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.
authors: From the Department of Physiology (K.S., J.D., J.A.F.), Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital (K.S., J.C., O.S., J.P., A.P.C., D.M.M., D.J.M.), Department of Medical Imaging (A.P.C., D.M.M., D.J.M.), and Department of Anaesthesia, Toronto General Hospital (L.V., J.D., J.A.F.), The University of Toronto, Canada; Department of Radiotherapy (B.P.), Imaging Division, University Medical Center Utrecht, Utrecht University, the Netherlands; and L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Canada.
authors: Kevin
authors: K
authors: Sam
authors: From the Department of Physiology (K.S., J.D., J.A.F.), Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital (K.S., J.C., O.S., J.P., A.P.C., D.M.M., D.J.M.), Department of Medical Imaging (A.P.C., D.M.M., D.J.M.), and Department of Anaesthesia, Toronto General Hospital (L.V., J.D., J.A.F.), The University of Toronto, Canada; Department of Radiotherapy (B.P.), Imaging Division, University Medical Center Utrecht, Utrecht University, the Netherlands; and L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Canada.
authors: Boris
authors: B
authors: Peltenburg
authors: From the Department of Physiology (K.S., J.D., J.A.F.), Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital (K.S., J.C., O.S., J.P., A.P.C., D.M.M., D.J.M.), Department of Medical Imaging (A.P.C., D.M.M., D.J.M.), and Department of Anaesthesia, Toronto General Hospital (L.V., J.D., J.A.F.), The University of Toronto, Canada; Department of Radiotherapy (B.P.), Imaging Division, University Medical Center Utrecht, Utrecht University, the Netherlands; and L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Canada.
authors: John
authors: J
authors: Conklin
authors: From the Department of Physiology (K.S., J.D., J.A.F.), Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital (K.S., J.C., O.S., J.P., A.P.C., D.M.M., D.J.M.), Department of Medical Imaging (A.P.C., D.M.M., D.J.M.), and Department of Anaesthesia, Toronto General Hospital (L.V., J.D., J.A.F.), The University of Toronto, Canada; Department of Radiotherapy (B.P.), Imaging Division, University Medical Center Utrecht, Utrecht University, the Netherlands; and L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Canada.
authors: Olivia
authors: O
authors: Sobczyk
authors: From the Department of Physiology (K.S., J.D., J.A.F.), Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital (K.S., J.C., O.S., J.P., A.P.C., D.M.M., D.J.M.), Department of Medical Imaging (A.P.C., D.M.M., D.J.M.), and Department of Anaesthesia, Toronto General Hospital (L.V., J.D., J.A.F.), The University of Toronto, Canada; Department of Radiotherapy (B.P.), Imaging Division, University Medical Center Utrecht, Utrecht University, the Netherlands; and L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Canada.
authors: Julien
authors: J
authors: Poublanc
authors: From the Department of Physiology (K.S., J.D., J.A.F.), Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital (K.S., J.C., O.S., J.P., A.P.C., D.M.M., D.J.M.), Department of Medical Imaging (A.P.C., D.M.M., D.J.M.), and Department of Anaesthesia, Toronto General Hospital (L.V., J.D., J.A.F.), The University of Toronto, Canada; Department of Radiotherapy (B.P.), Imaging Division, University Medical Center Utrecht, Utrecht University, the Netherlands; and L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Canada.
authors: Adrian P
authors: AP
authors: Crawley
authors: From the Department of Physiology (K.S., J.D., J.A.F.), Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital (K.S., J.C., O.S., J.P., A.P.C., D.M.M., D.J.M.), Department of Medical Imaging (A.P.C., D.M.M., D.J.M.), and Department of Anaesthesia, Toronto General Hospital (L.V., J.D., J.A.F.), The University of Toronto, Canada; Department of Radiotherapy (B.P.), Imaging Division, University Medical Center Utrecht, Utrecht University, the Netherlands; and L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Canada.
authors: Daniel M
authors: DM
authors: Mandell
authors: From the Department of Physiology (K.S., J.D., J.A.F.), Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital (K.S., J.C., O.S., J.P., A.P.C., D.M.M., D.J.M.), Department of Medical Imaging (A.P.C., D.M.M., D.J.M.), and Department of Anaesthesia, Toronto General Hospital (L.V., J.D., J.A.F.), The University of Toronto, Canada; Department of Radiotherapy (B.P.), Imaging Division, University Medical Center Utrecht, Utrecht University, the Netherlands; and L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Canada.
authors: Lakshmikumar
authors: L
authors: Venkatraghavan
authors: From the Department of Physiology (K.S., J.D., J.A.F.), Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital (K.S., J.C., O.S., J.P., A.P.C., D.M.M., D.J.M.), Department of Medical Imaging (A.P.C., D.M.M., D.J.M.), and Department of Anaesthesia, Toronto General Hospital (L.V., J.D., J.A.F.), The University of Toronto, Canada; Department of Radiotherapy (B.P.), Imaging Division, University Medical Center Utrecht, Utrecht University, the Netherlands; and L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Canada.
authors: James
authors: J
authors: Duffin
authors: From the Department of Physiology (K.S., J.D., J.A.F.), Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital (K.S., J.C., O.S., J.P., A.P.C., D.M.M., D.J.M.), Department of Medical Imaging (A.P.C., D.M.M., D.J.M.), and Department of Anaesthesia, Toronto General Hospital (L.V., J.D., J.A.F.), The University of Toronto, Canada; Department of Radiotherapy (B.P.), Imaging Division, University Medical Center Utrecht, Utrecht University, the Netherlands; and L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Canada.
authors: Joseph A
authors: JA
authors: Fisher
authors: From the Department of Physiology (K.S., J.D., J.A.F.), Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital (K.S., J.C., O.S., J.P., A.P.C., D.M.M., D.J.M.), Department of Medical Imaging (A.P.C., D.M.M., D.J.M.), and Department of Anaesthesia, Toronto General Hospital (L.V., J.D., J.A.F.), The University of Toronto, Canada; Department of Radiotherapy (B.P.), Imaging Division, University Medical Center Utrecht, Utrecht University, the Netherlands; and L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Canada.
authors: Sandra E
authors: SE
authors: Black
authors: From the Department of Physiology (K.S., J.D., J.A.F.), Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital (K.S., J.C., O.S., J.P., A.P.C., D.M.M., D.J.M.), Department of Medical Imaging (A.P.C., D.M.M., D.J.M.), and Department of Anaesthesia, Toronto General Hospital (L.V., J.D., J.A.F.), The University of Toronto, Canada; Department of Radiotherapy (B.P.), Imaging Division, University Medical Center Utrecht, Utrecht University, the Netherlands; and L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Canada. mikulis@uhnres.utoronto.ca.
authors: David J
authors: DJ
authors: Mikulis
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001931:Brain Mapping; D002245:Carbon Dioxide / Q000008:administration & dosage / Q000378:metabolism; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D049292:Leukoaraiosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010045:Outpatients; D010100:Oxygen / Q000097:blood; D012307:Risk Factors; D066127:White Matter / Q000000981:diagnostic imaging / Q000503:physiopathology*
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen