Reproducibility of a ramping protocol to measure cerebral vascular reactivity using functional magnetic resonance imaging.

Abstract

Though individual differences in arterial carbon dioxide and oxygen levels inherently exist, the degree of their influence on cerebral vascular reactivity (CVR) is less clear. We examined the reproducibility of BOLD signal changes to an iso-oxic ramping Pet CO2 protocol. CVR changes were induced by altering Pet CO2 while holding Pet O2 constant using a computer-controlled sequential gas delivery (SGD) device. Two MRI scans, each including a linear change in Pet CO2 , were performed using a 3-Tesla (3T) scanner. This ramp sequence consisted of 1min at 30mmHg followed by 4min period during where Pet CO2 was linearly increased from 30 to 50mmHg, 1min at 51mmHg, and concluded with 4min at baseline. The protocol was repeated at a separate visit with 3days between visits (minimum). Intraclass correlation coefficients (ICC) and coefficients of variation (CV) were used to verify reproducibility. Eleven subjects (6 females; mean age 26.5±5.7years) completed the full testing protocol. Good reproducibility was observed for the within-visit ramp sequence (Visit 1: ICC=0.82, CV=6.5%; Visit 2: ICC=0.74, CV=6.4%). Similarly, ramp sequence were reproducible between visits (Scan 1: ICC=0.74, CV=6.5%; Scan 2: ICC=0.66, CV=6.1%). Establishing reproducible methodologies for measuring BOLD signal changes in response to Pet CO2 alterations using a ramp protocol will allow researchers to study CVR functionality. Finally, adding a ramping protocol to CVR studies could provide information about changes in CVR over a broad range of Pet CO2 .