per glucose yield by 15-fold. During task-based stimulation, aerobic glycolysis occurs in localized brain regions, presenting a puzzle: why produce ATP inefficiently when, all else being equal, evolution should favor the efficient use of metabolic resources? The answer is that all else is not equal. We propose that a tradeoff exists between efficient ATP production and the efficiency with which ATP is spent to transmit information. Aerobic glycolysis, despite yielding little ATP per glucose, may support neuronal signaling in thin (< 0.5 µm), information-efficient axons. We call this the efficiency tradeoff hypothesis. This tradeoff has potential implications for interpretations of task-related BOLD "activation" observed in fMRI. We hypothesize that BOLD "activation" may index local increases in aerobic glycolysis, which support signaling in thin axons carrying "bottom-up" information, or "prediction error"-i.e., the BIAPEM (BOLD increases approximate prediction error metabolism) hypothesis. Finally, we explore implications of our hypotheses for human brain evolution, social behavior, and mental disorders.
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Affiliation(s)
- Jordan E Theriault
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
| | - Clare Shaffer
- Northeastern University, Department of Psychology, Boston, MA, USA
| | - Gerald A Dienel
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Department of Cell Biology and Physiology, University of New Mexico, Albuquerque, NM, USA
| | - Christin Y Sander
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Jacob M Hooker
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Bradford C Dickerson
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Lisa Feldman Barrett
- Northeastern University, Department of Psychology, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Karen S Quigley
- Northeastern University, Department of Psychology, Boston, MA, USA; VA Bedford Healthcare System, Bedford, MA, USA
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19
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Grijalva C, Hale D, Wu L, Toosizadeh N, Laksari K. Hyper-acute effects of sub-concussive soccer headers on brain function and hemodynamics. Front Hum Neurosci 2023; 17:1191284. [PMID: 37780960 PMCID: PMC10538631 DOI: 10.3389/fnhum.2023.1191284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Sub-concussive head impacts in soccer are drawing increasing research attention regarding their acute and long-term effects as players may experience thousands of headers in a single season. During these impacts, the head experiences rapid acceleration similar to what occurs during a concussion, but without the clinical implications. The physical mechanism and response to repetitive impacts are not completely understood. The objective of this work was to examine the immediate functional outcomes of sub-concussive level impacts from soccer heading in a natural, non-laboratory environment. Methods Twenty university level soccer athletes were instrumented with sensor-mounted bite bars to record impacts from 10 consecutive soccer headers. Pre- and post-header measurements were collected to determine hyper-acute changes, i.e., within minutes after exposure. This included measuring blood flow velocity using transcranial Doppler (TCD) ultrasound, oxyhemoglobin concentration using functional near infrared spectroscopy imaging (fNIRS), and upper extremity dual-task (UEF) neurocognitive testing. Results On average, the athletes experienced 30.7 ± 8.9 g peak linear acceleration and 7.2 ± 3.1 rad/s peak angular velocity, respectively. Results from fNIRS measurements showed an increase in the brain oxygenation for the left prefrontal cortex (PC) (p = 0.002), and the left motor cortex (MC) (p = 0.007) following the soccer headers. Additional analysis of the fNIRS time series demonstrates increased sample entropy of the signal after the headers in the right PC (p = 0.02), right MC (p = 0.004), and left MC (p = 0.04). Discussion These combined results reveal some variations in brain oxygenation immediately detected after repetitive headers. Significant changes in balance and neurocognitive function were not observed in this study, indicating a mild level of head impacts. This is the first study to observe hemodynamic changes immediately after sub-concussive impacts using non-invasive portable imaging technology. In combination with head kinematic measurements, this information can give new insights and a framework for immediate monitoring of sub-concussive impacts on the head.
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Affiliation(s)
- Carissa Grijalva
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States
| | - Dallin Hale
- Department of Physiology, University of Arizona, Tucson, AZ, United States
| | - Lyndia Wu
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Nima Toosizadeh
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States
- Arizona Center for Aging, Department of Medicine, University of Arizona, Tucson, AZ, United States
| | - Kaveh Laksari
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States
- Department of Aerospace and Mechanical Engineering, University of Arizona, Tucson, AZ, United States
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20
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Agarwal S, Welker KM, Black DF, Little JT, DeLone DR, Messina SA, Passe TJ, Bettegowda C, Pillai JJ. Detection and Mitigation of Neurovascular Uncoupling in Brain Gliomas. Cancers (Basel) 2023; 15:4473. [PMID: 37760443 PMCID: PMC10527022 DOI: 10.3390/cancers15184473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
Functional magnetic resonance imaging (fMRI) with blood oxygen level-dependent (BOLD) technique is useful for preoperative mapping of brain functional networks in tumor patients, providing reliable in vivo detection of eloquent cortex to help reduce the risk of postsurgical morbidity. BOLD task-based fMRI (tb-fMRI) is the most often used noninvasive method that can reliably map cortical networks, including those associated with sensorimotor, language, and visual functions. BOLD resting-state fMRI (rs-fMRI) is emerging as a promising ancillary tool for visualization of diverse functional networks. Although fMRI is a powerful tool that can be used as an adjunct for brain tumor surgery planning, it has some constraints that should be taken into consideration for proper clinical interpretation. BOLD fMRI interpretation may be limited by neurovascular uncoupling (NVU) induced by brain tumors. Cerebrovascular reactivity (CVR) mapping obtained using breath-hold methods is an effective method for evaluating NVU potential.
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Affiliation(s)
- Shruti Agarwal
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
| | - Kirk M. Welker
- Division of Neuroradiology, Department of Radiology, Mayo Clinic Rochester & Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA; (K.M.W.); (D.F.B.); (J.T.L.); (D.R.D.); (S.A.M.); (T.J.P.)
| | - David F. Black
- Division of Neuroradiology, Department of Radiology, Mayo Clinic Rochester & Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA; (K.M.W.); (D.F.B.); (J.T.L.); (D.R.D.); (S.A.M.); (T.J.P.)
| | - Jason T. Little
- Division of Neuroradiology, Department of Radiology, Mayo Clinic Rochester & Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA; (K.M.W.); (D.F.B.); (J.T.L.); (D.R.D.); (S.A.M.); (T.J.P.)
| | - David R. DeLone
- Division of Neuroradiology, Department of Radiology, Mayo Clinic Rochester & Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA; (K.M.W.); (D.F.B.); (J.T.L.); (D.R.D.); (S.A.M.); (T.J.P.)
| | - Steven A. Messina
- Division of Neuroradiology, Department of Radiology, Mayo Clinic Rochester & Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA; (K.M.W.); (D.F.B.); (J.T.L.); (D.R.D.); (S.A.M.); (T.J.P.)
| | - Theodore J. Passe
- Division of Neuroradiology, Department of Radiology, Mayo Clinic Rochester & Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA; (K.M.W.); (D.F.B.); (J.T.L.); (D.R.D.); (S.A.M.); (T.J.P.)
| | - Chetan Bettegowda
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
| | - Jay J. Pillai
- Division of Neuroradiology, Department of Radiology, Mayo Clinic Rochester & Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA; (K.M.W.); (D.F.B.); (J.T.L.); (D.R.D.); (S.A.M.); (T.J.P.)
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
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21
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Uludağ K. Physiological modeling of the BOLD signal and implications for effective connectivity: A primer. Neuroimage 2023; 277:120249. [PMID: 37356779 DOI: 10.1016/j.neuroimage.2023.120249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/12/2023] [Accepted: 06/23/2023] [Indexed: 06/27/2023] Open
Abstract
In this primer, I provide an overview of the physiological processes that contribute to the observed BOLD signal (i.e., the generative biophysical model), including their time course properties within the framework of the physiologically-informed dynamic causal modeling (P-DCM). The BOLD signal is primarily determined by the change in paramagnetic deoxygenated hemoglobin, which results from combination of changes in oxygen metabolism, and cerebral blood flow and volume. Specifically, the physiological origin of the so-called BOLD signal "transients" will be discussed, including the initial overshoot, steady-state activation and the post-stimulus undershoot. I argue that incorrect physiological assumptions in the generative model of the BOLD signal can lead to incorrect inferences pertaining to both local neuronal activity and effective connectivity between brain regions. In addition, I introduce the recent laminar BOLD signal model, which extends P-DCM to cortical depths-resolved BOLD signals, allowing for laminar neuronal activity to be determined using high-resolution fMRI data.
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Affiliation(s)
- Kâmil Uludağ
- Krembil Brain Institute, University Health Network Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Center for Neuroscience Imaging Research, Institute for Basic Science & Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Republic of Korea.
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22
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Song H, Fisher J, Özen AC, Akin B, Schumann S, Bock M. Quantification of regional CMRO 2 in human brain using dynamic 17O-MRI at 3T. Z Med Phys 2023:S0939-3889(23)00086-7. [PMID: 37558527 DOI: 10.1016/j.zemedi.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE To investigate the feasibility of cerebral metabolic rate of oxygen consumption (CMRO2) measurements with MRI at 3 Tesla in different brain regions. METHODS CMRO2 represents a key indicator of the physiological state of brain tissue. Dynamic 17O-MRI with inhalation of isotopically enriched 17O gas has been used to quantify global CMRO2 in brain white (WM) and gray matter (GM). However, global CMRO2 can only reflect the overall oxygen metabolism of the brain and cannot provide enough information on local tissue oxygen metabolism. To investigate the feasibility of determination of regional CMRO2 at a clinical 3 T MRI system, CMRO2 values in frontal, parietal and occipital WM and GM were determined in 5 healthy volunteers and compared to evaluate the regional differences of oxygen metabolism in WM and GM. Additionally, regional CMRO2 values were determined in deep brain structures including thalamus, dorsal striatum, caudate nucleus and insula cortex and in the cerebella, and compared with literature values from 15O-PET studies. RESULTS In cortical GM the determined CMRO2 values were in good agreement with the literature, whereas values in WM were about 32-48% higher than literature values. Regional analysis revealed a significantly higher CMRO2 in the occipital GM compared to the frontal and parietal GM. By contrast, no significant difference of CMRO2 was observed across the WM. In addition, CMRO2 in deep brain structures was lower compared to literature values and in the cerebella a good hemispheric symmetry of the tissue oxygen metabolism was found. CONCLUSION Dynamic 17O-MRI enables direct, non-invasive determination of regional CMRO2 in brain structures in healthy volunteers at 3T.
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Affiliation(s)
- Hao Song
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Johannes Fisher
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ali Caglar Özen
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Burak Akin
- Section on Functional Imaging Methods, NIMH, NIH, Bethesda, MD, USA
| | - Stefan Schumann
- Department of Anesthesiology and Critical Care, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Bock
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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23
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Biondetti E, Cho J, Lee H. Cerebral oxygen metabolism from MRI susceptibility. Neuroimage 2023; 276:120189. [PMID: 37230206 PMCID: PMC10335841 DOI: 10.1016/j.neuroimage.2023.120189] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/26/2023] [Accepted: 05/23/2023] [Indexed: 05/27/2023] Open
Abstract
This article provides an overview of MRI methods exploiting magnetic susceptibility properties of blood to assess cerebral oxygen metabolism, including the tissue oxygen extraction fraction (OEF) and the cerebral metabolic rate of oxygen (CMRO2). The first section is devoted to describing blood magnetic susceptibility and its effect on the MRI signal. Blood circulating in the vasculature can have diamagnetic (oxyhemoglobin) or paramagnetic properties (deoxyhemoglobin). The overall balance between oxygenated and deoxygenated hemoglobin determines the induced magnetic field which, in turn, modulates the transverse relaxation decay of the MRI signal via additional phase accumulation. The following sections of this review then illustrate the principles underpinning susceptibility-based techniques for quantifying OEF and CMRO2. Here, it is detailed whether these techniques provide global (OxFlow) or local (Quantitative Susceptibility Mapping - QSM, calibrated BOLD - cBOLD, quantitative BOLD - qBOLD, QSM+qBOLD) measurements of OEF or CMRO2, and what signal components (magnitude or phase) and tissue pools they consider (intravascular or extravascular). Validations studies and potential limitations of each method are also described. The latter include (but are not limited to) challenges in the experimental setup, the accuracy of signal modeling, and assumptions on the measured signal. The last section outlines the clinical uses of these techniques in healthy aging and neurodegenerative diseases and contextualizes these reports relative to results from gold-standard PET.
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Affiliation(s)
- Emma Biondetti
- Department of Neuroscience, Imaging and Clinical Sciences, "D'Annunzio University" of Chieti-Pescara, Chieti, Italy; Institute for Advanced Biomedical Technologies, "D'Annunzio University" of Chieti-Pescara, Chieti, Italy
| | - Junghun Cho
- Department of Biomedical Engineering, University at Buffalo, The State University of New York, New York, USA
| | - Hyunyeol Lee
- School of Electronic and Electrical Engineering, Kyungpook National University, Daegu, Republic of Korea; Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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24
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Bernard R, Valverde Salzmann M, Scheffler K, Pohmann R. Concurrent intrinsic optical imaging and fMRI at ultra-high field using magnetic field proof optical components. NMR IN BIOMEDICINE 2023; 36:e4909. [PMID: 36669650 DOI: 10.1002/nbm.4909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 06/15/2023]
Abstract
Intrinsic optical imaging (IOI) is a well established technique to quantify activation-related hemodynamical changes at the surface of the brain, which can be used to investigate the underlying processes of BOLD signal formation. To directly and quantitatively relate IOI and fMRI, simultaneous measurements with the two modalities are necessary. Here, a novel technical solution for a completely in-bore setup is presented, which uses only magnetic field proof components and thus allows concurrent recordings with a quality similar to that obtained in separate experiments. Measurements of the somatosensory cortex of rats with electrical forepaw stimulation were used to verify this approach. The high spatial and temporal resolution of the fMRI data, which is possible due to the high magnetic field of 14.1 T, the use of a point-spread function-based distortion correction and optimized additional anatomical images, allowed accurate colocalization of the images of the two modalities. Accordingly, detailed investigations of the temporal and spatial relationships between the hemodynamic parameters and the fMRI signal, which demonstrate the linear dependence of the BOLD effect on changes in the concentrations of oxygenated and deoxygenated hemoglobin, are possible. Comparisons between the signals emerging from arterial, venous and parenchymal areas are possible and show clearly distinct characteristics. The presented setup allows combining MRI measurements and optical recordings without serious losses in the data quality of either modality. While the proposed combination of fMRI and IOI can help to gain valuable insight into the generation of the BOLD effect, the setup can be easily modified to include different types of optical or MRI measurements.
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Affiliation(s)
- Rebekka Bernard
- Magnetic Resonance Center, Max-Planck-Institute for Biological Cybernetics, Tübingen, Germany
| | | | - Klaus Scheffler
- Magnetic Resonance Center, Max-Planck-Institute for Biological Cybernetics, Tübingen, Germany
- Department for Neuroimaging, University of Tübingen, Tübingen, Germany
| | - Rolf Pohmann
- Magnetic Resonance Center, Max-Planck-Institute for Biological Cybernetics, Tübingen, Germany
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25
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Deckers PT, Siero JCW, Mensink MO, Kronenburg A, Braun KPJ, van der Zwan A, Bhogal AA. Anesthesia Depresses Cerebrovascular Reactivity to Acetazolamide in Pediatric Moyamoya Vasculopathy. J Clin Med 2023; 12:4393. [PMID: 37445429 DOI: 10.3390/jcm12134393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/14/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
Measurements of cerebrovascular reactivity (CVR) are essential for treatment decisions in moyamoya vasculopathy (MMV). Since MMV patients are often young or cognitively impaired, anesthesia is commonly used to limit motion artifacts. Our aim was to investigate the effect of anesthesia on the CVR in pediatric MMV. We compared the CVR with multidelay-ASL and BOLD MRI, using acetazolamide as a vascular stimulus, in all awake and anesthesia pediatric MMV scans at our institution. Since a heterogeneity in disease and treatment influences the CVR, we focused on the (unaffected) cerebellum. Ten awake and nine anesthetized patients were included. The post-acetazolamide CBF and ASL-CVR were significantly lower in anesthesia patients (47.1 ± 15.4 vs. 61.4 ± 12.1, p = 0.04; 12.3 ± 8.4 vs. 23.7 ± 12.2 mL/100 g/min, p = 0.03, respectively). The final BOLD-CVR increase (0.39 ± 0.58 vs. 3.6 ± 1.2% BOLD-change (mean/SD), p < 0.0001), maximum slope of increase (0.0050 ± 0.0040%/s vs. 0.017 ± 0.0059%, p < 0.0001), and time to maximum BOLD-increase (~463 ± 136 and ~697 ± 144 s, p = 0.0028) were all significantly lower in the anesthesia group. We conclude that the response to acetazolamide is distinctively different between awake and anesthetized MMV patients, and we hypothesize that these findings can also apply to other diseases and methods of measuring CVR under anesthesia. Considering that treatment decisions heavily depend on CVR status, caution is warranted when assessing CVR under anesthesia.
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Affiliation(s)
- Pieter T Deckers
- Department of Neurosurgery, Universitair Medisch Centrum Utrecht, 3584 CX Utrecht, The Netherlands
- Department of Radiology and Nuclear Medicine, Meander Medisch Centrum, 3813 TZ Amersfoort, The Netherlands
| | - Jeroen C W Siero
- Department of Radiology, Universitair Medisch Centrum Utrecht, 3584 CX Utrecht, The Netherlands
- Spinoza Center for Neuroimaging, 1105 BK Amsterdam, The Netherlands
| | - Maarten O Mensink
- Pediatric Anesthesiology, Prinses Máxima Centrum, 3584 CS Utrecht, The Netherlands
| | - Annick Kronenburg
- Department of Neurosurgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Neurosurgery, Haaglanden Medical Center, 2512 VA The Hague, The Netherlands
| | - Kees P J Braun
- Department of Pediatric Neurology, Wilhelmina Children's Hospital, Universitair Medisch Centrum Utrecht, 3584 CX Utrecht, The Netherlands
| | - Albert van der Zwan
- Department of Neurosurgery, Universitair Medisch Centrum Utrecht, 3584 CX Utrecht, The Netherlands
| | - Alex A Bhogal
- Department of Radiology, Universitair Medisch Centrum Utrecht, 3584 CX Utrecht, The Netherlands
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26
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Schellekens W, Bhogal AA, Roefs ECA, Báez-Yáñez MG, Siero JCW, Petridou N. The many layers of BOLD. The effect of hypercapnic and hyperoxic stimuli on macro- and micro-vascular compartments quantified by CVR, M, and CBV across cortical depth. J Cereb Blood Flow Metab 2023; 43:419-432. [PMID: 36262088 PMCID: PMC9941862 DOI: 10.1177/0271678x221133972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022]
Abstract
Ultra-high field functional magnetic resonance imaging (fMRI) offers the spatial resolution to measure neuronal activity at the scale of cortical layers. However, cortical depth dependent vascularization differences, such as a higher prevalence of macro-vascular compartments near the pial surface, have a confounding effect on depth-resolved blood-oxygen-level dependent (BOLD) fMRI signals. In the current study, we use hypercapnic and hyperoxic breathing conditions to quantify the influence of all venous vascular and micro-vascular compartments on laminar BOLD fMRI, as measured with gradient-echo (GE) and spin-echo (SE) scan sequences, respectively. We find that all venous vascular and micro-vascular compartments are capable of comparable theoretical maximum signal intensities, as represented by the M-value parameter. However, the capacity for vessel dilation, as reflected by the cerebrovascular reactivity (CVR), is approximately two and a half times larger for all venous vascular compartments combined compared to the micro-vasculature at superficial layers. Finally, there is roughly a 35% difference in estimates of CBV changes between all venous vascular and micro-vascular compartments, although this relative difference was approximately uniform across cortical depth. Thus, our results suggest that fMRI BOLD signal differences across cortical depth are likely caused by differences in dilation properties between macro- and micro-vascular compartments.
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Affiliation(s)
- Wouter Schellekens
- Radiology Department, Center for Image Sciences, UMC Utrecht,
Netherlands
| | - Alex A Bhogal
- Radiology Department, Center for Image Sciences, UMC Utrecht,
Netherlands
| | - Emiel CA Roefs
- Radiology Department, Center for Image Sciences, UMC Utrecht,
Netherlands
| | - Mario G Báez-Yáñez
- Radiology Department, Center for Image Sciences, UMC Utrecht,
Netherlands
| | - Jeroen CW Siero
- Radiology Department, Center for Image Sciences, UMC Utrecht,
Netherlands
- Spinoza Centre for Neuroimaging, Amsterdam, The
Netherlands
| | - Natalia Petridou
- Radiology Department, Center for Image Sciences, UMC Utrecht,
Netherlands
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27
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Driesen NR, Herman P, Rowland MA, Thompson G, Qiu M, He G, Fineberg S, Barron DS, Helgeson L, Lacadie C, Chow R, Gueorguieva R, Straun TC, Krystal JH, Hyder F. Ketamine Effects on Energy Metabolism, Functional Connectivity and Working Memory in Healthy Humans. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.21.529425. [PMID: 36865249 PMCID: PMC9980048 DOI: 10.1101/2023.02.21.529425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Working memory (WM) is a crucial resource for temporary memory storage and the guiding of ongoing behavior. N-methyl-D-aspartate glutamate receptors (NMDARs) are thought to support the neural underpinnings of WM. Ketamine is an NMDAR antagonist that has cognitive and behavioral effects at subanesthetic doses. To shed light on subanesthetic ketamine effects on brain function, we employed a multimodal imaging design, combining gas-free calibrated functional magnetic resonance imaging (fMRI) measurement of oxidative metabolism (CMRO 2 ), resting-state cortical functional connectivity assessed with fMRI, and WM-related fMRI. Healthy subjects participated in two scan sessions in a randomized, double-blind, placebo-controlled design. Ketamine increased CMRO 2 and cerebral blood flow (CBF) in prefrontal cortex (PFC) and other cortical regions. However, resting-state cortical functional connectivity was not affected. Ketamine did not alter CBF-CMRO 2 coupling brain-wide. Higher levels of basal CMRO 2 were associated with lower task-related PFC activation and WM accuracy impairment under both saline and ketamine conditions. These observations suggest that CMRO 2 and resting-state functional connectivity index distinct dimensions of neural activity. Ketamine’s impairment of WM-related neural activity and performance appears to be related to its ability to produce cortical metabolic activation. This work illustrates the utility of direct measurement of CMRO 2 via calibrated fMRI in studies of drugs that potentially affect neurovascular and neurometabolic coupling.
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28
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Sten S, Podéus H, Sundqvist N, Elinder F, Engström M, Cedersund G. A quantitative model for human neurovascular coupling with translated mechanisms from animals. PLoS Comput Biol 2023; 19:e1010818. [PMID: 36607908 PMCID: PMC9821752 DOI: 10.1371/journal.pcbi.1010818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023] Open
Abstract
Neurons regulate the activity of blood vessels through the neurovascular coupling (NVC). A detailed understanding of the NVC is critical for understanding data from functional imaging techniques of the brain. Many aspects of the NVC have been studied both experimentally and using mathematical models; various combinations of blood volume and flow, local field potential (LFP), hemoglobin level, blood oxygenation level-dependent response (BOLD), and optogenetics have been measured and modeled in rodents, primates, or humans. However, these data have not been brought together into a unified quantitative model. We now present a mathematical model that describes all such data types and that preserves mechanistic behaviors between experiments. For instance, from modeling of optogenetics and microscopy data in mice, we learn cell-specific contributions; the first rapid dilation in the vascular response is caused by NO-interneurons, the main part of the dilation during longer stimuli is caused by pyramidal neurons, and the post-peak undershoot is caused by NPY-interneurons. These insights are translated and preserved in all subsequent analyses, together with other insights regarding hemoglobin dynamics and the LFP/BOLD-interplay, obtained from other experiments on rodents and primates. The model can predict independent validation-data not used for training. By bringing together data with complementary information from different species, we both understand each dataset better, and have a basis for a new type of integrative analysis of human data.
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Affiliation(s)
- Sebastian Sten
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Henrik Podéus
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Nicolas Sundqvist
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
| | - Fredrik Elinder
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Maria Engström
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Gunnar Cedersund
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
- * E-mail:
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29
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Hays Weeks CC, Zlatar ZZ, Meloy MJ, Shin DD, Thomas L, Wierenga CE. APOE Genotype Modifies the Association of Fusiform Gyrus Cerebral Metabolic Rate of Oxygen Consumption and Object Naming Performance. J Alzheimers Dis 2023; 91:1371-1383. [PMID: 36641668 DOI: 10.3233/jad-220749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The apolipoprotein E (APOE) ɛ4 allele confers risk for age and Alzheimer's disease related cognitive decline but the mechanistic link remains poorly understood. Blood oxygenation level dependent (BOLD) response in the fusiform gyrus (FG) during object naming appears greater among APOEɛ4 carriers even in the face of equivalent cognitive performance, suggesting neural compensation. However, BOLD is susceptible to known age and APOE-related vascular changes that could confound its interpretation. OBJECTIVE To address this limitation, we used calibrated fMRI during an object naming task and a hypercapnic challenge to obtain a more direct measure of neural function - percent change cerebral metabolic rate of oxygen consumption (%ΔCMRO2). METHODS Participants were 45 older adults without dementia (28 ɛ4-, 17 ɛ4+) between the ages of 65 and 85. We examined APOE-related differences in %ΔCMRO2 in the FG during object naming and the extent to which APOE modified associations between FG %ΔCMRO2 and object naming accuracy. Exploratory analyses also tested the hypothesis that %ΔCMRO2 is less susceptible to vascular compromise than are measures of %ΔCBF and %ΔBOLD. RESULTS We observed a modifying role of APOE on associations between FG %ΔCMRO2 and cognition, with ɛ4 carriers (but not non-carriers) demonstrating a positive association between right FG %ΔCMRO2 and object naming accuracy. CONCLUSION Results suggest that the relationship between neural function and cognition is altered among older adult APOEɛ4 carriers prior to the onset of dementia, implicating CMRO2 response as a potential mechanism to support cognition in APOE-related AD risk.
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Affiliation(s)
- Chelsea C Hays Weeks
- VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, UC San Diego, La Jolla, CA, USA
| | | | - M J Meloy
- VA San Diego Healthcare System, San Diego, CA, USA
| | | | - Liu Thomas
- Department of Radiology, UC San Diego, La Jolla, CA, USA
| | - Christina E Wierenga
- VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, UC San Diego, La Jolla, CA, USA
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30
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Shams S, Prokopiou P, Esmaelbeigi A, Mitsis GD, Chen JJ. Modeling the dynamics of cerebrovascular reactivity to carbon dioxide in fMRI under task and resting-state conditions. Neuroimage 2023; 265:119758. [PMID: 36442732 DOI: 10.1016/j.neuroimage.2022.119758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/11/2022] [Accepted: 11/18/2022] [Indexed: 11/26/2022] Open
Abstract
Conventionally, cerebrovascular reactivity (CVR) is estimated as the amplitude of the hemodynamic response to vascular stimuli, most commonly carbon dioxide (CO2). While the CVR amplitude has established clinical utility, the temporal characteristics of CVR (dCVR) have been increasingly explored and may yield even more pathology-sensitive parameters. This work is motivated by the current need to evaluate the feasibility of dCVR modeling in various experimental conditions. In this work, we present a comparison of several recently published/utilized model-based deconvolution (response estimation) approaches for estimating the CO2 response function h(t), including maximum a posteriori likelihood (MAP), inverse logit (IL), canonical correlation analysis (CCA), and basis expansion (using Gamma and Laguerre basis sets). To aid the comparison, we devised a novel simulation framework that incorporates a wide range of SNRs, ranging from 10 to -7 dB, representative of both task and resting-state CO2 changes. In addition, we built ground-truth h(t) into our simulation framework, overcoming the conventional limitation that the true h(t) is unknown. Moreover, to best represent realistic noise found in fMRI scans, we extracted noise from in-vivo resting-state scans. Furthermore, we introduce a simple optimization of the CCA method (CCAopt) and compare its performance to these existing methods. Our findings suggest that model-based methods can accurately estimate dCVR even amidst high noise (i.e. resting-state), and in a manner that is largely independent of the underlying model assumptions for each method. We also provide a quantitative basis for making methodological choices, based on the desired dCVR parameters, the estimation accuracy and computation time. The BEL method provided the highest accuracy and robustness, followed by the CCAopt and IL methods. Of the three, the CCAopt method has the lowest computational requirements. These findings lay the foundation for wider adoption of dCVR estimation in CVR mapping.
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Affiliation(s)
- Seyedmohammad Shams
- Rotman Research Institute, Baycrest Health Sciences, Canada; Department of Neurology, Henry Ford Health, USA
| | - Prokopis Prokopiou
- Department of Radiology, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - J Jean Chen
- Rotman Research Institute, Baycrest Health Sciences, Canada; Department of Bioengineering, McGill University, Canada; Department of Medical Biophysics, University of Toronto, Canada; Institute of Biomedical Engineering, University of Toronto, Canada.
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31
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Multi-Echo Investigations of Positive and Negative CBF and Concomitant BOLD Changes: Positive and negative CBF and BOLD changes. Neuroimage 2022; 263:119661. [PMID: 36198353 DOI: 10.1016/j.neuroimage.2022.119661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/21/2022] Open
Abstract
Unlike the positive blood oxygenation level-dependent (BOLD) response (PBR), commonly taken as an indication of an 'activated' brain region, the physiological origin of negative BOLD signal changes (i.e. a negative BOLD response, NBR), also referred to as 'deactivation' is still being debated. In this work, an attempt was made to gain a better understanding of the underlying mechanism by obtaining a comprehensive measure of the contributing cerebral blood flow (CBF) and its relationship to the NBR in the human visual cortex, in comparison to a simultaneously induced PBR in surrounding visual regions. To overcome the low signal-to-noise ratio (SNR) of CBF measurements, a newly developed multi-echo version of a center-out echo planar-imaging (EPI) readout was employed with pseudo-continuous arterial spin labeling (pCASL). It achieved very short echo and inter-echo times and facilitated a simultaneous detection of functional CBF and BOLD changes at 3 T with improved sensitivity. Evaluations of the absolute and relative changes of CBF and the effective transverse relaxation rate,R2* the coupling ratios, and their dependence on CBF at rest, CBFrest indicated differences between activated and deactivated regions. Analysis of the shape of the respective functional responses also revealed faster negative responses with more pronounced post-stimulus transients. Resulting differences in the flow-metabolism coupling ratios were further examined for potential distinctions in the underlying neuronal contributions.
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32
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Cerebrovascular reactivity in multiple sclerosis is restored with reduced inflammation during immunomodulation. Sci Rep 2022; 12:15453. [PMID: 36104366 PMCID: PMC9474533 DOI: 10.1038/s41598-022-19113-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/24/2022] [Indexed: 12/02/2022] Open
Abstract
Cerebrovascular reactivity (CVR) reflects the capacity of the brain’s vasculature to increase blood flow following a vasodilatory stimulus. Reactivity is an essential property of the brain’s blood vessels that maintains nutrient supplies in the face of changing demand. In Multiple Sclerosis (MS), CVR may be diminished with brain inflammation and this may contribute to neurodegeneration. We test the hypothesis that CVR is altered with MS neuroinflammation and that it is restored when inflammation is reduced. Using a breath-hold task during functional Magnetic Resonance Imaging (MRI), we mapped grey matter and white matter CVRs (CVRGM and CVRWM, respectively) in 23 young MS patients, eligible for disease modifying therapy, before and during Interferon beta treatment. Inflammatory activity was inferred from the presence of Gadolinium enhancing lesions at MRI. Eighteen age and gender-matched healthy controls (HC) were also assessed. Enhancing lesions were observed in 12 patients at the start of the study and in 3 patients during treatment. Patients had lower pre-treatment CVRGM (p = 0.04) and CVRWM (p = 0.02) compared to HC. In patients, a lower pre-treatment CVRGM was associated with a lower GM volume (r = 0.60, p = 0.003). On-treatment, there was an increase in CVRGM (p = 0.02) and CVRWM (p = 0.03) that negatively correlated with pre-treatment CVR (GM: r = − 0.58, p = 0.005; WM: r = − 0.60, p = 0.003). CVR increased when enhancing lesions reduced in number (GM: r = − 0.48, p = 0.02, WM: r = − 0.62, p = 0.003). Resolution of inflammation may restore altered cerebrovascular function limiting neurodegeneration in MS. Imaging of cerebrovascular function may thereby inform tissue physiology and improve treatment monitoring.
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Mareyam A, Shank E, Wald LL, Qin MK, Bonmassar G. A New Phased-Array Magnetic Resonance Imaging Receive-Only Coil for HBO2 Studies. SENSORS (BASEL, SWITZERLAND) 2022; 22:6076. [PMID: 36015836 PMCID: PMC9416538 DOI: 10.3390/s22166076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
The paper describes a new magnetic resonance imaging (MRI) phased-array receive-only (Rx) coil for studying decompression sickness and disorders of hyperbaricity, including nitrogen narcosis. Functional magnetic resonance imaging (fMRI) is noninvasive, is considered safe, and may allow studying the brain under hyperbaric conditions. All of the risks associated with simultaneous MRI and HBO2 therapy are described in detail, along with all of the mitigation strategies and regulatory testing. One of the most significant risks for this type of study is a fire in the hyperbaric chamber caused by the sparking of the MRI coils as a result of high-voltage RF arcs. RF pulses at 128 MHz elicit signals from human tissues, and RF sparking occurs commonly and is considered safe in normobaric conditions. We describe how we built a coil for HBO2-MRI studies by modifying an eight-channel phased-array MRI coil with all of the mitigation strategies discussed. The coil was fabricated and tested with a unique testing platform that simulated the worst-case RF field of a three-Tesla MRI in a Hyperlite hyperbaric chamber at 3 atm pressure. The coil was also tested in normobaric conditions for image quality in a 3 T scanner in volunteers and SNR measurement in phantoms. Further studies are necessary to characterize the coil safety in HBO2/MRI.
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Affiliation(s)
- Azma Mareyam
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Erik Shank
- Department of Anesthesia, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Lawrence L. Wald
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | | | - Giorgio Bonmassar
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
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Taylor AJ, Kim JH, Ress D. Temporal stability of the hemodynamic response function across the majority of human cerebral cortex. Hum Brain Mapp 2022; 43:4924-4942. [PMID: 35965416 PMCID: PMC9582369 DOI: 10.1002/hbm.26047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 07/13/2022] [Accepted: 07/25/2022] [Indexed: 12/23/2022] Open
Abstract
The hemodynamic response function (HRF) measured with functional magnetic resonance imaging is generated by vascular and metabolic responses evoked by brief (<4 s) stimuli. It is known that the human HRF varies across cortex, between subjects, with stimulus paradigms, and even between different measurements in the same cortical location. However, our results demonstrate that strong HRFs are remarkably repeatable across sessions separated by time intervals up to 3 months. In this study, a multisensory stimulus was used to activate and measure the HRF across the majority of cortex (>70%, with lesser reliability observed in some areas of prefrontal cortex). HRFs were measured with high spatial resolution (2‐mm voxels) in central gray matter to minimize variations caused by partial‐volume effects. HRF amplitudes and temporal dynamics were highly repeatable across four sessions in 20 subjects. Positive and negative HRFs were consistently observed across sessions and subjects. Negative HRFs were generally weaker and, thus, more variable than positive HRFs. Statistical measurements showed that across‐session variability is highly correlated to the variability across events within a session; these measurements also indicated a normal distribution of variability across cortex. The overall repeatability of the HRFs over long time scales generally supports the long‐term use of event‐related functional magnetic resonance imaging protocols.
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Affiliation(s)
- Amanda J Taylor
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
| | - Jung Hwan Kim
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
| | - David Ress
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
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35
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Himmelberg MM, Gardner JL, Winawer J. What has vision science taught us about functional MRI? Neuroimage 2022; 261:119536. [PMID: 35931310 DOI: 10.1016/j.neuroimage.2022.119536] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/21/2022] [Accepted: 08/02/2022] [Indexed: 10/31/2022] Open
Abstract
In the domain of human neuroimaging, much attention has been paid to the question of whether and how the development of functional magnetic resonance imaging (fMRI) has advanced our scientific knowledge of the human brain. However, the opposite question is also important; how has our knowledge of the visual system advanced our understanding of fMRI? Here, we discuss how and why scientific knowledge about the human and animal visual system has been used to answer fundamental questions about fMRI as a brain measurement tool and how these answers have contributed to scientific discoveries beyond vision science.
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Affiliation(s)
- Marc M Himmelberg
- Department of Psychology, New York University, NY, USA; Center for Neural Science, New York University, NY, USA.
| | | | - Jonathan Winawer
- Department of Psychology, New York University, NY, USA; Center for Neural Science, New York University, NY, USA
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36
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Lambers H, Wachsmuth L, Thomas D, Boumezbeur F, Hoesker V, Pradier B, Faber C. Fiber-based lactate recordings with fluorescence resonance energy transfer sensors by applying an magnetic resonance-informed correction of hemodynamic artifacts. NEUROPHOTONICS 2022; 9:032212. [PMID: 35558647 PMCID: PMC9084224 DOI: 10.1117/1.nph.9.3.032212] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
Significance: Fluorescence resonance energy transfer (FRET) sensors offer enormous benefits when studying neurophysiology through confocal microscopy. Yet, their use for fiber-based in vivo recordings is hampered by massive confounding effects and has therefore been scarcely reported. Aim: We aim to investigate whether in vivo fiber-based lactate recordings in the rodent brain are feasible with FRET sensors and implement a correction algorithm for the predominant hemodynamic artifact. Approach: We performed fiber-based FRET recordings of lactate (Laconic) and calcium (Twitch-2B) simultaneously with functional MRI and pharmacological MRI. MR-derived parameters were applied to correct hemodynamic artifacts. Results of FRET measurements were validated by local field potential, magnetic resonance spectroscopy, and blood analysis. Results: Hemodynamic artifacts dominated fiber-based in vivo FRET measurements with both Laconic and Twitch-2B. Our MR-based correction algorithm enabled to remove the artifacts and detect lactate and calcium changes during sensory stimulation or intravenous lactate injections. Conclusions: In vivo fiber-based lactate recordings are feasible using FRET-based sensors. However, signal corrections are required. MR-derived hemodynamic parameters can successfully be applied for artifact correction.
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Affiliation(s)
- Henriette Lambers
- University Hospital Münster, Translational Research Imaging Center (TRIC), Clinic for Radiology, Münster, Germany
| | - Lydia Wachsmuth
- University Hospital Münster, Translational Research Imaging Center (TRIC), Clinic for Radiology, Münster, Germany
| | - Dominik Thomas
- University Hospital Münster, Translational Research Imaging Center (TRIC), Clinic for Radiology, Münster, Germany
| | - Fawzi Boumezbeur
- NeuroSpin, CEA, CNRS, Paris-Saclay University, Gif-Sur-Yvette, France
| | - Vanessa Hoesker
- University Hospital Münster, Translational Research Imaging Center (TRIC), Clinic for Radiology, Münster, Germany
| | - Bruno Pradier
- University Hospital Münster, Translational Research Imaging Center (TRIC), Clinic for Radiology, Münster, Germany
| | - Cornelius Faber
- University Hospital Münster, Translational Research Imaging Center (TRIC), Clinic for Radiology, Münster, Germany
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Guilbert J, Légaré A, De Koninck P, Desrosiers P, Desjardins M. Toward an integrative neurovascular framework for studying brain networks. NEUROPHOTONICS 2022; 9:032211. [PMID: 35434179 PMCID: PMC8989057 DOI: 10.1117/1.nph.9.3.032211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/11/2022] [Indexed: 05/28/2023]
Abstract
Brain functional connectivity based on the measure of blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) signals has become one of the most widely used measurements in human neuroimaging. However, the nature of the functional networks revealed by BOLD fMRI can be ambiguous, as highlighted by a recent series of experiments that have suggested that typical resting-state networks can be replicated from purely vascular or physiologically driven BOLD signals. After going through a brief review of the key concepts of brain network analysis, we explore how the vascular and neuronal systems interact to give rise to the brain functional networks measured with BOLD fMRI. This leads us to emphasize a view of the vascular network not only as a confounding element in fMRI but also as a functionally relevant system that is entangled with the neuronal network. To study the vascular and neuronal underpinnings of BOLD functional connectivity, we consider a combination of methodological avenues based on multiscale and multimodal optical imaging in mice, used in combination with computational models that allow the integration of vascular information to explain functional connectivity.
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Affiliation(s)
- Jérémie Guilbert
- Université Laval, Department of Physics, Physical Engineering, and Optics, Québec, Canada
- Université Laval, Centre de recherche du CHU de Québec, Québec, Canada
| | - Antoine Légaré
- Université Laval, Department of Physics, Physical Engineering, and Optics, Québec, Canada
- Centre de recherche CERVO, Québec, Canada
- Université Laval, Department of Biochemistry, Microbiology, and Bioinformatics, Québec, Canada
| | - Paul De Koninck
- Centre de recherche CERVO, Québec, Canada
- Université Laval, Department of Biochemistry, Microbiology, and Bioinformatics, Québec, Canada
| | - Patrick Desrosiers
- Université Laval, Department of Physics, Physical Engineering, and Optics, Québec, Canada
- Centre de recherche CERVO, Québec, Canada
| | - Michèle Desjardins
- Université Laval, Department of Physics, Physical Engineering, and Optics, Québec, Canada
- Université Laval, Centre de recherche du CHU de Québec, Québec, Canada
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38
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Chiarelli AM, Germuska M, Chandler H, Stickland R, Patitucci E, Biondetti E, Mascali D, Saxena N, Khot S, Steventon J, Foster C, Rodríguez-Soto AE, Englund E, Murphy K, Tomassini V, Wehrli FW, Wise RG. A flow-diffusion model of oxygen transport for quantitative mapping of cerebral metabolic rate of oxygen (CMRO 2) with single gas calibrated fMRI. J Cereb Blood Flow Metab 2022; 42:1192-1209. [PMID: 35107026 PMCID: PMC9207485 DOI: 10.1177/0271678x221077332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
One promising approach for mapping CMRO2 is dual-calibrated functional MRI (dc-fMRI). This method exploits the Fick Principle to combine estimates of CBF from ASL, and OEF derived from BOLD-ASL measurements during arterial O2 and CO2 modulations. Multiple gas modulations are required to decouple OEF and deoxyhemoglobin-sensitive blood volume. We propose an alternative single gas calibrated fMRI framework, integrating a model of oxygen transport, that links blood volume and CBF to OEF and creates a mapping between the maximum BOLD signal, CBF and OEF (and CMRO2). Simulations demonstrated the method's viability within physiological ranges of mitochondrial oxygen pressure, PmO2, and mean capillary transit time. A dc-fMRI experiment, performed on 20 healthy subjects using O2 and CO2 challenges, was used to validate the approach. The validation conveyed expected estimates of model parameters (e.g., low PmO2), with spatially uniform OEF maps (grey matter, GM, OEF spatial standard deviation ≈ 0.13). GM OEF estimates obtained with hypercapnia calibrated fMRI correlated with dc-fMRI (r = 0.65, p = 2·10-3). For 12 subjects, OEF measured with dc-fMRI and the single gas calibration method were correlated with whole-brain OEF derived from phase measures in the superior sagittal sinus (r = 0.58, p = 0.048; r = 0.64, p = 0.025 respectively). Simplified calibrated fMRI using hypercapnia holds promise for clinical application.
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Affiliation(s)
- Antonio M Chiarelli
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy.,Institute for Advanced Biomedical Technologies, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Michael Germuska
- Department of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Hannah Chandler
- Department of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Rachael Stickland
- Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Eleonora Patitucci
- Department of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Emma Biondetti
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy.,Institute for Advanced Biomedical Technologies, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Daniele Mascali
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy.,Institute for Advanced Biomedical Technologies, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Neeraj Saxena
- Department of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Sharmila Khot
- Department of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Jessica Steventon
- Department of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Catherine Foster
- Wales Institute of Social and Economic Research and Data (WISERD), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Ana E Rodríguez-Soto
- Department of Radiology, University of California, San Diego, La Jolla, California, USA
| | - Erin Englund
- Department of Radiology, University of Colorado, Aurora, Colorado, USA
| | - Kevin Murphy
- Department of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Valentina Tomassini
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy.,Institute for Advanced Biomedical Technologies, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy.,Department of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK.,MS Centre, Dept of Clinical Neurology, SS. Annunziata University Hospital, Chieti, Italy.,Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.,Helen Durham Centre for Neuroinflammation, University Hospital of Wales, Cardiff, UK
| | - Felix W Wehrli
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Richard G Wise
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy.,Institute for Advanced Biomedical Technologies, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy.,Department of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
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Chen JJ, Uthayakumar B, Hyder F. Mapping oxidative metabolism in the human brain with calibrated fMRI in health and disease. J Cereb Blood Flow Metab 2022; 42:1139-1162. [PMID: 35296177 PMCID: PMC9207484 DOI: 10.1177/0271678x221077338] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Conventional functional MRI (fMRI) with blood-oxygenation level dependent (BOLD) contrast is an important tool for mapping human brain activity non-invasively. Recent interest in quantitative fMRI has renewed the importance of oxidative neuroenergetics as reflected by cerebral metabolic rate of oxygen consumption (CMRO2) to support brain function. Dynamic CMRO2 mapping by calibrated fMRI require multi-modal measurements of BOLD signal along with cerebral blood flow (CBF) and/or volume (CBV). In human subjects this "calibration" is typically performed using a gas mixture containing small amounts of carbon dioxide and/or oxygen-enriched medical air, which are thought to produce changes in CBF (and CBV) and BOLD signal with minimal or no CMRO2 changes. However non-human studies have demonstrated that the "calibration" can also be achieved without gases, revealing good agreement between CMRO2 changes and underlying neuronal activity (e.g., multi-unit activity and local field potential). Given the simpler set-up of gas-free calibrated fMRI, there is evidence of recent clinical applications for this less intrusive direction. This up-to-date review emphasizes technological advances for such translational gas-free calibrated fMRI experiments, also covering historical progression of the calibrated fMRI field that is impacting neurological and neurodegenerative investigations of the human brain.
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Affiliation(s)
- J Jean Chen
- Medical Biophysics, University of Toronto, Toronto, Canada.,Rotman Research Institute, Baycrest, Toronto, Canada
| | - Biranavan Uthayakumar
- Medical Biophysics, University of Toronto, Toronto, Canada.,Sunnybrook Research Institute, Toronto, Canada
| | - Fahmeed Hyder
- Magnetic Resonance Research Center (MRRC), Yale University, New Haven, Connecticut, USA.,Department of Radiology, Yale University, New Haven, Connecticut, USA.,Quantitative Neuroscience with Magnetic Resonance (QNMR) Research Program, Yale University, New Haven, Connecticut, USA.,Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA
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40
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Prasuhn J, Kunert L, Brüggemann N. Neuroimaging Methods to Map In Vivo Changes of OXPHOS and Oxidative Stress in Neurodegenerative Disorders. Int J Mol Sci 2022; 23:ijms23137263. [PMID: 35806267 PMCID: PMC9266616 DOI: 10.3390/ijms23137263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 12/11/2022] Open
Abstract
Mitochondrial dysfunction is a pathophysiological hallmark of most neurodegenerative diseases. Several clinical trials targeting mitochondrial dysfunction have been performed with conflicting results. Reliable biomarkers of mitochondrial dysfunction in vivo are thus needed to optimize future clinical trial designs. This narrative review highlights various neuroimaging methods to probe mitochondrial dysfunction. We provide a general overview of the current biological understanding of mitochondrial dysfunction in degenerative brain disorders and how distinct neuroimaging methods can be employed to map disease-related changes. The reviewed methodological spectrum includes positron emission tomography, magnetic resonance, magnetic resonance spectroscopy, and near-infrared spectroscopy imaging, and how these methods can be applied to study alterations in oxidative phosphorylation and oxidative stress. We highlight the advantages and shortcomings of the different neuroimaging methods and discuss the necessary steps to use these for future research. This review stresses the importance of neuroimaging methods to gain deepened insights into mitochondrial dysfunction in vivo, its role as a critical disease mechanism in neurodegenerative diseases, the applicability for patient stratification in interventional trials, and the quantification of individual treatment responses. The in vivo assessment of mitochondrial dysfunction is a crucial prerequisite for providing individualized treatments for neurodegenerative disorders.
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Affiliation(s)
- Jannik Prasuhn
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (L.K.)
- Department of Neurology, University Medical Center Schleswig Holstein, Campus Lübeck, 23538 Lübeck, Germany
- Center for Brain, Behavior and Metabolism, University of Lübeck, 23562 Lübeck, Germany
| | - Liesa Kunert
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (L.K.)
- Department of Neurology, University Medical Center Schleswig Holstein, Campus Lübeck, 23538 Lübeck, Germany
- Center for Brain, Behavior and Metabolism, University of Lübeck, 23562 Lübeck, Germany
| | - Norbert Brüggemann
- Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany; (J.P.); (L.K.)
- Department of Neurology, University Medical Center Schleswig Holstein, Campus Lübeck, 23538 Lübeck, Germany
- Center for Brain, Behavior and Metabolism, University of Lübeck, 23562 Lübeck, Germany
- Correspondence: ; Tel.: +49-451-500-43420; Fax: +49-451-500-43424
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41
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Vestergaard MB, Frederiksen JL, Larsson HBW, Cramer SP. Cerebrovascular Reactivity and Neurovascular Coupling in Multiple Sclerosis-A Systematic Review. Front Neurol 2022; 13:912828. [PMID: 35720104 PMCID: PMC9198441 DOI: 10.3389/fneur.2022.912828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/04/2022] [Indexed: 11/25/2022] Open
Abstract
The inflammatory processes observed in the central nervous system in multiple sclerosis (MS) could damage the endothelium of the cerebral vessels and lead to a dysfunctional regulation of vessel tonus and recruitment, potentially impairing cerebrovascular reactivity (CVR) and neurovascular coupling (NVC). Impaired CVR or NVC correlates with declining brain health and potentially plays a causal role in the development of neurodegenerative disease. Therefore, we examined studies on CVR or NVC in MS patients to evaluate the evidence for impaired cerebrovascular function as a contributing disease mechanism in MS. Twenty-three studies were included (12 examined CVR and 11 examined NVC). Six studies found no difference in CVR response between MS patients and healthy controls. Five studies observed reduced CVR in patients. This discrepancy can be because CVR is mainly affected after a long disease duration and therefore is not observed in all patients. All studies used CO2 as a vasodilating stimulus. The studies on NVC demonstrated diverse results; hence a conclusion that describes all the published observations is difficult to find. Future studies using quantitative techniques and larger study samples are needed to elucidate the discrepancies in the reported results.
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Affiliation(s)
- Mark B Vestergaard
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Jette L Frederiksen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Henrik B W Larsson
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark.,Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Stig P Cramer
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
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42
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Li B, Li J, Zhang Y, Chu Z, Zhang L, Ji Q. Dynamic changes of hepatic microenvironment related to graft function in donation after cardiac death liver transplantation. Eur J Radiol 2022; 154:110424. [DOI: 10.1016/j.ejrad.2022.110424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/31/2022] [Accepted: 06/22/2022] [Indexed: 11/30/2022]
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43
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Li W, Xu F, Zhu D, van Zijl PCM, Qin Q. T 2 -oximetry-based cerebral venous oxygenation mapping using Fourier-transform-based velocity-selective pulse trains. Magn Reson Med 2022; 88:1292-1302. [PMID: 35608208 PMCID: PMC9247032 DOI: 10.1002/mrm.29300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 12/14/2022]
Abstract
Purpose To develop a T2‐oximetry method for quantitative mapping of cerebral venous oxygenation fraction (Yv) using Fourier‐transform–based velocity‐selective (FT‐VS) pulse trains. Methods The venous isolation preparation was achieved by using an FT‐VS inversion plus a nonselective inversion (NSI) pulse to null the arterial blood signal while minimally affected capillary blood flows out into the venular vasculature during the outflow time (TO), and then applying an Fourier transform based velocity selective saturation (FT‐VSS) pulse to suppress the tissue signal. A multi‐echo readout was employed to obtain venous T2 (T2,v) efficiently with the last echo used to detect the residual CSF signal and correct its contamination in the fitting. Here we compared the performance of this FT‐VS–based venous isolation preparations with a traditional velocity‐selective saturation (VSS)–based approach (quantitative imaging of extraction of oxygen and tissue consumption [QUIXOTIC]) with different cutoff velocities for Yv mapping on 6 healthy volunteers at 3 Tesla. Results The FT‐VS–based methods yielded higher venous blood signal and temporal SNR with less CSF contamination than the velocity‐selective saturation–based results. The averaged Yv values across the whole slice measured in different experiments were close to the global Yv measured from the individual internal jugular vein. Conclusion The feasibility of the FT‐VS–based Yv estimation was demonstrated on healthy volunteers. The obtained high venous signal as well as the mitigation of CSF contamination led to a good agreement between the T2,v and Yv measured in the proposed method with the values in the literature. Click here for author‐reader discussions
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Affiliation(s)
- Wenbo Li
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Feng Xu
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Dan Zhu
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Peter C M van Zijl
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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44
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Jiang D, Lu H. Cerebral oxygen extraction fraction MRI: Techniques and applications. Magn Reson Med 2022; 88:575-600. [PMID: 35510696 PMCID: PMC9233013 DOI: 10.1002/mrm.29272] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/20/2022] [Accepted: 03/29/2022] [Indexed: 12/20/2022]
Abstract
The human brain constitutes 2% of the body's total mass but uses 20% of the oxygen. The rate of the brain's oxygen utilization can be derived from a knowledge of cerebral blood flow and the oxygen extraction fraction (OEF). Therefore, OEF is a key physiological parameter of the brain's function and metabolism. OEF has been suggested to be a useful biomarker in a number of brain diseases. With recent advances in MRI techniques, several MRI-based methods have been developed to measure OEF in the human brain. These MRI OEF techniques are based on the T2 of blood, the blood signal phase, the magnetic susceptibility of blood-containing voxels, the effect of deoxyhemoglobin on signal behavior in extravascular tissue, and the calibration of the BOLD signal using gas inhalation. Compared to 15 O PET, which is considered the "gold standard" for OEF measurement, MRI-based techniques are non-invasive, radiation-free, and are more widely available. This article provides a review of these emerging MRI-based OEF techniques. We first briefly introduce the role of OEF in brain oxygen homeostasis. We then review the methodological aspects of different categories of MRI OEF techniques, including their signal mechanisms, acquisition methods, and data analyses. The strengths and limitations of the techniques are discussed. Finally, we review key applications of these techniques in physiological and pathological conditions.
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Affiliation(s)
- Dengrong Jiang
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland, USA
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45
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Xu M, Bo B, Pei M, Chen Y, Shu CY, Qin Q, Hirschler L, Warnking JM, Barbier EL, Wei Z, Lu H, Herman P, Hyder F, Liu ZJ, Liang Z, Thompson GJ. High-resolution relaxometry-based calibrated fMRI in murine brain: Metabolic differences between awake and anesthetized states. J Cereb Blood Flow Metab 2022; 42:811-825. [PMID: 34910894 PMCID: PMC9014688 DOI: 10.1177/0271678x211062279] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Functional magnetic resonance imaging (fMRI) techniques using the blood-oxygen level-dependent (BOLD) signal have shown great potential as clinical biomarkers of disease. Thus, using these techniques in preclinical rodent models is an urgent need. Calibrated fMRI is a promising technique that can provide high-resolution mapping of cerebral oxygen metabolism (CMRO2). However, calibrated fMRI is difficult to use in rodent models for several reasons: rodents are anesthetized, stimulation-induced changes are small, and gas challenges induce noisy CMRO2 predictions. We used, in mice, a relaxometry-based calibrated fMRI method which uses cerebral blood flow (CBF) and the BOLD-sensitive magnetic relaxation component, R2', the same parameter derived in the deoxyhemoglobin-dilution model of calibrated fMRI. This method does not use any gas challenges, which we tested on mice in both awake and anesthetized states. As anesthesia induces a whole-brain change, our protocol allowed us to overcome the former limitations of rodent studies using calibrated fMRI. We revealed 1.5-2 times higher CMRO2, dependent upon brain region, in the awake state versus the anesthetized state. Our results agree with alternative measurements of whole-brain CMRO2 in the same mice and previous human anesthesia studies. The use of calibrated fMRI in rodents has much potential for preclinical fMRI.
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Affiliation(s)
- Mengyang Xu
- iHuman Institute, ShanghaiTech University, Shanghai, China.,School of Life Science and Technology, ShanghaiTech University, Shanghai, China.,Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Binshi Bo
- CAS Center for Excellence in Brain Sciences and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Mengchao Pei
- CAS Center for Excellence in Brain Sciences and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Yuyan Chen
- CAS Center for Excellence in Brain Sciences and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Christina Y Shu
- Biomedical Engineering, Yale University, New Haven, CT, USA.,Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA
| | - Qikai Qin
- iHuman Institute, ShanghaiTech University, Shanghai, China.,School of Life Science and Technology, ShanghaiTech University, Shanghai, China.,Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai, China
| | - Lydiane Hirschler
- Grenoble Institut des Neurosciences, Inserm, Univ. Grenoble Alpes, Grenoble, France.,C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan M Warnking
- Grenoble Institut des Neurosciences, Inserm, Univ. Grenoble Alpes, Grenoble, France
| | - Emmanuel L Barbier
- Grenoble Institut des Neurosciences, Inserm, Univ. Grenoble Alpes, Grenoble, France
| | - Zhiliang Wei
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
| | - Hanzhang Lu
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
| | - Peter Herman
- Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA.,Quantitative Neuroscience with Magnetic Resonance (QNMR) Core Center, Yale University, New Haven, CT, USA.,Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Fahmeed Hyder
- Biomedical Engineering, Yale University, New Haven, CT, USA.,Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA.,Quantitative Neuroscience with Magnetic Resonance (QNMR) Core Center, Yale University, New Haven, CT, USA.,Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Zhi-Jie Liu
- iHuman Institute, ShanghaiTech University, Shanghai, China.,School of Life Science and Technology, ShanghaiTech University, Shanghai, China.,Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai, China
| | - Zhifeng Liang
- CAS Center for Excellence in Brain Sciences and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
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46
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Deckers PT, Bhogal AA, Dijsselhof MB, Faraco CC, Liu P, Lu H, Donahue MJ, Siero JC. Hemodynamic and metabolic changes during hypercapnia with normoxia and hyperoxia using pCASL and TRUST MRI in healthy adults. J Cereb Blood Flow Metab 2022; 42:861-875. [PMID: 34851757 PMCID: PMC9014679 DOI: 10.1177/0271678x211064572] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Blood oxygenation level-dependent (BOLD) or arterial spin labeling (ASL) MRI with hypercapnic stimuli allow for measuring cerebrovascular reactivity (CVR). Hypercapnic stimuli are also employed in calibrated BOLD functional MRI for quantifying neuronally-evoked changes in cerebral oxygen metabolism (CMRO2). It is often assumed that hypercapnic stimuli (with or without hyperoxia) are iso-metabolic; increasing arterial CO2 or O2 does not affect CMRO2. We evaluated the null hypothesis that two common hypercapnic stimuli, 'CO2 in air' and carbogen, are iso-metabolic. TRUST and ASL MRI were used to measure the cerebral venous oxygenation and cerebral blood flow (CBF), from which the oxygen extraction fraction (OEF) and CMRO2 were calculated for room-air, 'CO2 in air' and carbogen. As expected, CBF significantly increased (9.9% ± 9.3% and 12.1% ± 8.8% for 'CO2 in air' and carbogen, respectively). CMRO2 decreased for 'CO2 in air' (-13.4% ± 13.0%, p < 0.01) compared to room-air, while the CMRO2 during carbogen did not significantly change. Our findings indicate that 'CO2 in air' is not iso-metabolic, while carbogen appears to elicit a mixed effect; the CMRO2 reduction during hypercapnia is mitigated when including hyperoxia. These findings can be important for interpreting measurements using hypercapnic or hypercapnic-hyperoxic (carbogen) stimuli.
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Affiliation(s)
- Pieter T Deckers
- Department of Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Alex A Bhogal
- Department of Radiology, Center for Image Sciences, University Medical Center Utrecht, Utrecht, Netherlands
| | - Mathijs Bj Dijsselhof
- Department of Radiology, Center for Image Sciences, University Medical Center Utrecht, Utrecht, Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam UMC (location VUmc), Amsterdam, Netherlands
| | - Carlos C Faraco
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Peiying Liu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Manus J Donahue
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jeroen Cw Siero
- Department of Radiology, Center for Image Sciences, University Medical Center Utrecht, Utrecht, Netherlands.,Spinoza Centre for Neuroimaging, Amsterdam, Netherlands
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47
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Petre B, Kragel P, Atlas LY, Geuter S, Jepma M, Koban L, Krishnan A, Lopez-Sola M, Losin EAR, Roy M, Woo CW, Wager TD. A multistudy analysis reveals that evoked pain intensity representation is distributed across brain systems. PLoS Biol 2022; 20:e3001620. [PMID: 35500023 PMCID: PMC9098029 DOI: 10.1371/journal.pbio.3001620] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 05/12/2022] [Accepted: 04/07/2022] [Indexed: 01/22/2023] Open
Abstract
Information is coded in the brain at multiple anatomical scales: locally, distributed across regions and networks, and globally. For pain, the scale of representation has not been formally tested, and quantitative comparisons of pain representations across regions and networks are lacking. In this multistudy analysis of 376 participants across 11 studies, we compared multivariate predictive models to investigate the spatial scale and location of evoked heat pain intensity representation. We compared models based on (a) a single most pain-predictive region or resting-state network; (b) pain-associated cortical-subcortical systems developed from prior literature ("multisystem models"); and (c) a model spanning the full brain. We estimated model accuracy using leave-one-study-out cross-validation (CV; 7 studies) and subsequently validated in 4 independent holdout studies. All spatial scales conveyed information about pain intensity, but distributed, multisystem models predicted pain 20% more accurately than any individual region or network and were more generalizable to multimodal pain (thermal, visceral, and mechanical) and specific to pain. Full brain models showed no predictive advantage over multisystem models. These findings show that multiple cortical and subcortical systems are needed to decode pain intensity, especially heat pain, and that representation of pain experience may not be circumscribed by any elementary region or canonical network. Finally, the learner generalization methods we employ provide a blueprint for evaluating the spatial scale of information in other domains.
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Affiliation(s)
- Bogdan Petre
- Dartmouth College, Hanover, New Hampshire, United States of America
| | - Philip Kragel
- University of Colorado Boulder, Colorado, United States of America
| | - Lauren Y. Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland, United States of America
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
- National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland, United States of America
| | - Stephan Geuter
- Johns Hopkins University, Baltimore, Maryland, United States of America
| | | | | | - Anjali Krishnan
- Brooklyn College of the City University of New York, Brooklyn, New York, United States of America
| | - Marina Lopez-Sola
- Department of Medicine, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | | | | | - Choong-Wan Woo
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Gyeonggi-do, Republic of Korea
| | - Tor D. Wager
- Dartmouth College, Hanover, New Hampshire, United States of America
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48
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Deng S, Franklin CG, O'Boyle M, Zhang W, Heyl BL, Jerabek PA, Lu H, Fox PT. Hemodynamic and metabolic correspondence of resting-state voxel-based physiological metrics in healthy adults. Neuroimage 2022; 250:118923. [PMID: 35066157 PMCID: PMC9201851 DOI: 10.1016/j.neuroimage.2022.118923] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 12/18/2022] Open
Abstract
Voxel-based physiological (VBP) variables derived from blood oxygen level dependent (BOLD) fMRI time-course variations include: amplitude of low frequency fluctuations (ALFF), fractional amplitude of low frequency fluctuations (fALFF) and regional homogeneity (ReHo). Although these BOLD-derived variables can detect between-group (e.g. disease vs control) spatial pattern differences, physiological interpretations are not well established. The primary objective of this study was to quantify spatial correspondences between BOLD VBP variables and PET measurements of cerebral metabolic rate and hemodynamics, being well-validated physiological standards. To this end, quantitative, whole-brain PET images of metabolic rate of glucose (MRGlu; 18FDG) and oxygen (MRO2; 15OO), blood flow (BF; H215O) and blood volume (BV; C15O) were obtained in 16 healthy controls. In the same subjects, BOLD time-courses were obtained for computation of ALFF, fALFF and ReHo images. PET variables were compared pair-wise with BOLD variables. In group-averaged, across-region analyses, ALFF corresponded significantly only with BV (R = 0.64; p < 0.0001). fALFF corresponded most strongly with MRGlu (R = 0.79; p < 0.0001), but also significantly (p < 0.0001) with MRO2 (R = 0.68), BF (R = 0.68) and BV (R=0.68). ReHo performed similarly to fALFF, with significant strong correspondence (p < 0.0001) with MRGlu (R = 0.78), MRO2 (R = 0.54), and, but less strongly with BF (R = 0.50) and BV (R=0.50). Mutual information analyses further clarified these physiological interpretations. When conditioned by BV, ALFF retained no significant MRGlu, MRO2 or BF information. When conditioned by MRGlu, fALFF and ReHo retained no significant MRO2, BF or BV information. Of concern, however, the strength of PET-BOLD correspondences varied markedly by brain region, which calls for future investigation on physiological interpretations at a regional and per-subject basis.
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Affiliation(s)
- Shengwen Deng
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA; Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Crystal G Franklin
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Michael O'Boyle
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Wei Zhang
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Betty L Heyl
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Paul A Jerabek
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, USA
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; South Texas Veterans Health Care System, San Antonio, TX, USA.
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49
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Young Adults with a Parent with Dementia Show Early Abnormalities in Brain Activity and Brain Volume in the Hippocampus: A Matched Case-Control Study. Brain Sci 2022; 12:brainsci12040496. [PMID: 35448026 PMCID: PMC9028426 DOI: 10.3390/brainsci12040496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023] Open
Abstract
Having a parent with Alzheimer’s disease (AD) and related dementias confers a risk for developing these types of neurocognitive disorders in old age, but the mechanisms underlying this risk are understudied. Although the hippocampus is often one of the earliest brain regions to undergo change in the AD process, we do not know how early in the lifespan such changes might occur or whether they differ early in the lifespan as a function of family history of AD. Using a rare sample, young adults with a parent with late-onset dementia, we investigated whether brain abnormalities could already be detected compared with a matched sample. Moreover, we employed simple yet novel techniques to characterize resting brain activity (mean and standard deviation) and brain volume in the hippocampus. Young adults with a parent with dementia showed greater resting mean activity and smaller volumes in the left hippocampus compared to young adults without a parent with dementia. Having a parent with AD or a related dementia was associated with early aberrations in brain function and structure. This early hippocampal dysfunction may be due to aberrant neural firing, which may increase the risk for a diagnosis of dementia in old age.
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50
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Nikparast F, Ganji Z, Danesh Doust M, Faraji R, Zare H. Brain pathological changes during neurodegenerative diseases and their identification methods: How does QSM perform in detecting this process? Insights Imaging 2022; 13:74. [PMID: 35416533 PMCID: PMC9008086 DOI: 10.1186/s13244-022-01207-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 03/13/2022] [Indexed: 12/14/2022] Open
Abstract
The presence of iron is essential for many biological processes in the body. But sometimes, for various reasons, the amount of iron deposition in different areas of the brain increases, which leads to problems related to the nervous system. Quantitative susceptibility mapping (QSM) is one of the newest magnetic resonance imaging (MRI)-based methods for assessing iron accumulation in target areas. This Narrative Review article aims to evaluate the performance of QSM compared to other methods of assessing iron deposition in the clinical field. Based on the results, we introduced related basic definitions, some neurodegenerative diseases, methods of examining iron deposition in these diseases, and their advantages and disadvantages. This article states that the QSM method can be introduced as a new, reliable, and non-invasive technique for clinical evaluations.
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Affiliation(s)
- Farzaneh Nikparast
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zohreh Ganji
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Danesh Doust
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reyhane Faraji
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hoda Zare
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. .,Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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