title: Neurovascular uncoupling in resting state fMRI demonstrated in patients with primary brain gliomas.
abstract: BACKGROUND
  To demonstrate that the problem of brain tumor-related neurovascular uncoupling (NVU) is a significant issue with respect to resting state blood oxygen level dependent (BOLD) functional MRI (rsfMRI) similar to task-based BOLD fMRI, in which signal detectability can be compromised by breakdown of normal neurovascular coupling.
  
  
  METHODS
  We evaluated seven de novo brain tumor patients who underwent resting state fMRI as part of comprehensive clinical fMRI exams at 3 Tesla. For each of the seven patients who demonstrated evidence of NVU on task-based motor fMRI, we performed both an independent component analysis (ICA) and an atlas-based parcellation-based seed correlation analysis (SCA) of the resting state fMRI data. For each patient, ipsilesional (IL) and contralesional (CL) regions of interest (ROIs) comprising primary motor and somatosensory cortices were used to evaluate BOLD signal changes on Z score maps derived from both ICA and SCA analysis for evidence of NVU. A subsequent two-tailed t-test was performed to determine whether statistically significant differences between the two sides were present that were consistent with NVU.
  
  
  RESULTS
  In seven patients, overall decreased BOLD signal (based on suprathreshold voxels in ICA and SCA-derived Z-score maps) was noted in IL compared with CL ROIs (P < 0.01), consistent with NVU.
  
  
  CONCLUSIONS
  We have demonstrated that NVU can result in false negative BOLD signal changes on rsfMRI comparable to previously published findings on standard motor task-based fMRI.
authors.affiliation: Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Shruti
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Haris I
authors.initials: HI
authors.lastname: Sair
authors.affiliation: Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Noushin
authors.initials: N
authors.lastname: Yahyavi-Firouz-Abadi
authors.affiliation: Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Raag
authors.initials: R
authors.lastname: Airan
authors.affiliation: Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Jay J
authors.initials: JJ
authors.lastname: Pillai
mesh_terms: D000328:Adult; D000465:Algorithms; D001331:Automation; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology*; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010100:Oxygen / Q000737:chemistry; D010363:Pattern Recognition, Automated; D025341:Principal Component Analysis; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted
chemical_list: D010100:Oxygen
keywords: motor activation; neurovascular uncoupling; presurgical mapping; resting state fMRI