Applications and limitations of whole-brain MAGIC VASO functional imaging

Neural activity induced by sensory stimulation can drive large-scale cerebrospinal fluid flow during wakefulness in humans

Cerebrospinal fluid (CSF) flow maintains healthy brain homeostasis, facilitating solute transport and the exchange of brain waste products. CSF flow is thus important for brain health, but the mechanisms that control its large-scale movement through the ventricles are not well understood. While it is well established that CSF flow is modulated by respiratory and cardiovascular dynamics, recent work has also demonstrated that neural activity is coupled to large waves of CSF flow in the ventricles during sleep. To test whether the temporal coupling between neural activity and CSF flow is in part due to a causal relationship, we investigated whether CSF flow could be induced by driving neural activity with intense visual stimulation. We manipulated neural activity with a flickering checkerboard visual stimulus and found that we could drive macroscopic CSF flow in the human brain. The timing and amplitude of CSF flow was matched to the visually evoked hemodynamic responses, suggesting neural activity can modulate CSF flow via neurovascular coupling. These results demonstrate that neural activity can contribute to driving CSF flow in the human brain and that the temporal dynamics of neurovascular coupling can explain this effect.

Cerebral blood volume sensitive layer-fMRI in the human auditory cortex at 7T: Challenges and capabilities

The development of ultra high field fMRI signal readout strategies and contrasts has led to the possibility of imaging the human brain in vivo and non-invasively at increasingly higher spatial resolutions of cortical layers and columns. One emergent layer-fMRI acquisition method with increasing popularity is the cerebral blood volume sensitive sequence named vascular space occupancy (VASO). This approach has been shown to be mostly sensitive to locally-specific changes of laminar microvasculature, without unwanted biases of trans-laminar draining veins. Until now, however, VASO has not been applied in the technically challenging cortical area of the auditory cortex. Here, we describe the main challenges we encountered when developing a VASO protocol for auditory neuroscientific applications and the solutions we have adopted. With the resulting protocol, we present preliminary results of laminar responses to sounds and as a proof of concept for future investigations, we map the topographic representation of frequency preference (tonotopy) in the auditory cortex.

Validating layer-specific VASO across species

Cerebral blood volume (CBV) has been shown to be a robust and important physiological parameter for quantitative interpretation of functional (f)MRI, capable of delivering highly localized mapping of neural activity. Indeed, with recent advances in ultra-high-field (≥7T) MRI hardware and associated sequence libraries, it has become possible to capture non-invasive CBV weighted fMRI signals across cortical layers. One of the most widely used approaches to achieve this (in humans) is through vascular-space-occupancy (VASO) fMRI. Unfortunately, the exact contrast mechanisms of layer-dependent VASO fMRI have not been validated for human fMRI and thus interpretation of such data is confounded. Here we validate the signal source of layer-dependent SS-SI VASO fMRI using multi-modal imaging in a rat model in response to neuronal activation (somatosensory cortex) and respiratory challenge (hypercapnia). In particular VASO derived CBV measures are directly compared to concurrent measures of total haemoglobin changes from high resolution intrinsic optical imaging spectroscopy (OIS). Quantified cortical layer profiling is demonstrated to be in agreement between VASO and contrast enhanced fMRI (using monocrystalline iron oxide nanoparticles, MION). Responses show high spatial localisation to layers of cortical processing independent of confounding large draining veins which can hamper BOLD fMRI studies, (depending on slice positioning). Thus, a cross species comparison is enabled using VASO as a common measure. We find increased VASO based CBV reactivity (3.1 ± 1.2 fold increase) in humans compared to rats. Together, our findings confirm that the VASO contrast is indeed a reliable estimate of layer-specific CBV changes. This validation study increases the neuronal interpretability of human layer-dependent VASO fMRI as an appropriate method in neuroscience application studies, in which the presence of large draining intracortical and pial veins limits neuroscientific inference with BOLD fMRI.

Comparing hand movement rate dependence of cerebral blood volume and BOLD responses at 7T

Functional magnetic resonance imaging (fMRI) based on the Blood Oxygenation Level Dependent (BOLD) contrast takes advantage of the coupling between neuronal activity and the hemodynamics to allow a non-invasive localisation of the neuronal activity. In general, fMRI experiments assume a linear relationship between neuronal activation and the observed hemodynamics. However, the relationship between BOLD responses, neuronal activity, and behaviour are often nonlinear. In addition, the nonlinearity between BOLD responses and behaviour may be related to neuronal process rather than a neurovascular uncoupling. Further, part of the nonlinearity may be driven by vascular nonlinearity effects in particular from large vessel contributions. fMRI based on cerebral blood volume (CBV), promises a higher microvascular specificity, potentially without vascular nonlinearity effects and reduced contamination of the large draining vessels compared to BOLD. In this study, we aimed to investigate differences in BOLD and VASO-CBV signal changes during a hand movement task over a broad range of movement rates. We used a double readout 3D-EPI sequence at 7T to simultaneously measure VASO-CBV and BOLD responses in the sensorimotor cortex. The measured BOLD and VASO-CBV responses increased very similarly in a nonlinear fashion, plateauing for movement rates larger than 1 Hz. Our findings show a tight relationship between BOLD and VASO-CBV responses, indicating that the overall interplay of CBV and BOLD responses are similar for the assessed range of movement rates. These results suggest that the observed nonlinearity of neuronal origin is already present in VASO-CBV measurements, and consequently shows relatively unchanged BOLD responses.

Cardiac cycle-induced EPI time series fluctuations in the brain: Their temporal shifts, inflow effects and T2∗ fluctuations

The cardiac-induced arterial pressure wave causes changes in cerebral blood flow velocities and volumes that affect the signals in echo-planar imaging (EPI). Using single-echo EPI time series data, acquired fast enough to unalias the cardiac frequency, we found that the cardiac cycle-induced signal fluctuations are delayed differentially in different brain regions. When referenced to the time series in larger arterial structures, the cortical voxels are only minimally shifted but significant shifts are observed in subcortical areas. Using double-echo EPI data we mapped the voxels’ “signal at zero echo time”, S₀, and apparent T2∗ over the cardiac cycle. S₀ pulsatility was maximised for voxels with a cardiac cycle-induced timing that was close to the arterial structures and is likely explained by enhanced inflow effects in the cortical areas compared to subcortical areas. Interestingly a consistent T2∗ waveform over the cardiac cycle was observed in all voxels with average amplitude ranges between 0.3-0.55% in grey matter and 0.15–0.22% in white matter. The timing of the T2∗ waveforms suggests a partial volume fluctuation where arteriolar blood volume changes are counterbalanced by changes in CSF volumes.

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The timing of cardiac cycle-induced fluctuations in EPI time series was measured with fast EPI.

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Fluctuations are delayed differentially in different brain regions.

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Cortical voxels are closely matching the timing of arterial structures whereas subcortical voxels are shifted.

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We used double-echo EPI to map S₀ and T₂^∗ in each voxel over the cardiac cycle.

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S₀ pulsatility varies across voxels but a consistent T₂^∗ pulsatility was found in all voxels.

Noise concerns and post-processing procedures in cerebral blood flow (CBF) and cerebral blood volume (CBV) functional magnetic resonance imaging

Functional neuroimaging with blood oxygenation level-dependent (BOLD) contrast has emerged as the most popular method for evaluating qualitative changes in brain function in humans. At typical human field strengths (1.5-3.0T), BOLD contrast provides a measure of changes in transverse water relaxation rates in and around capillary and venous blood, and as such provides only a surrogate marker of brain function that depends on dynamic changes in hemodynamics (e.g., cerebral blood flow and volume) and metabolism (e.g., oxygen extraction fraction and the cerebral metabolic rate of oxygen consumption). Alternative functional neuroimaging methods that are specifically sensitive to these constituents of the BOLD signal are being developed and applied in a growing number of clinical and neuroscience applications of quantitative cerebral physiology. These methods require additional considerations for interpreting and quantifying their contrast responsibly. Here, an overview of two popular methods, arterial spin labeling and vascular space occupancy, is presented specifically in the context of functional neuroimaging. Appropriate post-processing and experimental acquisition strategies are summarized with the motivation of reducing sensitivity to noise and unintended signal sources and improving quantitative accuracy of cerebral hemodynamics.

Non-invasive quantification of absolute cerebral blood volume during functional activation applicable to the whole human brain

PURPOSE

Cerebral blood volume (CBV) changes in many diverse pathologic conditions, and in response to functional challenges along with changes in blood flow, blood oxygenation, and the cerebral metabolic rate of oxygen. The feasibility of a new method for non-invasive quantification of absolute cerebral blood volume that can be applicable to the whole human brain was investigated.

METHODS

Multi-slice data were acquired at 3 T using a novel inversion recovery echo planar imaging (IR-EPI) pulse sequence with varying contrast weightings and an efficient rotating slice acquisition order, at rest and during visual activation. A biophysical model was used to estimate absolute cerebral blood volume at rest and during activation, and oxygenation during activation, on data from 13 normal human subjects.

RESULTS

Cerebral blood volume increased by 21.7% from 6.6 ± 0.8 mL/100 mL of brain parenchyma at rest to 8.0 ± 1.3 mL/100 mL of brain parenchyma in the occipital cortex during visual activation, with average blood oxygenation of 84 ± 2.1% during activation, comparing well with literature.

CONCLUSION

The method is feasible, and could foster improved understanding of the fundamental physiological relationship between neuronal activity, hemodynamic changes, and metabolism underlying brain activation; complement existing methods for estimating compartmental changes; and potentially find utility in evaluating vascular health.

Three-dimensional acquisition of cerebral blood volume and flow responses during functional stimulation in a single scan

In addition to the BOLD scan, quantitative functional MRI studies require measurement of both cerebral blood volume (CBV) and flow (CBF) dynamics. The ability to detect CBV and CBF responses in a single additional scan would shorten the total scan time and reduce temporal variations. Several approaches for simultaneous CBV and CBF measurement during functional MRI experiments have been proposed in two-dimensional (2D) mode covering one to three slices in one repetition time (TR). Here, we extended the principles from previous work and present a three-dimensional (3D) whole-brain MRI approach that combines the vascular-space-occupancy (VASO) and flow-sensitive alternating inversion recovery (FAIR) arterial spin labeling (ASL) techniques, allowing the measurement of CBV and CBF dynamics, respectively, in a single scan. 3D acquisitions are complicated for such a scan combination as the time to null blood signal during a steady state needs to be known. We estimated this using Bloch simulations and demonstrate that the resulting 3D acquisition can detect activation patterns and relative signal changes of quality comparable to that of the original separate scans. The same was found for temporal signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). This approach provides improved acquisition efficiency when both CBV and CBF responses need to be monitored during a functional task.

Noninvasive MRI measurement of the absolute cerebral blood volume-cerebral blood flow relationship during visual stimulation in healthy humans

PURPOSE

The relationship between cerebral blood volume (CBV) and cerebral blood flow (CBF) underlies blood oxygenation level-dependent functional MRI signal. This study investigates the potential for improved characterization of the CBV-CBF relationship in humans, and examines sex effects as well as spatial variations in the CBV-CBF relationship.

METHODS

Healthy subjects were imaged noninvasively at rest and during visual stimulation, constituting the first MRI measurement of the absolute CBV-CBF relationship in humans with complete coverage of the functional areas of interest.

RESULTS

CBV and CBF estimates were consistent with the literature, and their relationship varied both spatially and with sex. In a region of interest with stimulus-induced activation in CBV and CBF at a significance level of the P < 0.05, a power function fit resulted in CBV = 2.1 CBF(0.32) across all subjects, CBV = 0.8 CBF(0.51) in females and CBV = 4.4 CBF(0.15) in males. Exponents decreased in both sexes as ROIs were expanded to include less significantly activated regions.

CONCLUSION

Consideration for potential sex-related differences, as well as regional variations under a range of physiological states, may reconcile some of the variation across literature and advance our understanding of the underlying cerebrovascular physiology.

Noninvasive functional imaging of cerebral blood volume with vascular-space-occupancy (VASO) MRI

Functional MRI (fMRI) based on changes in cerebral blood volume (CBV) can probe directly vasodilatation and vasoconstriction during brain activation or physiologic challenges, and can provide important insights into the mechanism of blood oxygenation level-dependent (BOLD) signal changes. At present, the most widely used CBV fMRI technique in humans is called vascular-space-occupancy (VASO) MRI, and this article provides a technical review of this method. VASO MRI utilizes T1 differences between blood and tissue to distinguish between these two compartments within a voxel, and employs a blood-nulling inversion recovery sequence to yield an MR signal proportional to 1 - CBV. As such, vasodilatation will result in a VASO signal decrease and vasoconstriction will have the reverse effect. The VASO technique can be performed dynamically with a temporal resolution comparable with several other fMRI methods, such as BOLD or arterial spin labeling (ASL), and is particularly powerful when conducted in conjunction with these complementary techniques. The pulse sequence and imaging parameters of VASO can be optimized such that the signal change is predominantly of CBV origin, but careful considerations should be taken to minimize other contributions, such as those from the BOLD effect, cerebral blood flow (CBF) and cerebrospinal fluid (CSF). The sensitivity of the VASO technique is the primary disadvantage when compared with BOLD, but this technique is increasingly demonstrating its utility in neuroscientific and clinical applications.

Physiologic underpinnings of negative BOLD cerebrovascular reactivity in brain ventricles

With a growing need for specific biomarkers in vascular diseases, there has been a surging interest in mapping cerebrovascular reactivity (CVR) of the brain. This index can be measured by conducting a hypercapnia challenge while acquiring blood-oxygenation-level-dependent (BOLD) signals. A BOLD signal increase with hypercapnia is the expected outcome and represents the majority of literature reports; in this work we report an intriguing observation of an apparently negative BOLD CVR response at 3T, during inhalation of 5% CO2 with balance medical air. These "negative-CVR" clusters were specifically located in the ventricular regions of the brain, where CSF is abundant and results in an intense baseline signal. The amplitude of the CVR response was -0.51±0.44% (N=14, age 26±4 years). We hypothesized that this observation might not be due to a decrease in oxygenation but rather a volume effect in which bright CSF signal is replaced by a less intensive blood signal as a result of vasodilation. To test this, we performed an inversion-recovery (IR) experiment to suppress the CSF signal (N=10, age 27±5 years). This maneuver in imaging sequence reversed the sign of the signal response (to 0.66±0.25%), suggesting that the volume change was the predominant reason for the apparently negative CVR in the BOLD experiment. Further support of this hypothesis was provided by a BOLD hyperoxia experiment, in which no voxels showed a negative response, presumably because vasodilation is not usually associated with this challenge. Absolute CBF response to hypercapnia was measured in a new group of subjects (N=8, age 29±7 years) and it was found that CBF in ventricular regions increased by 48% upon CO2 inhalation, suggesting that blood oxygenation most likely increased rather than decreased. The findings from this study suggest that CO2 inhalation results in the dilation of ventricular vessels accompanied by shrinkage in CSF space, which is responsible for the apparently negative CVR in brain ventricles.

Implementation of vascular-space-occupancy MRI at 7T

Vascular-space-occupancy (VASO) MRI exploits the difference between blood and tissue T1 to null blood signal and measure cerebral blood volume changes using the residual tissue signal. VASO imaging is more difficult at higher field because of sensitivity loss due to the convergence of tissue and blood T1 values and increased contamination from blood-oxygenation-level-dependent (BOLD) effects. In addition, compared to 3T, 7T MRI suffers from increased geometrical distortions, e.g., when using echo-planar-imaging, and from increased power deposition, the latter especially problematic for the spin-echo-train sequences commonly used for VASO MRI. Third, non-steady-state blood spin effects become substantial at 7T when only a head coil is available for radiofrequency transmit. In this study, the magnetization-transfer-enhanced-VASO approach was applied to maximize tissue-blood signal difference, which boosted signal-to-noise ratio by 149% ± 13% (n = 7) compared to VASO. Second, a 3D fast gradient-echo sequence with low flip-angle (7°) and short echo-time (1.8 ms) was used to minimize the BOLD effect and to reduce image distortion and power deposition. Finally, a magnetization-reset technique was combined with a motion-sensitized-driven-equilibrium approach to suppress three types of non-steady-state spins. Our initial functional MRI results in normal human brains at 7T with this optimized VASO sequence showed better signal-to-noise ratio than at 3T.

IRON fMRI measurements of CBV and implications for BOLD signal

Changes in cerebral blood volume (CBV) and blood magnetization each induce changes in the transverse relaxation rate of MRI signal that are associated with changes in cerebral activity. BOLD signal, the preeminent method for non-invasive localization of task-induced brain function in human subjects, reflects a combination of changes in CBV and blood magnetization. Intravenous injection of paramagnetic contrast media, usually iron oxide particles surrounded by larger macromolecules, can overwhelm the BOLD response and sensitize signal to blood plasma volume, a method we have deemed "IRON" fMRI. The practical advantage of this technique is the ability to optimize blood magnetization at any echo time, enabling high detection power and the use of short echo times; for these reasons, IRON fMRI has become a valuable imaging tool in animal models. The temporal response of blood plasma volume is quite different from blood flow and BOLD signal; thus, CBV has been identified as a prominent source of transient features of the BOLD response. This article reviews the methodological advantages of the IRON method and how CBV measurements have informed our understanding of the BOLD response.

A review of the development of Vascular-Space-Occupancy (VASO) fMRI

Vascular-Space-Occupancy (VASO) fMRI is a non-invasive technique to detect brain activation based on changes in Cerebral Blood Volume (CBV), as opposed to conventional BOLD fMRI, which is based on changes in blood oxygenation. This technique takes advantage of the T1 difference between blood and surrounding tissue, and uses an inversion recovery pulse sequence to null blood signal while maintaining part of the tissue signal. The VASO signal intensity can thus be considered proportional to 1-CBV. When neural activation causes CBV to increase, the VASO signal will show a decrease, allowing the detection of activated regions in the brain. Activation-induced changes in VASO signal, ∆S/S, are in the order of -1%. Absolute quantification of ∆CBV requires additional assumptions on baseline CBV and water contents of the parenchyma and blood. The first VASO experiment was conducted approximately 10 years ago. The original goal of nulling the blood signal was to isolate and measure extravascular BOLD effects, thus a long TE of 50 ms was used in the inversion recovery experiment. Instead of a positive signal change, a slight decrease in signal was observed, which became more pronounced when TE was shortened to 10 ms. These findings led to the hypothesis of a CBV signal mechanism and the development of VASO fMRI. Since its discovery, VASO has been validated by comparison with MION-CBV studies in animals and has been used in humans and animals to understand metabolic and hemodynamic changes during brain activation and physiologic challenges. With recent development of more sensitive VASO acquisitions, the availability of arterial-based VASO sequences, and improvement in spatial coverage, this technique is finding its place in neuroscience and clinical studies.

Gray matter nulled and vascular space occupancy dependent fMRI response to visual stimulation during hypoxic hypoxia

Two cerebral blood volume (CBV)-weighted fMRI techniques, gray matter nulled (GMN) and vascular space occupancy (VASO)-dependent techniques at spatial resolution of 2 × 2 × 5 mm(3), were compared in the study investigating functional responses in the human visual cortex to stimulation in normoxia (inspired O(2) = 21%) and mild hypoxic hypoxia (inspired O(2) = 12%). GMN and VASO signals and T(2)* were quantified in activated voxels. While the CBV-weighted signal changes in voxels activated by visual stimulation were similar in amplitude in both fMRI techniques in both oxygenation conditions, the number of activated voxels during hypoxic hypoxia was significantly reduced by 72 ± 22% in GMN fMRI and 66 ± 23% in VASO fMRI. T(2)* prolonged in GMN and VASO activated voxels in normoxia by 1.6 ± 0.5 ms and 1.7 ± 0.5 ms, respectively. In hypoxia, however, T(2)* shortened in GMN-activated voxels by 0.7 ± 0.6 ms (p < 0.001 relative to normoxia), but prolonged in VASO-activated ones by 1.1 ± 0.6 ms (p < 0.05 relative to normoxia). The data show that the hemodynamic responses to visual stimulation were not affected by hypoxic hypoxia, but T(2)* increases by both CBV-weighted fMRI techniques were smaller in activated voxels in hypoxia. The mechanisms influencing GMN fMRI signal in both oxygenation conditions were explored by simulating effects of the oxygen extraction fraction (OEF) and partial voluming with cerebral spinal fluid (CSF) and white matter in imaging voxels. It is concluded that while GMN fMRI data point to increased, rather than decreased OEF during visual stimulation in hypoxia, partial voluming by CSF is likely to affect the CBV quantification by GMN fMRI under the experimental conditions used.

Quantitative functional MRI: concepts, issues and future challenges

Since its inception 20 years ago, functional magnetic resonance imaging (fMRI) of the human brain based on the blood oxygenation level dependent (BOLD) contrast phenomenon has proliferated and matured. Today it is the predominant functional brain imaging modality with the majority of applications being in basic cognitive neuroscience where it has primarily been used as a tool to localize brain activity. While the magnitude of the BOLD response is often used in these studies as a surrogate for the level of neuronal activity, the link between the two is, in fact, quite indirect. The BOLD response is dependent upon hemodynamic (blood flow and volume) and metabolic (oxygen consumption) responses as well as acquisition details. Furthermore, the relationship between neuronal activity and the hemodynamic response, termed neurovascular coupling, is itself complex and incompletely understood. Quantitative fMRI techniques have therefore been developed to measure the hemodynamic and metabolic responses to modulations in brain activity. These methods have not only helped clarify the behaviour and origins of the BOLD signal under normal physiological conditions but they have also provided a potentially valuable set of tools for exploring pathophysiological conditions. Such quantitative methods will be critical to realize the potential of fMRI in a clinical context, where simple BOLD measurements cannot be uniquely interpreted, and to enhance the power of fMRI in basic neuroscience research. In this article, recent advances in human quantitative fMRI methods are reviewed, outstanding issues discussed and future challenges and opportunities highlighted.

Application of whole-brain CBV-weighted fMRI to a cognitive stimulation paradigm: robust activation detection in a stroop task experiment using 3D GRASE VASO

Brain activation studies generally utilize blood oxygenation level dependent (BOLD) contrast, most commonly measured using the gradient-echo echo-planar imaging (EPI) technique. BOLD contrast arises from regional changes in cerebral blood flow (CBF), cerebral blood volume (CBV), and the local metabolic rate of oxygen consumption. An alternative to BOLD is the detection of activation through direct measurement of these parameters. A noninvasive approach to measure activation-related CBV changes is the vascular space occupancy (VASO) method, which exploits blood as an endogenous contrast agent by selectively nulling the magnetization of the water spins in the blood. Using a recently developed multislice variant of VASO that enables single-shot whole-brain coverage by virtue of a three-dimensional GRASE readout, we here present the first application of VASO to an fMRI study with a whole-brain cognitive task. Within acceptable measurement times (∼12 minutes), brain activation during a Stroop color-word matching task could be detected reliably both on the group (N = 12) and single subject level, as evident from a qualitative comparison with separately acquired BOLD data and literature reports.

Cerebral blood flow, blood volume, and oxygen metabolism dynamics in human visual and motor cortex as measured by whole-brain multi-modal magnetic resonance imaging

The development of neuroimaging methods to characterize flow-metabolism coupling is crucial for understanding mechanisms that subserve oxygen delivery. Functional magnetic resonance imaging (fMRI) using blood-oxygenation-level-dependent (BOLD) contrast reflects composite changes in cerebral blood volume (CBV), cerebral blood flow (CBF), and the cerebral metabolic rate of oxygen consumption (CMRO(2)). However, it is difficult to separate these parameters from the composite BOLD signal, thereby hampering MR-based flow-metabolism coupling studies. Here, a novel, noninvasive CBV-weighted MRI approach (VASO-FLAIR with 3D GRASE (GRadient-And-Spin-Echo)) is used in conjunction with CBF-weighted and BOLD fMRI in healthy volunteers (n=7) performing simultaneous visual (8 Hz flashing-checkerboard) and motor (1 Hz unilateral joystick) tasks. This approach allows for CBV, CBF, and CMRO(2) to be estimated, yielding (mean+/-s.d.): DeltaCBF=63%+/-12%, DeltaCBV=17%+/-7%, and DeltaCMRO(2)=13%+/-11% in the visual cortex, and DeltaCBF=46%+/-11%, DeltaCBV=8%+/-3%, and DeltaCMRO(2)=12%+/-13% in the motor cortex. Following the visual and motor tasks, the BOLD signal became more negative (P=0.003) and persisted longer (P=0.006) in the visual cortex compared with the motor cortex, whereas CBV and CBF returned to baseline earlier and equivalently. The proposed whole-brain technique should be useful for assessing regional discrepancies in hemodynamic reactivity without the use of intravascular contrast agents.

Magnetization transfer enhanced vascular-space-occupancy (MT-VASO) functional MRI

Vascular-space-occupancy (VASO) MRI is a novel technique that uses blood signal nulling to detect blood volume alterations through changes in tissue signal. VASO has relatively low signal to noise ratio (SNR) because only 10-20% of tissue signal remain at the time of blood nulling. Here, it is shown that by adding a magnetization transfer (MT) prepulse it is possible to increase SNR either by attenuating the initial tissue magnetization when the MT pulse is placed before inversion, or, accelerating the recovery process when the pulse is applied after the inversion. To test whether the MT pulse would affect the blood nulling time in VASO, MT effects in blood were measured both ex vivo in a bovine blood phantom and in vivo in human brain. Such effects were found to be sufficiently small (<2.5%) under a saturation power <or= 3 microT, length=500 ms, and frequency offset >or=40 ppm to allow use of the same nulling time. Subsequently, functional MRI experiments using MT-VASO were performed in human visual cortex at 3 Tesla. The relative signal changes in MT-VASO were of the same magnitude as in VASO, while the contrast to noise ratio (CNR) was enhanced by 44+/-12% and 36+/-11% respectively. Therefore, MT-VASO should provide a means for increasing inherently low CNR in VASO experiments while preserving the CBV sensitivity.

Vascular space occupancy (VASO) cerebral blood volume-weighted MRI identifies hemodynamic impairment in patients with carotid artery disease

PURPOSE

To assess the role of vascular space occupancy (VASO) magnetic resonance imaging (MRI), a noninvasive cerebral blood volume (CBV)-weighted technique, for evaluating CBV reactivity in patients with internal carotid artery (ICA) stenosis.

MATERIALS AND METHODS

VASO reactivity, defined as a signal change in response to hypercapnic stimulus (4-second exhale, 14-second breath-hold), was measured in the left and right ICA flow territories in patients (n=10) with varying degrees of unilateral and bilateral ICA stenosis and in healthy volunteers (n=10).

RESULTS

Percent VASO reactivity was more negative (P<0.01) bilaterally in patients (ipsilateral: -3.6+/-1.5%; contralateral: -3.4+/-1.2%) compared with age-matched controls (left: -1.9+/-0.6%; right: -1.9+/-0.8%). Owing to the nature of the VASO contrast mechanism, this more negative VASO reactivity was attributed to autoregulatory CBV effects in patients. A postbreath-hold overshoot, which was absent in healthy volunteers, was observed unilaterally in a subset of patients.

CONCLUSION

More negative VASO reactivity was observed in patients with ICA stenosis and may be a marker of autoregulatory effects. Furthermore, the postbreath-hold overshoot observed in patients is consistent with compensatory microvascular vasoconstriction and may be a marker of hemodynamic impairment. Based on the results of this feasibility study, VASO should be useful for identifying CBV adjustments in patients with steno-occlusive disease of the ICA.

Current trends and challenges in MRI acquisitions to investigate brain function

Functional magnetic resonance imaging (fMRI) studies using the blood oxygenation level dependent (BOLD) response have become a widely used tool for noninvasive assessment of functional organization of the brain. Yet the technique is still fairly new, with many significant challenges remaining. Capitalizing on additional contrast mechanisms available with MRI, several other functional imaging techniques have been developed that potentially provide improved quantification or specificity of neuronal function. This article reviews the challenges and the current state of the art in MRI-based methods of imaging cognitive function.

T1-weighted functional imaging based on a contrast agent in presurgical mapping

PURPOSE

To assess the applicability of T1-weighted images in the presence of a contrast agent for functional mapping free of susceptibility artifacts, in comparison to the blood oxygenation level-dependent (BOLD) imaging.

MATERIALS AND METHODS

Six patients and five control subjects were scanned using BOLD and T1-weighted functional imaging, in the presence of a Gd-DTPA contrast-agent (TOFICA). In the control group, low- and high-resolution BOLD images were performed. Functional stimuli included motor and language activations.

RESULTS

Both BOLD and TOFICA methods resulted in activations in the expected anatomical regions. The TOFICA mapping gave less distributed and with higher percent signal changes in comparison with the BOLD images. Gd-DTPA remained almost constant in the blood for at least 15 min post injection. In one patient with surgical clips, no signal was detected in the left cerebral hemisphere using BOLD imaging, but activation could be mapped using the TOFICA method.

CONCLUSION

T1-weighted imaging in the presence of a contrast agent can be used for functional mapping. This method is insensitive to susceptibility artifacts, and is therefore advantageous in the evaluation of presurgical cases and in areas of the brain close to cavities in which the BOLD method cannot reliably be applied.

A functional magnetic resonance imaging technique based on nulling extravascular gray matter signal

A new functional magnetic resonance imaging (fMRI) technique is proposed based on nulling the extravascular gray matter (GM) signal, using a spatially nonselective inversion pulse. The remaining MR signal provides cerebral blood volume (CBV) information from brain activation. A theoretical framework is provided to characterize the sources of GM-nulled (GMN) fMRI signal, effects of partial voluming of cerebrospinal fluid (CSF) and white matter, and behaviors of GMN fMRI signal during brain activation. Visual stimulation paradigm was used to explore the GMN fMRI signal behavior in the human brain at 3T. It is shown that the GMN fMRI signal increases by 7.2%+/-1.5%, which is two to three times more than that obtained with vascular space occupancy (VASO)-dependent fMRI (-3.2%+/-0.2%) or blood oxygenation level-dependent (BOLD) fMRI (2.9%+/-0.7%), using a TR of 3,000 ms and a resolution of 2 x 2 x 5 mm(3). Under these conditions the fMRI signal-to-noise ratio (SNR(fMRI)) for BOLD, GMN, and VASO images was 4.97+/-0.76, 4.56+/-0.86, and 2.43+/-1.06, respectively. Our study shows that both signal intensity and activation volume in GMN fMRI depend on spatial resolution because of partial voluming from CSF. It is shown that GMN fMRI is a convenient tool to assess CBV changes associated with brain activation.

Evaluation of MRI models in the measurement of CMRO2 and its relationship with CBF

The aim of this study was to investigate the various MRI biophysical models in the measurements of local cerebral metabolic rate of oxygen (CMRO(2)) and the corresponding relationship with cerebral blood flow (CBF) during brain activation. This aim was addressed by simultaneously measuring the relative changes in CBF, cerebral blood volume (CBV), and blood oxygen level dependent (BOLD) MRI signals in the human visual cortex during visual stimulation. A radial checkerboard delivered flash stimulation at five different frequencies. Two MRI models, the single-compartment model (SCM) and the multicompartment model (MCM), were used to determine the relative changes in CMRO(2) using three methods: [1] SCM with parameters identical to those used in a prior MRI study (M = 0.22; alpha = 0.38); [2] SCM with directly measured parameters (M from hypercapnia and alpha from measured deltaCBV and deltaCBF); and [3] MCM. The magnitude of relative changes in CMRO(2) and the nonlinear relationship between CBF and CMRO(2) obtained with Methods [2] and [3] were not in agreement with those obtained using Method [1]. However, the results of Methods [2] and [3] were aligned with positron emission tomography findings from the literature. Our results indicate that if appropriate parameters are used, the SCM and MCM models are equivalent for quantifying the values of CMRO(2) and determining the flow-metabolism relationship.

Direct estimation of evoked hemoglobin changes by multimodality fusion imaging

In the last two decades, both diffuse optical tomography (DOT) and blood oxygen level dependent (BOLD)-based functional magnetic resonance imaging (fMRI) methods have been developed as noninvasive tools for imaging evoked cerebral hemodynamic changes in studies of brain activity. Although these two technologies measure functional contrast from similar physiological sources, i.e., changes in hemoglobin levels, these two modalities are based on distinct physical and biophysical principles leading to both limitations and strengths to each method. In this work, we describe a unified linear model to combine the complimentary spatial, temporal, and spectroscopic resolutions of concurrently measured optical tomography and fMRI signals. Using numerical simulations, we demonstrate that concurrent optical and BOLD measurements can be used to create cross-calibrated estimates of absolute micromolar deoxyhemoglobin changes. We apply this new analysis tool to experimental data acquired simultaneously with both DOT and BOLD imaging during a motor task, demonstrate the ability to more robustly estimate hemoglobin changes in comparison to DOT alone, and show how this approach can provide cross-calibrated estimates of hemoglobin changes. Using this multimodal method, we estimate the calibration of the 3 tesla BOLD signal to be -0.55%+/-0.40% signal change per micromolar change of deoxyhemoglobin.

VASO-based calculations of CBV change: accounting for the dynamic CSF volume

The goal of the vascular space occupancy (VASO) imaging technique is to use selective nulling of the blood signal to infer relative changes in cerebral blood volume (CBV). In accordance with recent work, we show that changes in the local CSF fraction (x(c)) with activation can significantly impact the VASO signal, thereby limiting our ability to infer DeltaCBV from DeltaVASO alone. Here we calculate CBV change using a VASO-based method which ACcounts for the Dynamic Cerebrospinal (ACDC) fluid fraction. By combining data from two separate VASO acquisitions that eliminate either the blood signal (VASO(b)) or the CSF signal (VASO(c)), a nonlinear least-squares optimization may then be used to simultaneously solve for the relative changes in CBV and CSF with activation. The method is applied across the whole brain during a breath-holding task, offering insight into the relationship between changes in CBV and x(c) associated with global vasodilatation. Calculations of mean changes in CBV in different volumes of interest obtained from the proposed method compare much better with previous (gold-standard) PET data than traditional VASO methods that do not account for a nonzero Deltax(c) with activation. This confirms the necessity of incorporating the dynamic CSF volume into VASO-based calculations of DeltaCBV.

The BOLD response and vascular reactivity during visual stimulation in the presence of hypoxic hypoxia

A disproportionate increase in cerebral blood flow (CBF) relative to the cerebral metabolic rate of oxygen (CMRO(2)), in response to neuronal activation, results in a decreased oxygen extraction fraction (OEF) and hence local 'hyperoxygenation'. The mismatch is the key 'physiological substrate' for blood oxygenation level dependent (BOLD) fMRI. The mismatch may reflect inefficient O(2) diffusion in the brain tissue, a factor requiring maintenance of a steep [O(2)] gradient between capillary bed and neural cell mitochondria. The aim of this study was to assess vascular responsiveness to reduced blood oxygen saturation, using both BOLD fMRI and the CBV-weighted vascular space occupancy (VASO)-dependent fMRI technique, during visual activation in hypoxic hypoxia. Our fMRI results show decreased amplitude and absence of initial sharp overshoot in the BOLD response, while VASO signal was not influenced by decreasing oxygen saturation down to 0.85. The results suggest that the OEF during visual activation may be different in hypoxia relative to normoxia, due to a more efficient oxygen extraction under compromised oxygen availability. The data also indicate that vascular reactivity to brain activation is not affected by mild hypoxia.

The post-stimulation undershoot in BOLD fMRI of human brain is not caused by elevated cerebral blood volume

Functional magnetic resonance imaging (fMRI) based on blood oxygenation level dependent (BOLD) contrast is the most widely used technique for imaging human brain function. However, the dynamic interplay of altered cerebral blood flow (CBF), cerebral blood volume (CBV), and oxidative metabolism (CMRO2) is not yet fully understood. One of the characteristics of the BOLD response is the post-stimulation undershoot, that is increased deoxyhemoglobin, which has been suggested to originate from a delayed recovery of elevated CBV or CMRO2 to baseline. To investigate the CBV contribution to the post-stimulation BOLD undershoot, we performed bolus-tracking experiments using a paramagnetic contrast agent in eight healthy subjects at 3 T. In an initial BOLD experiment without contrast agent, we determined the individual hemodynamic responsiveness. In two separate experiments, we then evaluated the relative CBV (rCBV) during visual stimulation and the post-stimulation undershoot, respectively. The results confirm a pronounced rCBV increase during stimulation (31.4+/-8.6%), but reveal no change in rCBV relative to baseline in the post-stimulation phase (0.7+/-7.2%). This finding renders a CBV contribution to the BOLD MRI undershoot unlikely and--in conjunction with a rapid post-stimulation return of CBF to baseline--supports the idea of a prolonged elevation of oxidative metabolism.