Cerebrovascular reactivity and white matter integrity

Kevin Sam; Boris Peltenburg; John Conklin; Olivia Sobczyk; Julien Poublanc; Adrian P. Crawley; Daniel M. Mandell; Lakshmikumar Venkatraghavan; James Duffin; Joseph A. Fisher; Sandra E. Black; David J. Mikulis

doi:10.1212/WNL.0000000000003373

Cerebrovascular reactivity and white matter integrity

Kevin Sam, Boris Peltenburg, John Conklin, Olivia Sobczyk, Julien Poublanc, Adrian P. Crawley, Daniel M. Mandell, Lakshmikumar Venkatraghavan, James Duffin, Joseph A. Fisher, Sandra E. Black, David J. Mikulis^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective: To compare the diffusion and perfusion MRI metrics of normal-appearing white matter (NAWM) with and without impaired cerebrovascular reactivity (CVR). Methods: Seventy-five participants with moderate to severe leukoaraiosis underwent blood oxygen level-dependent CVR mapping using a 3T MRI system with precise carbon dioxide stimulus manipulation. Several MRI metrics were statistically compared between areas of NAWM with positive and negative CVR using one-way analysis of variance with Bonferroni correction for multiple comparisons. Results: Areas of NAWM with negative CVR showed a significant reduction in fractional anisotropy by a mean (SD) of 3.7% (2.4), cerebral blood flow by 22.1% (8.2), regional cerebral blood volume by 22.2% (7.0), and a significant increase in mean diffusivity by 3.9% (3.1) and time to maximum by 10.9% (13.2) (p <0.01), compared to areas with positive CVR. Conclusions: Impaired CVR is associated with subtle changes in the tissue integrity of NAWM, as evaluated using several quantitative diffusion and perfusion MRI metrics. These findings suggest that impaired CVR may contribute to the progression of white matter disease.

Original language	English
Pages (from-to)	2333-2339
Number of pages	7
Journal	Neurology
Volume	87
Issue number	22
DOIs	https://doi.org/10.1212/WNL.0000000000003373
Publication status	Published - 29 Nov 2016

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title = "Cerebrovascular reactivity and white matter integrity",

abstract = "Objective: To compare the diffusion and perfusion MRI metrics of normal-appearing white matter (NAWM) with and without impaired cerebrovascular reactivity (CVR). Methods: Seventy-five participants with moderate to severe leukoaraiosis underwent blood oxygen level-dependent CVR mapping using a 3T MRI system with precise carbon dioxide stimulus manipulation. Several MRI metrics were statistically compared between areas of NAWM with positive and negative CVR using one-way analysis of variance with Bonferroni correction for multiple comparisons. Results: Areas of NAWM with negative CVR showed a significant reduction in fractional anisotropy by a mean (SD) of 3.7% (2.4), cerebral blood flow by 22.1% (8.2), regional cerebral blood volume by 22.2% (7.0), and a significant increase in mean diffusivity by 3.9% (3.1) and time to maximum by 10.9% (13.2) (p <0.01), compared to areas with positive CVR. Conclusions: Impaired CVR is associated with subtle changes in the tissue integrity of NAWM, as evaluated using several quantitative diffusion and perfusion MRI metrics. These findings suggest that impaired CVR may contribute to the progression of white matter disease.",

author = "Kevin Sam and Boris Peltenburg and John Conklin and Olivia Sobczyk and Julien Poublanc and Crawley, {Adrian P.} and Mandell, {Daniel M.} and Lakshmikumar Venkatraghavan and James Duffin and Fisher, {Joseph A.} and Black, {Sandra E.} and Mikulis, {David J.}",

year = "2016",

month = nov,

day = "29",

doi = "10.1212/WNL.0000000000003373",

language = "English",

volume = "87",

pages = "2333--2339",

journal = "Neurology",

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TY - JOUR

T1 - Cerebrovascular reactivity and white matter integrity

AU - Sam, Kevin

AU - Peltenburg, Boris

AU - Conklin, John

AU - Sobczyk, Olivia

AU - Poublanc, Julien

AU - Crawley, Adrian P.

AU - Mandell, Daniel M.

AU - Venkatraghavan, Lakshmikumar

AU - Duffin, James

AU - Fisher, Joseph A.

AU - Black, Sandra E.

AU - Mikulis, David J.

PY - 2016/11/29

Y1 - 2016/11/29

N2 - Objective: To compare the diffusion and perfusion MRI metrics of normal-appearing white matter (NAWM) with and without impaired cerebrovascular reactivity (CVR). Methods: Seventy-five participants with moderate to severe leukoaraiosis underwent blood oxygen level-dependent CVR mapping using a 3T MRI system with precise carbon dioxide stimulus manipulation. Several MRI metrics were statistically compared between areas of NAWM with positive and negative CVR using one-way analysis of variance with Bonferroni correction for multiple comparisons. Results: Areas of NAWM with negative CVR showed a significant reduction in fractional anisotropy by a mean (SD) of 3.7% (2.4), cerebral blood flow by 22.1% (8.2), regional cerebral blood volume by 22.2% (7.0), and a significant increase in mean diffusivity by 3.9% (3.1) and time to maximum by 10.9% (13.2) (p <0.01), compared to areas with positive CVR. Conclusions: Impaired CVR is associated with subtle changes in the tissue integrity of NAWM, as evaluated using several quantitative diffusion and perfusion MRI metrics. These findings suggest that impaired CVR may contribute to the progression of white matter disease.

AB - Objective: To compare the diffusion and perfusion MRI metrics of normal-appearing white matter (NAWM) with and without impaired cerebrovascular reactivity (CVR). Methods: Seventy-five participants with moderate to severe leukoaraiosis underwent blood oxygen level-dependent CVR mapping using a 3T MRI system with precise carbon dioxide stimulus manipulation. Several MRI metrics were statistically compared between areas of NAWM with positive and negative CVR using one-way analysis of variance with Bonferroni correction for multiple comparisons. Results: Areas of NAWM with negative CVR showed a significant reduction in fractional anisotropy by a mean (SD) of 3.7% (2.4), cerebral blood flow by 22.1% (8.2), regional cerebral blood volume by 22.2% (7.0), and a significant increase in mean diffusivity by 3.9% (3.1) and time to maximum by 10.9% (13.2) (p <0.01), compared to areas with positive CVR. Conclusions: Impaired CVR is associated with subtle changes in the tissue integrity of NAWM, as evaluated using several quantitative diffusion and perfusion MRI metrics. These findings suggest that impaired CVR may contribute to the progression of white matter disease.

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SN - 0028-3878

VL - 87

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EP - 2339

JO - Neurology

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Cerebrovascular reactivity and white matter integrity

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