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Magnetic Resonance Imaging for Assessment of Cerebrovascular Reactivity in Cerebral Small Vessel Disease. A Systematic Review.

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)833-41
JournalJournal of Cerebral Blood Flow and Metabolism
Volume36
Early online date16 Feb 2016
DOIs
Publication statusPublished - May 2016

Abstract

Cerebral small vessel disease (SVD) pathophysiology is poorly understood. Cerebrovascular reactivity (CVR) impairment may play a role, but evidence to date is mainly indirect. MRI allows investigation of CVR directly in the tissues affected by SVD. We systematically reviewed the use of MRI to measure CVR in subjects with SVD. Five studies (total n=155 SVD subjects, 84 controls) provided relevant data. The studies included different types of patients. Each study used BOLD MRI to assess CVR but a different vasoactive stimulus and method of calculating CVR. CVR decreased with increasing white matter hyperintensities in two studies (n=17, 11%) and in the presence of microbleeds in another. Three studies (n=138, 89%) found no association of CVR with white matter hyperintensities. No studies provided tissue-specific CVR values. CVR decreased with age in three studies, and with female gender and increasing diastolic blood pressure in one study. Safety and tolerability data were limited. Larger studies using CVR appear to be feasible and are needed, preferably with more standardized methods, to determine if specific clinical or radiological features of SVD are more or less associated with impaired CVR.

    Research areas

  • BOLD MRI; Cerebral small vessel disease; cerebrovascular reactivity; hypercapnia; white matter hyperintensity

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