Assessment of hemodynamic response during focal neural activity in human using bolus tracking, arterial spin labeling and BOLD techniques

Limbic Perfusion Is Reduced in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is an illness characterized by a diverse range of debilitating symptoms including autonomic, immunologic, and cognitive dysfunction. Although neurological and cognitive aberrations have been consistently reported, relatively little is known regarding the regional cerebral blood flow (rCBF) in ME/CFS. In this study, we studied a cohort of 31 ME/CSF patients (average age: 42.8 ± 13.5 years) and 48 healthy controls (average age: 42.9 ± 12.0 years) using the pseudo-continuous arterial spin labeling (PCASL) technique on a whole-body clinical 3T MRI scanner. Besides routine clinical MRI, the protocol included a session of over 8 min-long rCBF measurement. The differences in the rCBF between the ME/CSF patients and healthy controls were statistically assessed with voxel-wise and AAL ROI-based two-sample t-tests. Linear regression analysis was also performed on the rCBF data by using the symptom severity score as the main regressor. In comparison with the healthy controls, the patient group showed significant hypoperfusion (uncorrected voxel wise p ≤ 0.001, FWE p ≤ 0.01) in several brain regions of the limbic system, including the anterior cingulate cortex, putamen, pallidum, and anterior ventral insular area. For the ME/CFS patients, the overall symptom severity score at rest was significantly associated with a reduced rCBF in the anterior cingulate cortex. The results of this study show that brain blood flow abnormalities in the limbic system may contribute to ME/CFS pathogenesis.

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.

Task-evoked brain functional magnetic susceptibility mapping by independent component analysis (χICA)

BACKGROUND

Conventionally, independent component analysis (ICA) is performed on an fMRI magnitude dataset to analyze brain functional mapping (AICA). By solving the inverse problem of fMRI, we can reconstruct the brain magnetic susceptibility (χ) functional states. Upon the reconstructed χ dataspace, we propose an ICA-based brain functional χ mapping method (χICA) to extract task-evoked brain functional map.

NEW METHODS

A complex division algorithm is applied to a timeseries of fMRI phase images to extract temporal phase changes (relative to an OFF-state snapshot). A computed inverse MRI (CIMRI) model is used to reconstruct a 4D brain χ response dataset. χICA is implemented by applying a spatial InfoMax ICA algorithm to the reconstructed 4D χ dataspace.

RESULTS

With finger-tapping experiments on a 7T system, the χICA-extracted χ-depicted functional map is similar to the SPM-inferred functional χ map by a spatial correlation of 0.67 ± 0.05. In comparison, the AICA-extracted magnitude-depicted map is correlated with the SPM magnitude map by 0.81 ± 0.05. The understanding of the inferiority of χICA to AICA for task-evoked functional map is an ongoing research topic.

COMPARISON WITH EXISTING METHODS

For task-evoked brain functional mapping, we compare the data-driven ICA method with the task-correlated SPM method. In particular, we compare χICA with AICA for extracting task-correlated timecourses and functional maps.

CONCLUSION

χICA can extract a χ-depicted task-evoked brain functional map from a reconstructed χ dataspace without the knowledge about brain hemodynamic responses. The χICA-extracted brain functional χ map reveals a bidirectional BOLD response pattern that is unavailable (or different) from AICA.

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.

An introduction to normalization and calibration methods in functional MRI

In functional magnetic resonance imaging (fMRI), the blood oxygenation level dependent (BOLD) signal is often interpreted as a measure of neural activity. However, because the BOLD signal reflects the complex interplay of neural, vascular, and metabolic processes, such an interpretation is not always valid. There is growing evidence that changes in the baseline neurovascular state can result in significant modulations of the BOLD signal that are independent of changes in neural activity. This paper introduces some of the normalization and calibration methods that have been proposed for making the BOLD signal a more accurate reflection of underlying brain activity for human fMRI studies.

Cortical responses to amphetamine exposure studied by pCASL MRI and pharmacokinetic/pharmacodynamic dose modeling

INTRODUCTION

Perfusion measurement by arterial spin labeling (ASL) techniques is well suited for pharmaceutical magnetic resonance imaging (phMRI) studies to investigate how drugs change the cerebral perfusion status and further, neuronal activity.

MATERIALS AND METHOD

Twelve healthy normal male volunteers participated in the study which was based on a double blinded design. Six subjects were randomly selected to receive a single oral dose of 20mg d-amphetamine and six were given placebo. Perfusion measurements by pseudo-continuous ASL (pCASL) technique were repeatedly performed at 10 different time points with a 3T clinical MRI scanner during a 10 hour period after dose together with physiologic data and blood sample collections. The dynamic changes in cerebral perfusion in response to the plasma concentration variations of d-amphetamine were analyzed at voxel-level and for regions of interest.

RESULTS

Compared to the placebo group a 20% reduction in cerebral blood flow (CBF) was observed in gray matter for the subjects that received d-amphetamine. The most significant reduction of regional CBF (rCBF) was detected in the basal ganglia, frontal region and insular cortex using voxel based analysis. A relation between d-amphetamine exposure and CBF response was found using PK/PD modeling, which predicted on average a 15% decrease of the CBF in gray matter at a plasma concentration of 30 ng/ml.

CONCLUSION

In this study we have demonstrated that repeated perfusion measurements by pCASL technique was sufficiently robust to differentiate the neurological response between the groups that received d-amphetamine and placebo. Quantitative and repetitive CBF measurements can be used for PK/PD modeling of CNS drug responses in humans.

Quantitative functional magnetic resonance imaging of brain activity using bolus-tracking arterial spin labeling

Blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) is the most widely used method for mapping neural activity in the brain. The interpretation of altered BOLD signals is problematic when cerebral blood flow (CBF) or cerebral blood volume change because of aging and/or neurodegenerative diseases. In this study, a recently developed quantitative arterial spin labeling (ASL) approach, bolus-tracking ASL (btASL), was applied to an fMRI experiment in the rat brain. The mean transit time (MTT), capillary transit time (CTT), relative cerebral blood volume of labeled water (rCBV(lw)), relative cerebral blood flow (rCBF), and perfusion coefficient in the forelimb region of the somatosensory cortex were quantified during neuronal activation and in the resting state. The average MTT and CTT were 1.939+/-0.175 and 1.606+/-0.106 secs, respectively, in the resting state. Both times decreased significantly to 1.616+/-0.207 and 1.305+/-0.201 secs, respectively, during activation. The rCBV(lw), rCBF, and perfusion coefficient increased on average by a factor of 1.123+/-0.006, 1.353+/-0.078, and 1.479+/-0.148, respectively, during activation. In contrast to BOLD techniques, btASL yields physiologically relevant indices of the functional hyperemia that accompanies neuronal activation.

Propofol allows precise quantitative arterial spin labelling functional magnetic resonance imaging in the rat

Functional magnetic resonance imaging (fMRI) techniques highlight cerebral vascular responses which are coupled to changes in neural activation. However, two major difficulties arise when employing these techniques in animal studies. First is the disturbance of cerebral blood flow due to anaesthesia and second is the difficulty of precise reproducible quantitative measurements. These difficulties were surmounted in the current study by using propofol and quantitative arterial spin labelling (QASL) to measure relative cerebral blood volume of labelled water (rCBV(lw),) mean transit time (MTT) and capillary transit time (CTT). The ASL method was applied to measure the haemodynamic response in the primary somatosensory cortex following forepaw stimulation in the rat. Following stimulation an increase in signal intensity and rCBV(lw) was recorded, this was accompanied by a significant decrease in MTT (1.97+/-0.06s to 1.44+/-0.04s) and CTT (1.76+/-0.06s to 1.39+/-0.07s). Two animals were scanned repeatedly on two different experimental days. Stimulation in the first animal was applied to the same forepaw during the initial and repeat scan. In the second animal stimulation was applied to different forepaws on the first and second days. The control and activated ASL signal intensities, rCBVlw on both days were almost identical in both animals. The basal MTT and CTT during the second scan were also very similar to the values obtained during the first scan. The MTT recorded from the animal that underwent stimulation to the same paw during both scanning sessions was very similar on the first and second days. In conclusion, propofol induces little physiological disturbance and holds potential for longitudinal QASL fMRI studies.

BOLD-specific cerebral blood volume and blood flow changes during neuronal activation in humans

To understand and predict the blood-oxygenation level-dependent (BOLD) fMRI signal, an accurate knowledge of the relationship between cerebral blood flow (DeltaCBF) and volume (DeltaCBV) changes is critical. Currently, this relationship is widely assumed to be characterized by Grubb's power-law, derived from primate data, where the power coefficient (alpha) was found to be 0.38. The validity of this general formulation has been examined previously, and an alpha of 0.38 has been frequently cited when calculating the cerebral oxygen metabolism change (DeltaCMRo(2)) using calibrated BOLD. However, the direct use of this relationship has been the subject of some debate, since it is well established that the BOLD signal is primarily modulated by changes in 'venous' CBV (DeltaCBV(v), comprising deoxygenated blood in the capillary, venular, and to a lesser extent, in the arteriolar compartments) instead of total CBV, and yet DeltaCBV(v) measurements in humans have been extremely scarce. In this work, we demonstrate reproducible DeltaCBV(v) measurements at 3 T using venous refocusing for the volume estimation (VERVE) technique, and report on steady-state DeltaCBV(v) and DeltaCBF measurements in human subjects undergoing graded visual and sensorimotor stimulation. We found that: (1) a BOLD-specific flow-volume power-law relationship is described by alpha = 0.23 +/- 0.05, significantly lower than Grubb's constant of 0.38 for total CBV; (2) this power-law constant was not found to vary significantly between the visual and sensorimotor areas; and (3) the use of Grubb's value of 0.38 in gradient-echo BOLD modeling results in an underestimation of DeltaCMRo(2).

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.

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.

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.

Flow-metabolism coupling in human visual, motor, and supplementary motor areas assessed by magnetic resonance imaging

Combined blood oxygenation level-dependent (BOLD) and arterial spin labeling (ASL) functional MRI (fMRI) was performed for simultaneous investigation of neurovascular coupling in the primary visual cortex (PVC), primary motor cortex (PMC), and supplementary motor area (SMA). The hypercapnia-calibrated method was employed to estimate the fractional change in cerebral metabolic rate of oxygen consumption (CMR(O2)) using both a group-average and a per-subject calibration. The group-averaged calibration showed significantly different CMR(O2)-CBF coupling ratios in the three regions (PVC: 0.34 +/- 0.03; PMC: 0.24 +/- 0.03; and SMA: 0.40 +/- 0.02). Part of this difference emerges from the calculated values of the hypercapnic calibration constant M in each region (M(PVC) = 6.6 +/- 3.4, M(PMC) = 4.3 +/- 3.5, and M(SMA) = 7.2 +/- 4.1), while a relatively minor part comes from the spread and shape of the sensorimotor BOLD-CBF responses. The averages of the per-subject calibrated CMR(O2)-CBF slopes were 0.40 +/- 0.04 (PVC), 0.31 +/- 0.03 (PMC), and 0.44 +/- 0.03 (SMA). These results are 10-30% higher than group-calibrated values, and are potentially more useful for quantifying individual differences in focal functional responses. The group-average calibrated motor coupling value is increased to 0.28 +/- 0.03 when stimulus-correlated increases in end-tidal CO(2) are included. Our results support the existence of regional differences in neurovascular coupling, and argue for the importance of achieving optimal accuracy in hypercapnia calibrations to resolve method-dependent variations in published results.

[Functional exploration of the brain by fMRI]

Functional magnetic resonance imaging (fMRI) permits to obtain physiological information about MRI signal, which is modulated by electrical, biochemical, and physiological properties of the cerebral tissue. It is possible to characterize the brain interactions from an fMRI signal. Particularly, the use of a spectral analysis at a given frequency allows access to the time series chronology, which occurs within various activated areas of the brain. Thus, spectral parameters such as coherency and phase shift may be calculated from presupposed stationary stochastic signals and of an estimate of the cross-spectral power density function. Coherency describes a correlation structure in frequency domain between signals and thus allows obtaining an accurate estimate of the phase relation (time delay), which connects the signals between them. We describe in the last part of the article a calculation method integrating spectral information obtained previously and which makes it possible to evaluate the intensity of the existing interaction between two distinct cerebral areas.

Applications and limitations of whole-brain MAGIC VASO functional imaging

This work extends the multiple acquisitions with global inversion cycling vascular space occupancy (MAGIC VASO) method to human whole-brain functional magnetic resonance imaging (fMRI) at 3.0 Tesla and demonstrates the need to consider the dynamic contribution of cerebrospinal fluid (CSF) to the relative VASO signal change (DeltaVASO/VASO). Simulations were performed to determine the optimal slice number between global inversions, and correction factors were obtained to account for incomplete blood nulling in particular slices. The necessity of an accurate estimate of resting cerebral blood volume (CBV(rest)) is discussed in the context of DeltaCBV/CBV calculations. A three-compartment model is proposed to include both the resting and changing fractional CSF contribution (x(c,rest) and Deltax(c), respectively) to DeltaVASO/VASO. A MAGIC VASO sequence that provides whole-brain coverage is demonstrated using a paradigm comprised of visual, motor, and auditory stimulation. Activated regions are quantitatively compared in the corresponding blood oxygenation level-dependent (BOLD) images. Estimates of the minimum DeltaCBV/CBV resulting from motor and visual stimulation were comparable to previous findings at 17 +/- 8% (N = 8) and 19 +/- 9% (N = 6), respectively. The absence of VASO activation for auditory stimulation and evidence of activation-induced decreases in CSF volume fraction around the insula and superior temporal gyrus support the possibility of a Deltax(c) contribution to the VASO signal. Without specific knowledge of the CSF components (x(c,rest) and Deltax(c)), inference of DeltaCBV/CBV from DeltaVASO/VASO is severely limited.

Sevoflurane 0.25 MAC preferentially affects higher order association areas: a functional magnetic resonance imaging study in volunteers

BACKGROUND

Functional magnetic resonance imaging (fMRI) can objectively measure the subjective effects of anesthesia. Memory-related regions (association areas) are affected by subanesthetic doses of volatile anesthetics. In this study we measured the regional neuronal effects of 0.25 MAC sevoflurane in healthy volunteers and differentiated the effect between primary cortical regions and association areas.

METHODS

The effect of 0.25 MAC sevoflurane on visual, auditory, and motor activation was studied in 16 ASA I volunteers. With fMRI (3 Tesla Siemens magnetom), regional cerebral blood flow (rCBF) was measured by the pulsed arterial spin labeling technique. Subjects inhaled a mixture of O2 and 0.25 MAC sevoflurane and standard ASA monitoring was performed. Visual, auditory, and motor activation tasks were used. rCBF was measured in the awake state and during inhalation of 0.25 MAC sevoflurane, without and with activation. The change in rCBF (deltaCBF) with 0.25 MAC Sevoflurane during baseline state and with activation was calculated in 11 regions of interest related to visual, auditory, and motor activation tasks.

RESULTS

The change from baseline rCBF with 0.25 MAC sevoflurane was not statistically significant in the 11 regions of interest. With activation there was a significant increase in CBF in several regions. However, only in the primary and secondary visual cortices (V1, V2), thalamus, hippocampus, and supplementary motor area was the decrease in activation with 0.25 MAC sevoflurane statistically significant (P < 0.05).

CONCLUSION

Memory-related regions (association areas) are affected by subanesthetic concentrations of volatile anesthetics. Using fMRI, this study showed that 0.25 MAC sevoflurane predominantly affects the primary visual cortex, the related association cortex, and certain other higher order association cortices.

Quantification of cerebral blood flow in nonhuman primates using arterial spin labeling and a two-compartment model

Noninvasive absolute quantification of cerebral blood flow (CBF) with high spatial resolution is still a challenging task. Arterial spin labeling (ASL) is a promising magnetic resonance imaging (MRI) method for accurate perfusion quantification. However, modeling of ASL data is far from being standardized and has not been investigated in great detail. In this study, two-compartment modeling of monkey ASL data in three physiological conditions (baseline, sensory activated and globally elevated CBF) is reported. Absolute perfusion and arterial transit times were derived for gray matter (GM) and white matter (WM) separately. The uncertainties of the model's result were determined by Monte Carlo simulations. The fitted CBF values for GM were 133 ml/min/100 ml at baseline condition, 165 ml/min/100 ml during visual stimulation and 234 ml/min/100 ml for globally elevated CBF after intravenous injection of acetazolamide. The ratio of GM to WM CBF was 2.5 at baseline and was found to decrease to 1.6 after application of acetazolamide. The corresponding arterial transit times decreased from 742 to 607 ms in GM and from 985 to 875 ms in WM. Monte Carlo simulations showed that absolute CBF values can be determined with an error of 11-15%, while the arterial transit time values have a coefficient of variation of 25-31%. With an alternative acquisition scheme, the precision of the arterial transit times can be improved significantly. The CBF values in the occipital lobe of the monkey brain quantified with ASL are higher than previously reported in positron emission tomography studies.

Measurement of cerebral perfusion with arterial spin labeling: Part 2. Applications

Arterial spin labeling (ASL) uses magnetic resonance imaging methods to measure cerebral blood flow (CBF) non-invasively. ASL CBF validly localizes brain function and may be especially useful for studies where the time frame of behavioral change is more than a few minutes, such as in longitudinal and treatment studies. ASL measures of cerebral perfusion are highly accurate in detecting lesion laterality in temporal lobe epilepsy, stenotic-occlusive disease, and brain tumors. Among lesioned patients, ASL CBF has excellent concurrent validity when correlated with CBF measured by Positron Emission Tomography or with dynamic susceptibility-weighted magnetic resonance. ASL CBF can predict tumor grading in vivo and can predict six-month response to the surgical treatment of brain tumors. ASL's capability to selectively and non-invasively tag flow in major vessels may refine the monitoring of treatment of cerebrovascular disease and brain tumors. Conclusions about the utility of ASL are limited by the small sample sizes of the studies currently in the literature and by the uncertainty caused by the effect of brain disease on transit times of the magnetic tag. As the method evolves, ASL techniques will likely become more widely used in clinical research and practice.

Exploring large-scale brain networks in functional MRI

Increasing emphasis has been recently put on large-scale network processing of brain functions. To explore these networks, many approaches have been proposed in functional magnetic resonance imaging (fMRI). Their objective is to answer the following two questions: (1) what brain regions are involved in the functional process under investigation? and (2) how do these regions interact? We review some of the key concepts and corresponding methods to cope with both issues.

Venous refocusing for volume estimation: VERVE functional magnetic resonance imaging

A novel, noninvasive magnetic resonance imaging-based method for measuring changes in venous cerebral blood volume (CBV(v)) is presented. Venous refocusing for volume estimation (VERVE) exploits the dependency of the spin-spin relaxation rate of deoxygenated blood on the refocusing interval. Interleaved CPMG EPI acquisitions following a train of either tightly or sparsely spaced hard refocusing pulses (every 3.7 or 30 msec, respectively) at matched echo time were used to isolate the blood signal while minimizing the intravascular blood oxygenation level dependent (BOLD) signal contribution. The technique was employed to determine the steady-state increase in the CBV(v) in the visual cortex (VC) in seven healthy adult volunteers during flickering checkerboard photic stimulation. A functional activation model and a set of previously collected in vitro human whole blood relaxometry data were used to evaluate the intravascular BOLD effect on the VERVE signal. The average VC venous blood volume change was estimated to be 16 +/- 2%. This method has the potential to provide efficient and continuous monitoring of venous cerebral blood volume, thereby enabling further exploration of the mechanism underlying BOLD signal changes upon physiologic, pathophysiologic, and pharmacologic perturbations.

Estimation of the Hemodynamic Response Function in event-related functional MRI: directed acyclic graphs for a general Bayesian inference framework

A convenient way to analyze BOLD fMRI data consists of modeling the whole brain as a stationary, linear system characterized by its transfer function: the Hemodynamic Response Function (HRF). HRF estimation, though of the greatest interest, is still under investigation, for the problem is ill-conditioned. In this paper, we recall the most general Bayesian model for HRF estimation and show how it can beneficially be translated in terms of graphical models, leading to (i) a clear and efficient representation of all structural and functional relationships entailed by the model, and (ii) a straightforward numerical scheme to approximate the joint posterior distribution, allowing for estimation of the HRF, as well as all other model parameters. We finally apply this novel technique on both simulations and real data.

Hypercapnic normalization of BOLD fMRI: comparison across field strengths and pulse sequences

The blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) signal response to neural stimulation is influenced by many factors that are unrelated to the stimulus. These factors are physiological, such as the resting venous cerebral blood volume (CBV(v)) and vessel size, as well as experimental, such as pulse sequence and static magnetic field strength (B(0)). Thus, it is difficult to compare task-induced fMRI signals across subjects, field strengths, and pulse sequences. This problem can be overcome by normalizing the neural activity-induced BOLD fMRI response by a global hypercapnia-induced BOLD signal. To demonstrate the effectiveness of the BOLD normalization approach, gradient-echo BOLD fMRI at 1.5, 4, and 7 T and spin-echo BOLD fMRI at 4 T were performed in human subjects. For neural stimulation, subjects performed sequential finger movements at 2 Hz, while for global stimulation, subjects breathed a 5% CO(2) gas mixture. Under all conditions, voxels containing primarily large veins and those containing primarily active tissue (i.e., capillaries and small veins) showed distinguishable behavior after hypercapnic normalization. This allowed functional activity to be more accurately localized and quantified based on changes in venous blood oxygenation alone. The normalized BOLD signal induced by the motor task was consistent across different magnetic fields and pulse sequences, and corresponded well with cerebral blood flow measurements. Our data suggest that the hypercapnic normalization approach can improve the spatial specificity and interpretation of BOLD signals, allowing comparison of BOLD signals across subjects, field strengths, and pulse sequences. A theoretical framework for this method is provided.

Measuring blood volume and vascular transfer constant from dynamic, T(2)*-weighted contrast-enhanced MRI

Dynamic, contrast-enhanced MRI (deMRI) is increasingly being used to evaluate cerebral microcirculation. There are two different approaches for analyzing deMRI data. Intravascular indicator dilution theory has been used to estimate blood volume (and perfusion), usually from T(2)- or T(2) (*)-weighted images of the first pass of the bolus. However, the theory assumes that the tracer (i.e., contrast agent) remains intravascular, which is often not the case when the blood-brain barrier (BBB) is damaged. Furthermore, the method provides no information on the vascular transfer constant. Pharmacokinetic modeling analyses of T(1)-weighted images after first pass do give values of the vascular transfer constant and the volume of the extravascular, extracellular space (EES), but they generally are unable to give estimates of blood volume. In this study we apply pharmacokinetic modeling to dynamic T(2) (*)-weighted imaging of the first pass of a tracer bolus. This method, which we call first-pass pharmacokinetic modeling (FPPM), gives an estimate of the blood volume, vascular transfer constant, and EES volume. The method was applied to a group of 26 patients with surgically proven tumors (10 glioblastomas multiforme (GBMs), six lymphomas, and 10 meningiomas). The measurements of the blood volume and transfer constant were consistent with the known physiology of these tumors.

Estimation of the hemodynamic response in event-related functional MRI: Bayesian networks as a framework for efficient Bayesian modeling and inference

A convenient way to analyze blood-oxygen-level-dependent functional magnetic resonance imaging data consists of modeling the whole brain as a stationary, linear system characterized by its transfer function: the hemodynamic response function (HRF). HRF estimation, though of the greatest interest, is still under investigation, for the problem is ill-conditioned. In this paper, we recall the most general Bayesian model for HRF estimation and show how it can beneficially be translated in terms of Bayesian graphical models, leading to 1) a clear and efficient representation of all structural and functional relationships entailed by the model, and 2) a straightforward numerical scheme to approximate the joint posterior distribution, allowing for estimation of the HRF, as well as all other model parameters. We finally apply this novel technique on both simulations and real data.

Perfusion imaging using arterial spin labeling

Arterial spin labeling is a magnetic resonance method for the measurement of cerebral blood flow. In its simplest form, the perfusion contrast in the images gathered by this technique comes from the subtraction of two successively acquired images: one with, and one without, proximal labeling of arterial water spins after a small delay time. Over the last decade, the method has moved from the experimental laboratory to the clinical environment. Furthermore, numerous improvements, ranging from new pulse sequence implementations to extensive theoretical studies, have broadened its reach and extended its potential applications. In this review, the multiple facets of this powerful yet difficult technique are discussed. Different implementations are compared, the theoretical background is summarized, and potential applications of various implementations in research as well as in the daily clinical routine are proposed. Finally, a summary of the new developments and emerging techniques in this field is provided.

The physiology and metabolism of neuronal activation: in vivo studies by NMR and other methods

In this article, a review is made of the current knowledge concerning the physiology and metabolism of neuronal activity, as provided by the application of NMR approaches in vivo. The evidence furnished by other functional spectroscopic and imaging techniques, such as PET and optical methods, are also discussed. In spite of considerable amounts of studies presented in the literature, several controversies concerning the mechanisms underlying brain function still remain, mainly due to the difficult assessment of the single vascular and metabolic dynamics which generally influence the functional signals. In this framework, methodological and technical improvements are required to provide new and reliable experimental elements, which can support or eventually modify the current models of activation.

Unsupervised robust nonparametric estimation of the hemodynamic response function for any fMRI experiment

This paper deals with the estimation of the blood oxygen level-dependent response to a stimulus, as measured in functional magnetic resonance imaging (fMRI) data. A precise estimation is essential for a better understanding of cerebral activations. The most recent works have used a nonparametric framework for this estimation, considering each brain region as a system characterized by its impulse response, the so-called hemodynamic response function (HRF). However, the use of these techniques has remained limited since they are not well-adapted to real fMRI data. Here, we develop a threefold extension to previous works. We consider asynchronous event-related paradigms, account for different trial types and integrate several fMRI sessions into the estimation. These generalizations are simultaneously addressed through a badly conditioned observation model. Bayesian formalism is used to model temporal prior information of the underlying physiological process of the brain hemodynamic response. By this way, the HRF estimate results from a tradeoff between information brought by the data and by our prior knowledge. This tradeoff is modeled with hyperparameters that are set to the maximum-likelihood estimate using an expectation conditional maximization algorithm. The proposed unsupervised approach is validated on both synthetic and real fMRI data, the latter originating from a speech perception experiment.

Measurements of cerebral perfusion and arterial hemodynamics during visual stimulation using TURBO-TILT

Estimation of cerebral blood flow (CBF) in functional perfusion imaging could benefit from a method capable of separating effects of arterial arrival time and trailing edge. To accomplish this, the transfer insensitive labeling technique (TILT) was combined with a train of 13 consecutive acquisitions, called TURBO-TILT. Visual activation maps obtained at 13 postlabeling delay times (TI) showed a spatial shift from regions surrounding the arterial vasculature at short TI to brain parenchyma at longer delay times. High baseline CBF and short arrival times were found for the voxels with maximum activation at short TI (<1200 ms), while CBF values (43 ml / 100 g tissue/min) and its increase upon activation (55%) at longer TI were in agreement with literature data on regional cerebral perfusion.

Relation between relative cerebral blood flow, relative cerebral blood volume, and mean transit time in patients with acute ischemic stroke determined by perfusion-weighted MRI

The relation between relative cerebral blood flow (relCBF), relative cerebral blood volume (relCBV), and mean transit time (MTT) changes was examined in 20 patients with acute cerebral ischemia (<6 h) using perfusion-weighted magnetic resonance imaging. Regions of interest (ROI) were selected on MTT maps covering the entire MTT abnormal cortical area. These ROIs were transferred to the relCBF and relCBV maps to analyze the relation between relCBF, relCBV, and MTT on a voxel-by-voxel basis. On the unaffected side, a tight coupling of relCBF and relCBV was found with little variation of MTT. In hypoperfused cortex, relCBV was increased at all investigated relCBF categories, and there was greater relCBV variability than on the unaffected side. Only a severe decrease of relCBF, to less than 0.3, in comparison with the unaffected side was associated with a reduction of relCBV less than 1.0. In contrast to the unaffected side, a power law function (relCBV = 2.283 x relCBF0.549) resulted in a better fit than using a linear function for the correlation of relCBF and relCBV. MTT ratios increased steadily with decreasing CBF values. In conclusion, there is a clear relation between different perfusion-weighted magnetic resonance imaging parameters in acute ischemia, reflecting both the degree of hemodynamic failure as well as compensatory mechanisms including vasodilation.

Imaging methods for evaluating brain function in man

Imaging of brain function and neurotransmission is an important bridge between basic and clinical research. Regional cerebral energy metabolism and blood flow are normally coupled to regional cerebral function. Positron tomography (PET) studies of cerebral glucose metabolism and blood flow, single photon tomography (SPECT) and MRI studies of cerebral perfusion, have been used to image cerebral development and aging in man. The sensitivity, temporal resolution, spatial resolution and lack of radiation have led to the widespread utilization of blood oxygen level dependent (BOLD) and MRI perfusion techniques. PET and SPECT methods for studying cerebral neurotransmission include studies of dopaminergic, serotonergic, cholinergic, opiate and GABAergic neurotransmission in man. Studies of cerebral neurotransmission in man have helped to delineate the mechanisms of action of antipsychotic and antidepressant drugs, the diagnosis and progression of Parkinson's disease, and to evaluate neuroprotective drugs. The strengths, limitations, and application of these modalities are reviewed. The application of these methods to cerebral development and aging are briefly discussed.

Robust Bayesian estimation of the hemodynamic response function in event-related BOLD fMRI using basic physiological information

In BOLD fMRI data analysis, robust and accurate estimation of the Hemodynamic Response Function (HRF) is still under investigation. Parametric methods assume the shape of the HRF to be known and constant throughout the brain, whereas non-parametric methods mostly rely on artificially increasing the signal-to-noise ratio. We extend and develop a previously proposed method that makes use of basic yet relevant temporal information about the underlying physiological process of the brain BOLD response in order to infer the HRF in a Bayesian framework. A general hypothesis test is also proposed, allowing to take advantage of the knowledge gained regarding the HRF to perform activation detection. The performances of the method are then evaluated by simulation. Great improvement is shown compared to the Maximum-Likelihood estimate in terms of estimation error, variance, and bias. Robustness of the estimators with regard to the actual noise structure or level, as well as the stimulus sequence, is also proven. Lastly, fMRI data with an event-related paradigm are analyzed. As suspected, the regions selected from highly discriminating activation maps resulting from the method exhibit a certain inter-regional homogeneity in term of HRF shape, as well as noticeable inter-regional differences.

Changes of cerebral blood flow, oxygenation, and oxidative metabolism during graded motor activation

In the present studies fMRI and a hypercapnic calibration procedure were used to monitor simultaneous changes in cerebral blood flow (CBF), cerebral blood oxygenation, and cerebral metabolic rate of oxygen (CMRO(2)) during activation in the sensorimotor cortex. In the first set of experiments seven volunteers performed bilateral, self-paced finger tapping and in the second set of experiments six volunteers performed bilateral finger tapping with six different frequencies (0.5-3 Hz). During the latter task relative CBF and BOLD signal intensity changes varied linearly as a function of stimulus frequency. In good agreement with recent PET and fMRI data increases in CMRO(2) were smaller than the corresponding changes in CBF during self-paced finger tapping and at all levels of graded motor activation. At a single level of activation and during graded activation there was a positive linear relationship between CBF and CMRO(2) with ratios of approximately 3:1. Comparable proportionality constants have been found in the visual cortex and primary sensory cortex, indicating similarities between the relationship of CBF and CMRO(2) in various cortical regions.

Functional magnetic resonance imaging of the visual system

Functional magnetic resonance imaging (fMRI), which is a technique useful for non-invasive mapping of brain function, is well suited for studying the visual system. This review highlights current clinical applications and research studies involving patients with visual deficits. Relevant reports regarding the investigation of the brain's role in visual processing and some newer fMRI techniques are also reviewed. Functional magnetic resonance imaging has been used for presurgical mapping of visual cortex in patients with brain lesions and for studying patients with amblyopia, optic neuritis, and residual vision in homonymous hemianopia. Retinotopic borders, motion processing, and visual attention have been the topics of several fMRI studies. These reports suggest that fMRI can be useful in clinical and research studies in patients with visual deficits.

Imaging function in the working brain with fMRI

The intrinsic flexibility of functional magnetic resonance imaging has allowed ever more innovative neuroscience applications. New acquisition and analysis techniques have contributed to improvements in detection sensitivity, as well as spatial and temporal resolution. Furthermore, by considering the dynamic evolution of the active brain areas in a network, computational models are making the first steps towards linking brain and mind.

Spatial localization and resolution of BOLD fMRI

It has been demonstrated that the blood-oxygenation-level-dependent (BOLD) fMRI initial dip allows us to resolve (without differential subtraction) structures of the order of 0.5 mm. However, recent results support the proposition that even the later, positive BOLD fMRI signal component can allow us to resolve structures less than 1 mm in size by using differential subtraction when the signal-to-noise ratio is high. So, with a sufficient signal-to-noise ratio, the later, positive component should be useable as a probe for testing cognitive neuroscientific hypotheses that predict neuroanatomical dissociations of less than 1mm.

A comparative fMRI study: T2*-weighted imaging versus R2* mapping

Functional magnetic resonance imaging experiments were performed in human motor cortex at 1.5 T by sampling two successive gradient recalled echo images in a single shot. Several aspects of brain mapping methods based on T2*-weighted imaging and R2* mapping were quantitatively compared. These include the detected activation volume, functional contrast (FC), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Studies based on the R2* mapping method have the following potential advantages: maximum functional contrast, less dependent on TE; and reduced inflow effects. R2* mapping produced the highest functional contrast, but not the largest activation volume due to the reduced signal-to-noise ratio and inflow effects. The sensitivity for activation detection is significantly correlated with the contrast-to-noise ratio, which is determined by both the SNR and FC.