Blood Oxygen Level Research Articles

20 Congenital Left Temporal Lobe Cyst: A Case Study of rs-fMRI and Cognitive Performance

Objective:Behavior is the product of interconnected brain regions that work together as networks. This case study examines whether there are differences between a participant with a large congenital left temporal lobe cyst, which impacted the volume of structures in the region, and control subjects of similar age on cognitive tasks and network connectivity as measured by resting-state functional magnetic resonance imaging (rs-fMRI).Participants and Methods:The case participant (CP; 71 year old female) and controls (CON; n = 25; 48% female) were recruited as part of a larger aging study. CON were chosen from the larger study population by age (+/- 10 years from CP; Range = 68-86 years). Cognitive tasks included: Shopping list memory task, Montreal Cognitive Assessment, WAIS-IV subtests: Digit Span, Digit-Symbol, Symbol Span, and Letter-Number Sequencing. For rs-fMRI, we administered four blood-oxygen level dependent (BOLD) functional connectivity (rs-fMRI) scans at 6 minutes each. Image processing was conducted using the CONN toolbox. Independent sample t-tests evaluated differences between CP and CON. Segregation was evaluated in the Auditory (Au), Cerebellar-basal ganglia (CBBG), Cingulo-Opercular Task Control (COTC), Dorsal Attention (DA), Default Mode (DMN), Fronto-Parietal Task Control (FPTC), Salience (Sa), Sensory Somatomotor Hand (SSH), Sensory Somatomotor Mouth (SSM), Visual (Vi), and Ventral Attention (VA) networks to assess CP’s functional segregation by network throughout the brain. Bonferroni correction was applied to account for multiple comparisons in cognitive testing (.05/7 for significance at p < 0.007) and network segregation (.05/11 for significance at p < .005).Results:Independent samples t-tests did not reveal significant differences across cognitive tasks (t(24) <1.04, p > .05). Network segregation did not reveal significant differences between CP and CON across networks examined (t(24) < 1.269, p > .005). However, DMN and DA segregation trended toward significance (t(24) = -2.724, p = .006 and t(24) =-2.006, p = .028), respectively) with CP demonstrating lower segregation as compared to CON.Conclusions:CP performed similarly on cognitive testing to CON, indicating that the congenital presence of a large temporal lobe cyst did not impact global cognition, list learning and memory, working memory, or processing speed. CP did not demonstrate significantly different segregation across networks of interest after Bonferroni correction. Our cognitive performance results are consistent with a similar case-study examining language, which revealed intact linguistic abilities (Tuckete et al., 2022). The lack of differences in cognitive performance and segregation highlight the capacity for plasticity in the human brain, even in the presence of a large structural abnormality. This also suggests that the processes of aging in this case are not markedly different from controls. In future research we intend to expand on this case study by evaluating right temporal to hippocampal seeds and language network seeds to delve deeper into memory and language functioning.

Evaluation of vestibular functions in patients with obstructive sleep apnea syndrome

Background To determine the anatomical proximity of the vestibular nuclei to the respiratory nuclei and the effect of susceptibility of the posterior labyrinth to a hypoxic state on the vestibular system. Objective It was aimed to evaluate the possible effects of periodic hypoxia on vestibular reflexes and proprioceptive perception in patients with obstructive sleep apnea syndrome (OSAS). Material and methods The study was conducted with 40 patients diagnosed with moderate and severe OSAS and 21 healthy individuals. All individuals were evaluated with Dizziness Handicap Inventory, ocular vestibular evoked myogenic potential (oVEMP), cervical vestibular evoked myogenic potential (cVEMP), video head impulse test (vHIT), videonystagmography (VNG) and sportKAT 3000. Results In the vHIT, a statistically significant difference was found between the groups in terms of anterior and posterior semicircular canal vestibulo-ocular reflex gains (p < .05). A negative correlation was found between the lateral gain asymmetry and RALP gain asymmetry and the awake blood oxygen level in the OSAS groups. There was a statistically significant difference between the groups in terms of wave response rates cVEMP 100 dB nHL and oVEMP 100–110 dB nHL (p < .05). Conclusion and Significance It was concluded that vestibular reflexes and proprioceptive perception were affected due to periodic/chronic hypoxia in patients with moderate and severe OSAS.

GABA, glutamatergic dynamics and BOLD contrast assessed concurrently using functional MRS during a cognitive task.

A recurring issue in functional neuroimaging is how to link task-driven haemodynamic blood oxygen level dependent functional MRI (BOLD-fMRI) responses to underlying neurochemistry at the synaptic level. Glutamate and γ-aminobutyric acid (GABA), the major excitatory and inhibitory neurotransmitters respectively, are typically measured with MRS sequences separately from fMRI, in the absence of a task. The present study aims to resolve this disconnect, developing acquisition and processing techniques to simultaneously assess GABA, glutamate and glutamine (Glx) and BOLD in relation to a cognitive task, at 3 T. Healthy subjects (N = 81) performed a cognitive task (Eriksen flanker), which was presented visually in a task-OFF, task-ON block design, with individual event onset timing jittered with respect to the MRS readout. fMRS data were acquired from the medial anterior cingulate cortex during task performance, using an adapted MEGA-PRESS implementation incorporating unsuppressed water-reference signals at a regular interval. These allowed for continuous assessment of BOLD activation, through T2 *-related changes in water linewidth. BOLD-fMRI data were additionally acquired. A novel linear model was used to extract modelled metabolite spectra associated with discrete functional stimuli, building on well established processing and quantification tools. Behavioural outcomes from the flanker task, and activation patterns from the BOLD-fMRI sequence, were as expected from the literature. BOLD response assessed through fMRS showed a significant correlation with fMRI, specific to the fMRS-targeted region of interest; fMRS-assessed BOLD additionally correlated with lengthening of response time in the incongruent flanker condition. While no significant task-related changes were observed for GABA+, a significant increase in measured Glx levels (~8.8%) was found between task-OFF and task-ON periods. These findings verify the efficacy of our protocol and analysis pipelines for the simultaneous assessment of metabolite dynamics and BOLD. As well as establishing a robust basis for further work using these techniques, we also identify a number of clear directions for further refinement in future studies.

Detection of resting-state functional connectivity in the lumbar spinal cord with 3T MRI

Functional MRI (fMRI) of the spinal cord is an expanding area of research with potential to investigate neuronal activity in the central nervous system. We aimed to characterize the functional connectivity features of the human lumbar spinal cord using resting-state fMRI (rs-fMRI) at 3T, using region-based and data-driven analysis approaches. A 3D multi-shot gradient echo resting-state blood oxygenation level dependent-sensitive rs-fMRI protocol was implemented in 26 healthy participants. Average temporal signal-to-noise ratio in the gray matter was 16.35 ± 4.79 after denoising. Evidence of synchronous signal fluctuations in the ventral and dorsal horns with their contralateral counterparts was observed in representative participants using interactive, exploratory seed-based correlations. Group-wise average in-slice Pearson’s correlations were 0.43 ± 0.17 between ventral horns, and 0.48 ± 0.16 between dorsal horns. Group spatial independent component analysis (ICA) was used to identify areas of coherent activity¸ and revealed components within the gray matter corresponding to anatomical regions. Lower-dimensionality ICA revealed bilateral components corresponding to ventral and dorsal networks. Additional separate ICAs were run on two subsets of the participant group, yielding two sets of components that showed visual consistency and moderate spatial overlap. This work shows feasibility of rs-fMRI to probe the functional features and organization of the lumbar spinal cord.

Design and Implementation of an Open-Source and Internet-of-Things-Based Health Monitoring System

Across the globe, COVID-19 had far-reaching impacts that included healthcare facilities, public health, as well as all forms of transport. Hospitals were experiencing staffing shortages at the same time as patients were experiencing healthcare issues. Consequently, even in developing countries without full access to technology, remote health monitoring became necessary. There was a greater severity of the pandemic in countries with fewer financial and technical resources. It became evident that such remote health monitoring systems that not only allowed the user to monitor their basic health information, but also to communicate that information to healthcare personnel, were essential. In this article, we present an open-source, Internet-of-Things (IoT)-based health monitoring system that is intended to mitigate the basic healthcare challenges posed by remote areas of developing countries. To facilitate remote health monitoring, an IoT server has been configured on an ESP32 chip as part of this study. The microcontroller was also connected to a Max 30100 sensor, a DHT11 sensor, and a global positioning system GPS module. As a result of this, the user is able to measure the heart rate (HR), blood oxygen level (SpO2), human body temperature, ambient temperature and humidity, as well as the location of the user. Through the internet protocol, the important vital signs can be displayed in real time on the dashboard using a private communication network. This article presents the details of a complete system design, implementation, testing, and results. Such systems can help limit the spread of infectious diseases like COVID-19.

Joint classification and segmentation for an interpretable diagnosis of acute respiratory distress syndrome from chest x-rays.

Acute respiratory distress syndrome (ARDS) is a life-threatening condition that can cause a dramatic drop in blood oxygen levels due to widespread lung inflammation. Chest radiography is widely used as a primary modality to detect ARDS due to its crucial role in diagnosing the syndrome, and the x-ray images can be obtained promptly. However, despite the extensive literature on chest x-ray (CXR) image analysis, there is limited research on ARDS diagnosis due to the scarcity of ARDS-labeled datasets. Additionally, many machine learning-based approaches result in high performance in pulmonary disease diagnosis, but their decisions are often not easily interpretable, which can hinder their clinical acceptance. This work aims to develop a method for detecting signs of ARDS in CXR images that can be clinically interpretable. To achieve this goal, an ARDS-labeled dataset of chest radiography images is gathered and annotated for training and evaluation of the proposed approach. The proposed deep classification-segmentation model, Dense-Ynet, provides an interpretable framework for automatically diagnosing ARDS in CXR images. The model takes advantage of lung segmentation in diagnosing ARDS. By definition, ARDS causes bilateral diffuse infiltrates throughout the lungs. To consider the local involvement of lung areas, each lung is divided into upper and lower halves, and our model classifies the resulting lung quadrants. The quadrant-based classification strategy yields the area under the receiver operating characteristic curve of 95.1% (95% CI 93.5 to 96.1), which allows for providing a reference for the model's predictions. In terms of segmentation, the model accurately identifies lung regions in CXR images even when lung boundaries are unclear in abnormal images. This study provides an interpretable decision system for diagnosing ARDS, by following the definition used by clinicians for the diagnosis of ARDS from CXR images.

Development of pulmonary embolism in a patient after COVID-19 disease: A case report

Pulmonary embolism (PE) Is a life-threatening condition in which a blood clot occurs in the pulmonary artery. It can damage part of the lung due to decreased blood flow and can be fatal due to decreasing oxygen levels in blood [1]. Here we present the case of a 49-year-old male patient presented in trauma and emergency with LRTI symptoms. His RT-PCR test for COVID-19 was positive. On echocardiography patient’s right ventricle and right atrium were dilated, blood reports showed an increasing D-Dimer level and the patient had persistent hypoxia. Therefore, e was thrombolysed with Alteplase 50 mg and managed with conservative treatment. PE is a life-threatening complication of COVID-19. Doctors should not underestimate this and it must be ruled out for better outcomes of patients.

Effects of NMDA-receptor blockade by ketamine on mentalizing and its neural correlates in humans: a randomized control trial

Schizophrenia is associated with various deficits in social cognition that remain relatively unaltered by antipsychotic treatment. While faulty glutamate signaling has been associated with general cognitive deficits as well as negative symptoms of schizophrenia, no direct link between manipulation of glutamate signaling and deficits in mentalizing has been demonstrated thus far. Here, we experimentally investigated whether ketamine, an uncompetitive N-methyl-D-aspartate receptor antagonist known to induce psychotomimetic effects, influences mentalizing and its neural correlates. In a randomized, placebo-controlled between-subjects experiment, we intravenously administered ketamine or placebo to healthy participants performing a video-based social cognition task during functional magnetic resonance imaging. Psychotomimetic effects of ketamine were assessed using the Positive and Negative Syndrome Scale. Compared to placebo, ketamine led to significantly more psychotic symptoms and reduced mentalizing performance (more “no mentalizing” errors). Ketamine also influenced blood oxygen level dependent (BOLD) response during mentalizing compared to placebo. Specifically, ketamine increased BOLD in right posterior superior temporal sulcus (pSTS) and increased connectivity between pSTS and anterior precuneus. These increases may reflect a dysfunctional shift of attention induced by ketamine that leads to mentalizing deficits. Our findings show that a psychotomimetic dose of ketamine impairs mentalizing and influences its neural correlates, a result compatible with the notion that deficient glutamate signaling may contribute to deficits in mentalizing in schizophrenia. The results also support efforts to seek novel psychopharmacological treatments for psychosis and schizophrenia targeting glutamatergic transmission.

Functional FDG-PET: Measurement of Task Related Neural Activity in Humans-A Compartment Model Approach and Comparison to fMRI.

Neuroimaging holds an essential position in global healthcare, as brain-related disorders are a substantial and growing burden. Non-degenerative disorders such as stress, depression and anxiety share common function related traits of diffuse and fluctuating changes, such as change in brain-based functions of mood, behavior and cognitive abilities, where underlying physiological mechanism remain unresolved. In this study we developed a novel application for studying intra-subject task-activated brain function by the quantitative physiological measurement of the change in glucose metabolism in a single scan setup. Data were acquired on a PET/MR-scanner. We implemented a functional [18F]-FDG PET-scan with double boli-tracer administration and finger-tapping activation, as proof-of-concept, in five healthy participants. The [18F]-FDG data were analyzed using a two-tissue compartment double boli kinetic model with an image-derived input function. For stand-alone visual reference, blood oxygenation level dependent (BOLD) functional MRI (fMRI) was acquired in the same session and analyzed separately. We were able to measure the cerebral glucose metabolic rate during baseline as well as activation. Results showed increased glucose metabolic rate during activation by 36.3-87.9% mean 62.0%, locally in the peak seed region of M1 in the brain, on an intra-subject level, as well as very good spatial accuracy on group level, and localization compared to the BOLD fMRI result at subject and group level. Our novel method successfully determined the relative increase in the cerebral metabolic rate of glucose on a voxel level with good visual association to fMRI at the subject-level, holding promise for future individual clinical application. This approach will be easily adapted in future clinical perspectives and pharmacological interventions studies.

Attenuation study with hemoglobin microbubbles for acoustic blood oxygen level dependent imaging

A new microbubble-based biosensor for BOLD imaging applications was developed and acoustically characterized using ultrasound. The biosensor design was based on the use of hemoglobin protein as a shell component of microbubbles, which undergoes changes in structure upon oxygen binding, leading to changes in the mechanical properties of the shells. The acoustic characterization was performed using an ultrasound acoustic transducer with a center frequency of 1 MHz, which was used both as a source and a receiver. The transducer transmitted 5 us pulses at a PRF of 10 Hz at peak-negative pressures ranging from 0 to 0.1 MPa. The microbubbles were then excited, and their signals were measured and transformed to frequency domain using Fast-Fourier transform, from which attenuation was computed. The oxygen-saturated hemoglobin microbubbles were added to either oxy or deoxy PBS at a concentration of 4.5 × 6 mB/ml to collect the microbubble signal. The results showed that the biosensor has potential for use in BOLD imaging applications. The results showed that hemoglobin microbubbles were displaying distinct attenuation properties between oxy and deoxy conditions, thereby showing response to different levels of oxygen.

Is the Brainstem Activation Different Between Healthy Young Male and Female Volunteers at Initiation of Voiding? A High Definition 7-Tesla Magnetic Resonance Imaging Study.

Assessing brainstem function in humans through typical neuroimaging modalities has been challenging. Our objective was to evaluate brain and brainstem activation patterns during initiation of voiding in healthy males and females utilizing a 7 Tesla magnetic resonance imaging (MRI) scanner and a noninvasive brain-bladder functional MRI (fMRI) protocol. Twenty healthy adult volunteers (10 males and 10 females) with no history of urinary symptoms were recruited. Each volunteer underwent a clinic uroflow and postvoid residual assessment and was asked to consume water prior to entering the scanner. Anatomical and diffusion tensor images were obtained first, followed by a blood oxygenation level dependent (BOLD) resting-state fMRI (rs-fMRI) during the empty bladder. Subjects indicated when they felt the urge to void, and a full bladder rs-fMRI was obtained. Once completed, the subjects began 5 voiding cycles, where the first 7.5 seconds of each voiding cycle was identified as "initiation of voiding." BOLD activation maps were generated, and regions of interests with a t-value greater than 2.1 were deemed statistically significant. We present 5 distinct regions within the periaqueductal gray (PAG) and pontine micturition center (PMC) with statistically significant activation associated with an initiation of voiding in both men and women, 3 within the PAG and 2 within the PMC. Several additional areas in the brain also demonstrated activation as well. When comparing males to females, there was an overall lower BOLD activation seen in females throughout all regions, with the exception of the caudate lobe. Our study effectively defines regions within the PAG and PMC involved in initiation of voiding in healthy volunteers. To our knowledge, this is the first study investigating differences between male and female brainstem activation utilizing an ultra-high definition 7T MRI.

Validation of Hypoxia Detection Sequences on the MR Linac

Magnetic resonance linear accelerator (MRL) systems permit acquisition of novel imaging at the time of radiotherapy. A validated MR hypoxia imaging biomarker could select patients for adaptive radiotherapy with hypoxia modification or dose escalation. The aims of this study were (1) to develop a protocol for quantitative hypoxia sensitive MRI (2) to validate these in prostate cancer (PCa) against pimonidazole-stained prostatectomy sections. Blood oxygen level dependent (BOLD), intravoxel incoherent motion (IVIM), oxygen-enhanced (OE) and dynamic contrast enhanced (DCE) MRI were used. Sequences were developed on a diagnostic 1.5 T MR (MRD) and MRL with healthy volunteers and PCa patients. The Hyprogen trial includes men with localized PCa scheduled for prostatectomy. Imaging is acquired twice prior to surgery and oral pimonidazole is taken 8-16 hours before surgery. Whole prostate (WP) and dominant prostatic lesion (DIL) were outlined on T2-weighted (T2W) images and a 'normal prostate' (NP) volume created by subtracting DIL from WP. Contours were applied to parametric maps from the quantitative MRI, with median and IQR extracted. Patient-specific 3D-printed prostate molds were created from WP volumes and used to guide prostate whole organ dissection. Three of 20 patients recruited to date. MRI data were acquired successfully. A personalized prostate mold was produced for each patient and facilitated dissection of the prostatectomy specimen in a matching plane to MRI to validate hypoxia detection of the MR protocol. Correlation with pimonidazole staining is underway. Imaging parameter median values for NP and DIL acquired on MRD and MRL for the first patient are shown (Table 1). The expected differences between NP and DIL for T1 and D are seen and median values for T2* are consistent with reported values in the literature. The MR hypoxia protocol can be acquired safely and is well-tolerated on the MRL. Once validated against pimonidazole staining adaptive radiotherapy protocols will be developed to use this information.

A Different Olfactory Perception in Anosmic Patients: Evidence from Functional MRI

Purpose: Olfactory system is a vital sensory system in mammals, giving them the ability to connect with their environment. Anosmia, or the complete loss of olfaction ability, which could be caused by injuries, is an interesting topic for inspectors with the aim of diagnosing patients. Sniffing test is currently utilized to examine if an individual is suffering from anosmia; however, functional Magnetic Resonance Imaging (fMRI) provides unique information about the structure and function of the different areas of the human brain, and therefore this noninvasive method could be used as a tool to locate the olfactory-related regions of the brain.&#x0D; Materials and Methods: In this study, by recruiting 31 healthy and anosmic individuals, we investigated the neural Blood Oxygenation Level Dependent (BOLD) responses in the olfactory cortices following two odor stimuli, rose and eucalyptus, by using a 3T MR scanner.&#x0D; Results: Comparing the two groups, we observed a network of brain areas being more active in normal individuals when smelling the odors. In addition, a number of brain areas also showed an activation decline during the odor stimuli, which is hypothesized as a resource allocation deactivation.&#x0D; Conclusion: This study illustrated alterations in the brain activity between normal individuals and anosmic patients when smelling odors, and could potentially help for a better anosmia diagnosis in the future.

Towards high-resolution quantitative assessment of vascular dysfunction

Neurovascular alterations are increasingly recognized as a key feature of many brain diseases. They can manifest as a reduction in resting cerebral blood flow or cerebrovascular reactivity (CVR) in the whole brain or in specific regions, depending on the underlying condition. Neurovascular impairment is observed in hypertension, Alzheimer’s disease, stroke, multiple sclerosis and cerebral small vessel disease. Magnetic resonance imaging (MRI)-derived CVR mapping is a reliable marker of vascular dysfunction and has been performed mainly at standard functional MRI (fMRI) resolutions of 2–3 mm using the blood oxygen level dependent (BOLD) contrast. However, vascular alterations may occur at a finer scale (i.e., in the capillary bed) which would be better characterized with smaller voxel sizes. Capillaries in gray matter deliver oxygen and glucose to neural tissue and are arranged in a mesh structure, with variable density across the cortical depth. Given that the human cortex is, on average, 2.5 mm thick, submillimetric voxel sizes are effective in increasing the spatial specificity of measurements of hemodynamic and metabolic changes. Novel MRI sequences offer the possibility to map physiological parameters at high resolution with relatively simple experimental setups. In particular, pairing the BOLD acquisition with a contrast sensitive to blood volume changes, while administering a mild hypercapnic challenge, allows for simultaneous mapping of CVR, cerebral metabolic rate of oxygen consumption and other relevant parameters at a high resolution and can be performed at the clinical field strength of 3 T. We propose that this approach will help provide crucial insights into vascular impairment.

Stretchable Multi‐Channel Ionotronic Electrodes for In Situ Dual‐Modal Monitoring of Muscle–Vascular Activity

AbstractIn situ dual‐modal detection of electrophysiology (EP) and blood oxygen (BO) during muscle–vascular activity is crucial for healthcare and human–machine interaction. It requires an integrated monitoring system: a transparent electrode for EP detection directly adhered to skin and a near‐infrared spectroscopy (NIRs) layer for BO detection. In particular, the multi‐channel, highly transparent, stretchable electrodes should be well developed. In this study, 16‐channel transparent ionotronic electrodes are fabricated based on a stretchable and printable ionogel, demonstrating excellent properties such as high transparency, large stretchability, wet adhesion, biocompatibility, softness, and long‐term stability. The electrode exhibits stable contact impedance for 24 h and a 2‐week periodic EP monitoring. The 16‐channel transparent ionotronic electrode outperforms stretchable gold electrodes by providing stable EP monitoring with minimal interference in NIRs for blood oxygen detection. An in situ negative correlation is found between EP intensity and blood oxygen level over time. This study paves the way for designing transparent ionotronics for synchronous optical‐related monitoring and highlights the potential use of an in situ dual‐modal monitoring system for the study of muscle–vascular coupling in neurocience and rehabilitation.

Estimation of fMRI responses related to epileptic discharges using Bayesian hierarchical modeling.

Simultaneous electroencephalography-functional MRI (EEG-fMRI) is a unique and noninvasive method for epilepsy presurgical evaluation. When selecting voxels by null-hypothesis tests, the conventional analysis may overestimate fMRI response amplitudes related to interictal epileptic discharges (IEDs), especially when IEDs are rare. We aimed to estimate fMRI response amplitudes represented by blood oxygen level dependent (BOLD) percentage changes related to IEDs using a hierarchical model. It involves the local and distributed hemodynamic response homogeneity to regularize estimations. Bayesian inference was applied to fit the model. Eighty-two epilepsy patients who underwent EEG-fMRI and subsequent surgery were included in this study. A conventional voxel-wise general linear model was compared to the hierarchical model on estimated fMRI response amplitudes and on the concordance between the highest response cluster and the surgical cavity. The voxel-wise model overestimated fMRI responses compared to the hierarchical model, evidenced by a practically and statistically significant difference between the estimated BOLD percentage changes. Only the hierarchical model differentiated brief and long-lasting IEDs with significantly different BOLD percentage changes. Overall, the hierarchical model outperformed the voxel-wise model on presurgical evaluation, measured by higher prediction performance. When compared with a previous study, the hierarchical model showed higher performance metric values, but the same or lower sensitivity. Our results demonstrated the capability of the hierarchical model of providing more physiologically reasonable and more accurate estimations of fMRI response amplitudes induced by IEDs. To enhance the sensitivity of EEG-fMRI for presurgical evaluation, it may be necessary to incorporate more appropriate spatial priors and bespoke decision strategies.

Stronger influence of systemic than local hemodynamic-vascular factors on resting-state BOLD functional connectivity

Correlated fluctuations in the blood oxygenation level dependent (BOLD) signal of resting-state functional MRI (i.e., BOLD-functional connectivity, BOLD-FC) reflect a spectrum of neuronal and non-neuronal processes. In particular, there are multiple hemodynamic-vascular influences on BOLD-FC on both systemic (e.g., perfusion delay) and local levels (e.g., neurovascular coupling). While the influence of individual factors has been studied extensively, combined and comparative studies of systemic and local hemodynamic-vascular factors on BOLD-FC are scarce, notably in humans. We employed a multi-modal MRI approach to investigate and compare distinct hemodynamic-vascular processes and their impact on homotopic BOLD-FC in healthy controls and patients with unilateral asymptomatic internal carotid artery stenosis (ICAS). Asymptomatic ICAS is a cerebrovascular disorder, in which neuronal functioning is largely preserved but hemodynamic-vascular processes are impaired, mostly on the side of stenosis. Investigated indicators for local hemodynamic-vascular processes comprise capillary transit time heterogeneity (CTH) and cerebral blood volume (CBV) from dynamic susceptibility contrast (DSC) MRI, and cerebral blood flow (CBF) from pseudo-continuous arterial spin labeling (pCASL). Indicators for systemic processes are time-to-peak (TTP) from DSC MRI and BOLD lags from functional MRI. For each of these parameters, their influence on BOLD-FC was estimated by a comprehensive linear mixed model. Equally across groups, we found that individual mean BOLD-FC, local (CTH, CBV, and CBF) and systemic (TTP and BOLD lag) hemodynamic-vascular factors together explain 40.7% of BOLD-FC variance, with 20% of BOLD-FC variance explained by hemodynamic-vascular factors, with an about two-times larger contribution of systemic versus local factors. We conclude that regional differences in blood supply, i.e., systemic perfusion delays, exert a stronger influence on BOLD-FC than impairments in local neurovascular coupling.

Unveiling Breakthroughs in Post-resuscitation Supportive Care for Out-of-Hospital Cardiac Arrest Survivors: A Narrative Review.

Survivors of out-of-hospital cardiac arrest (OHCA) experience significant mortality rates and neurological impairment, potentially attributed to the hypoxic-ischemic injury sustained amid the cardiac arrest episode. Post-resuscitation care plays a crucial role in determining outcomes for survivors of OHCA. Supportive therapies have proven to be influential in shaping these outcomes. However, targeting higher blood pressure or oxygen levels during the post-resuscitative phase has not been shown to offer any mortality or neurological benefits. In terms of maintaining hemodynamic instability after resuscitation, it is recommended to use norepinephrine rather than epinephrine. While extracorporeal cardiopulmonary resuscitation has shown promising results, targeted temperature management has been found ineffective in improving outcomes despite its previous potential. This review also investigates various challenges and barriers associated with the practical implementation of these supportive therapies in clinical settings. The review also highlights areas ripe for future research and proposes potential directions to further enhance post-resuscitation supportive care for OHCA survivors.

Comparing the efficacy of data-driven denoising methods for a multi-echo fMRI acquisition at 7T

In functional magnetic resonance imaging (fMRI) of the brain the measured signal is corrupted by several (e.g. physiological, motion, and thermal) noise sources and depends on the image acquisition. Imaging at ultrahigh field strength is becoming increasingly popular as it offers increased spatial accuracy. The latter is of particular benefit in brainstem neuroimaging given the small cross-sectional area of most nuclei. However, physiological noise scales with field strength in fMRI acquisitions. Although this problem is in part solved by decreasing voxel size, it is clear that adequate physiological denoising is of utmost importance in brainstem-focused fMRI experiments. Multi-echo sequences have been reported to facilitate highly effective denoising through TE-dependence of Blood Oxygen Level Dependent (BOLD) signals, in a denoising method referred to as multi-echo independent component analysis (ME-ICA). It has not been explored previously how ME-ICA compares to other data-driven denoising approaches at ultrahigh field strength. In the current study, we compared the efficacy of several denoising methods, including anatomical component based correction (aCompCor), Automatic Removal of Motion Artifacts (ICA-AROMA) aggressive and non-aggressive options, ME-ICA, and a combination of ME-ICA and aCompCor. We assessed several data quality metrics, including temporal signal-to-noise ratio (tSNR), delta variation signal (DVARS), spectral density of the global signal, functional connectivity and Shannon spectral entropy. Moreover, we looked at the ability of each method to uncouple the global signal and respiration. In line with previous reports at lower field strengths, we demonstrate that after applying ME-ICA, the data is best post-processed in order to remove spatially diffuse noise with a method such as aCompCor. Our findings indicate that ME-ICA combined with aCompCor and the aggressive option of ICA-AROMA are highly effective denoising approaches for multi-echo data acquired at 7T. ME-ICA combined with aCompCor potentially preserves more signal-of-interest as compared to the aggressive option of ICA-AROMA.

Feature-based Attentional Amplitude Modulations of the Steady-state Visual Evoked Potentials Reflect Blood Oxygen Level Dependent Changes in Feature-sensitive Visual Areas.

Recent EEG studies have investigated basic principles of feature-based attention by means of frequency-tagged random dot kinematograms in which different colors are simultaneously presented at different temporal frequencies to elicit steady-state visual evoked potentials (SSVEPs). These experiments consistently showed global facilitation of the to-be-attended random dot kinematogram-a basic principle of feature-based attention. SSVEP source estimation suggested that posterior visual cortex from V1 to area hMT+/V5 is broadly activated by frequency-tagged stimuli. What is presently unknown is whether the feature-based attentional facilitation of SSVEPs is a rather unspecific neural response including all visual areas that follow the "on/off," or whether SSVEP feature-based amplitude enhancements are driven by activity in visual areas most sensitive to a specific feature, such as V4v in the case of color. Here, we leverage multimodal SSVEP-fMRI recordings in human participants and a multidimensional feature-based attention paradigm to investigate this question. Attending to shape produced significantly greater SSVEP-BOLD covariation in primary visual cortex compared with color. SSVEP-BOLD covariation during color selection increased along the visual hierarchy, with greatest values in areas V3 and V4. Importantly, in area hMT+/V5, we found no differences between shape and color selection. Results suggest that SSVEP amplitude enhancements in feature-based attention is not an unspecific enhancement of neural activity in all visual areas following the "on/off." These findings open new avenues to investigating neural dynamics of competitive interactions in specific visual areas sensitive to a certain feature in a more economical way and better temporal resolution compared with fMRI.