Heterogeneous Cerebral Vasoreactivity Dynamics in Patients with Carotid Stenosis

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2013 Oct 3

PMID 24086687

Citations 8

Authors

Ting-Yu Chang

Wan-Chun Kuan

Kuo-Lun Huang

Chien-Hung Chang

Yeu-Jhy Chang

Ho-Fai Wong

Tsong-Hai Lee

Ho-Ling Liu

Affiliations

Soon will be listed here.

Abstract

Cerebral vasoreactivity (CVR) can be assessed by functional MRI (fMRI) using hypercapnia challenges. In normal subjects, studies have shown temporal variability of CVR blood oxygenation level-dependent responses among different brain regions. In the current study, we analyzed the variability of BOLD CVR dynamics by fMRI with a breath-holding task in 17 subjects with unilateral carotid stenosis before they received carotid stenting. Great heterogeneity of CVR dynamics was observed when comparing BOLD responses between ipsilateral and contralateral hemispheres in each patient, especially in middle cerebral artery (MCA) territories. While some subjects (n=12) had similar CVR responses between either hemisphere, the others (n=5) had a poorly correlated pattern of BOLD changes between ipsilateral and contralateral hemispheres. In the latter group, defined as impaired CVR, post-stenting perfusion tended to be more significantly increased. Our data provides the first observation of divergent temporal BOLD responses during breath holding in patients with carotid stenosis. The development of collateral circulation and the derangement of cerebral hemodynamics can be detected through this novel analysis of the different patterns of BOLD changes. The results also help in prediction of robust increase of perfusion or hyperperfusion after carotid stenting.

Citing Articles

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