This Article Full Text Full Text (PDF) All Versions of this Article: 37/2/382    most recent 01.STR.0000198807.31299.43v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Roc, A. C. Articles by Detre, J. A. Search for Related Content PubMed PubMed Citation Articles by Roc, A. C. Articles by Detre, J. A. Related Collections Computerized tomography and Magnetic Resonance Imaging Other imaging

(Stroke. 2006;37:382.)
© 2006 American Heart Association, Inc.

Original Contributions

Altered Hemodynamics and Regional Cerebral Blood Flow in Patients With Hemodynamically Significant Stenoses

Anne C. Roc, MS; Jiongjiong Wang, PhD; Beau M. Ances, MD, PhD; David S. Liebeskind, MD; Scott E. Kasner, MD John A. Detre, MD

From the Center for Functional Neuroimaging (A.C.R., J.W., J.A.D.), Department of Neurology (S.E.K., J.A.D.), and Department of Radiology (J.W., J.A.D.), Hospital of the University of Pennsylvania, Philadelphia; Departments of Neuroscience and Radiology (B.M.A.), University of California at San Diego; and UCLA Stroke Center and Department of Neurology (D.S.L.), University of California at Los Angeles.

Correspondence to John A. Detre, MD, Hospital of the University of Pennsylvania, Department of Neurology, 3W Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104. E-mail detre{at}mail.med.upenn.edu

Background and Purpose— Blood oxygen level–dependent (BOLD) contrast largely depends on changes in cerebral blood flow (CBF). Because cerebrovascular disease may result in altered CBF, we assessed the temporal dynamics and magnitude of the BOLD response in patients with major arterial stenoses.

Methods— Seven patients with hemodynamically significant stenoses affecting the anterior circulation (primarily left internal carotid and middle cerebral arteries) were compared with 7 neurologically healthy subjects. Continuous arterial spin-labeled perfusion MRI was used to measure resting CBF globally and within various vascular distributions. The BOLD response was acquired during a visually guided bilateral handball squeeze task while motor performance was recorded by a pressure transducer.

Results— Baseline CBF was reduced in bilateral middle cerebral artery and left anterior cerebral artery territories in patients. A prolonged BOLD hemodynamic response was observed in patients in bilateral primary motor cortices but not visual cortex. Patients also exhibited a larger early negative BOLD response, or "initial dip," in left primary motor cortex. There were no differences in motor performance between groups, suggesting behavioral differences were not primarily responsible for the characteristics of the BOLD response.

Conclusions— An initial deoxygenation followed by a delayed hyperemic BOLD response was observed in patients, although resting flow values were not within an ischemic range. A simple visuomotor BOLD activation paradigm can reflect alterations in the hemodynamic response in patients with hemodynamically significant stenoses.

Key Words: hemodynamics • perfusion • stroke

This article has been cited by other articles:

				R.P.H. Bokkers, P.J. van Laar, K.C.C. van de Ven, L.J. Kapelle, C.J.M. Klijn, and J. Hendrikse Arterial Spin-Labeling MR Imaging Measurements of Timing Parameters in Patients with a Carotid Artery Occlusion AJNR Am. J. Neuroradiol., October 1, 2008; 29(9): 1698 - 1703. [Abstract] [Full Text] [PDF]

				N. Altaf, P. S. Morgan, A. Moody, S. T. MacSweeney, J. R. Gladman, and D. P. Auer Brain White Matter Hyperintensities Are Associated with Carotid Intraplaque Hemorrhage Radiology, July 1, 2008; 248(1): 202 - 209. [Abstract] [Full Text] [PDF]

				P. J. van Laar, Y. van der Graaf, W. P. T. M. Mali, J. van der Grond, and J. Hendrikse Effect of Cerebrovascular Risk Factors on Regional Cerebral Blood Flow Radiology, December 1, 2007; 246(1): 198 - 204. [Abstract] [Full Text] [PDF]