Variations In Cerebral Blood Flow Research Articles

Age-associated patterns in gray matter volume, cerebral perfusion and BOLD oscillations in children and adolescents.

Healthy brain development involves changes in brain structure and function that are believed to support cognitive maturation. However, understanding how structural changes such as grey matter thinning relate to functional changes is challenging. To gain insight into structure-function relationships in development, the present study took a data driven approach to define age-related patterns of variation in gray matter volume (GMV), cerebral blood flow (CBF) and blood-oxygen level dependent (BOLD) signal variation (fractional amplitude of low-frequency fluctuations; fALFF) in 59 healthy children aged 7-18 years, and examined relationships between modalities. Principal components analysis (PCA) was applied to each modality in parallel, and participant scores for the top components were assessed for age associations. We found that decompositions of CBF, GMV and fALFF all included components for which scores were significantly associated with age. The dominant patterns in GMV and CBF showed significant (GMV) or trend level (CBF) associations with age and a strong spatial overlap, driven by increased signal intensity in default mode network (DMN) regions. GMV, CBF and fALFF additionally showed components accounting for 3-5% of variability with significant age associations. However, these patterns were relatively spatially independent, with small-to-moderate overlap between modalities. Independence of age effects was further demonstrated by correlating individual subject maps between modalities: CBF was significantly less correlated with GMV and fALFF in older children relative to younger. These spatially independent effects of age suggest that the parallel decline observed in global GMV and CBF may not reflect spatially synchronized processes. Hum Brain Mapp 38:2398-2407, 2017. © 2017 Wiley Periodicals, Inc.

Quantification of Serial Cerebral Blood Flow in Acute Stroke Using Arterial Spin Labeling.

Perfusion-weighted imaging is used to select patients with acute ischemic stroke for intervention, but knowledge of cerebral perfusion can also inform the understanding of ischemic injury. Arterial spin labeling allows repeated measurement of absolute cerebral blood flow (CBF) without the need for exogenous contrast. The aim of this study was to explore the relationship between dynamic CBF and tissue outcome in the month after stroke onset. Patients with nonlacunar ischemic stroke underwent ≤5 repeated magnetic resonance imaging scans at presentation, 2 hours, 1 day, 1 week, and 1 month. Imaging included vessel-encoded pseudocontinuous arterial spin labeling using multiple postlabeling delays to quantify CBF in gray matter regions of interest. Receiver-operator characteristic curves were used to predict tissue outcome using CBF. Repeatability was assessed in 6 healthy volunteers and compared with contralateral regions of patients. Diffusion-weighted and T2-weighted fluid attenuated inversion recovery imaging were used to define tissue outcome. Forty patients were included. In contralateral regions of patients, there was significant variation of CBF between individuals, but not between scan times (mean±SD: 53±42 mL/100 g/min). Within ischemic regions, mean CBF was lowest in ischemic core (17±23 mL/100 g/min), followed by regions of early (21±26 mL/100 g/min) and late infarct growth (25±35 mL/100 g/min; ANOVA P<0.0001). Between patients, there was marked overlap in presenting and serial CBF values. Knowledge of perfusion dynamics partially explained tissue fate. Factors such as metabolism and tissue susceptibility are also likely to influence tissue outcome.

Post-treatment changes of tumour perfusion parameters can help to predict survival in patients with high-grade astrocytoma.

Vascular characteristics of tumour and peritumoral volumes of high-grade gliomas change with treatment. This work evaluates the variations of T2*-weighted perfusion parameters as overall survival (OS) predictors. Forty-five patients with histologically confirmed high-grade astrocytoma (8 grade III and 37 grade IV) were included. All patients underwent pre- and post-treatment T2*-weighted contrast-enhanced magnetic resonance (MR) imaging. Tumour, peritumoral and control volumes were segmented. Relative variations of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), Ktrans-T2*, kep-T2*, ve-T2* and vp-T2* were calculated. Differences regarding tumour grade and surgical resection extension were evaluated with ANOVA tests. For each parameter, two groups were defined by non-supervised clusterisation. Survival analysis were performed on these groups. For the tumour region, the 90th percentile increase or stagnation of CBV was associated with shorter survival, while a decrease related to longer survival (393 ± 189 vs 594 ± 294days; log-rank p = 0.019; Cox hazard-ratio, 2.31; 95% confidence interval [CI], 1.12-4.74). Ktrans-T2* showed similar results (414 ± 177 vs 553 ± 312days; log-rank p = 0.037; hazard-ratio, 2.19; 95% CI, 1.03-4.65). The peritumoral area values showed no relationship with OS. Post-treatment variations of the highest CBV and Ktrans-T2* values in the tumour volume are predictive factors of OS in patients with high-grade gliomas. • Vascular characteristics of high-grade glioma tumour and peritumoral regions change with treatment. • Quantitative assessment of MRI perfusion provides valuable information regarding tumour aggressiveness. • Quantitative T2*-weighted perfusion parameters can help to predict overall survival. • Post-treatment variations of CBV and K trans-T2 values are predictive factors of OS. • Increased values may justify treatment intensification in these patients.

Feelings and Senses Given to the Music Present at the Hospital during Hemodynamic Procedures: Cardiac Catheterization and Coronary Angioplasty

Several studies indicate that music has soothing effects and is beneficial in reducing stress and anxiety in coronary patients. It is known that reactions to music are considered to be subjective, however, results of previous studies suggest that variables such as changes in heart rate, in cerebral blood flow and heart rate variability increase with a faster musical tempo, regardless of individual preferences. The effects of stress on the cardiovascular system have also been proven. However, the meanings assigned to music when used during hemodynamic procedures are unknown, as are the meanings of the experience of these procedures. The aim of this research is to understand the senses and feelings of music for patients undergoing hemodynamic procedures, identify and interpret the related fantasies and emotions and study the possibility of deploying in hospitals the “Musical Method for Hemodynamic Procedures”, being developed by the author. This research is based on a Clinical-Qualitative Methodology. The sampling method is the theoretical saturation. The semi structured interview was used in order to obtain data that were submitted to content analysis. The subjects are patients undergoing hemodynamic procedures in the Hospital SEMPER (Permanent Medical Service), Belo Horizonte, Brazil. We conclude that within the experience of listening to music while undergoing catheterization, 100% of the patients interviewed claimed they had overcome the experience of stress and felt calm, tranquility, peace and happiness. Some patients described the music as a companion, as something that diverts their attention from fear, transporting them to an imaginary place, to another dimension. The episodic memory, the capacity to recognize a musical excerpt for which the spatiotemporal context surrounding its former encounter could be recalled, was also important, with surprising results, in the case of patients who underwent catheterization in the presence of music and, later, angioplasty without the presence of music.

Kinetic Models for Measuring P-glycoprotein Function at the Blood-Brain Barrier with Positron Emission Tomography.

P-glycoprotein function is associated with a number of neurodegenerative and psychiatric diseases as well as with pharmacoresistance to for example antiepileptic drugs. The ability to measure P-gp function in vivo would allow for an increased understanding of the mechanisms of disease and treatment. This review assesses the various approaches to in vivo quantification of P-gp function using currently available P-gp tracers and PET in humans. First, the use of compartment models, and their interpretation in terms of P-gp function at the blood-brain barrier, is discussed. Then, the methods that have been used to quantify PET data of the P-gp tracers [11C]verapamil, [11C]N-desmetyl-loperamide (dLop), [11C]laniquidar, [11C]phenytoin, [11C]tariquidar and [11C]elacridar are reviewed. In summary, the extraction of P-gp substrate PET tracers, which is their plasma to tissue rate constant K corrected for variations in regional cerebral blood flow, is generally considered to be the preferred measure of P-gp function.

Cerebral perfusion alterations in type 2 diabetes and its relation to insulin resistance and cognitive dysfunction

To explore the effect of T2DM on cerebral perfusion, and the relationship between cerebral perfusion changes and cognitive impairment as well as diabetic variables, by using a whole-brain arterial spin-labeling (ASL) MRI technique. This prospective study was approved by the local institutional review board and was performed between November 2012 and October 2013. All subjects provided informed consent. Forty T2DM patients and 41 age-, sex- and education-matched healthy controls were included. Cerebral blood flow (CBF) map was obtained by pulsed ASL perfusion imaging at 3 T MRI. Voxel-wise comparisons on CBF maps with and without partial volume effects (PVEs) correction were performed between groups. Associations between CBF and cognitive functioning, and between CBF and diabetic variables were investigated by using voxel-wise, whole-brain correlation analyses. In T2DM patients, PVEs uncorrected CBF was decreased in the posterior cingulate cortex (PCC), precuneus and bilateral occipital lobe, and increased in the anterior cingulate cortex (corrected P < .05). These changes were largely unchanged after PVEs correction. Correlation analyses revealed that in patients, hypoperfusion in PCC and precuneus regions were related to higher insulin resistance level and deficits in clock-drawing performance, while the occipital hypoperfusion was associated with worse visual-memory performance, regardless of PVEs correction. The cerebral hypoperfusion pattern in T2DM resembles the pattern observed in the early stage of dementia, and increased insulin resistance might be an important risk factor as well as treatment target for such CBF dysregulation.

Contribution of prostanoid signaling to the evolution of spreading depolarization and the associated cerebral blood flow response.

The significance of prostanoid signaling in neurovascular coupling during somatosensory stimulation is increasingly more appreciated, yet its involvement in mediating the cerebral blood flow (CBF) response to spreading depolarization (SD) has remained inconclusive. Selective cyclooxygenase (COX) enzyme inhibitors (NS-398, SC-560) or an antagonist (L161,982) of the EP4 type prostaglandin E2 receptor were applied topically to a cranial window over the parietal cortex of isoflurane-anesthetized Sprague-Dawley rats (n = 60). Global forebrain ischemia was induced by occlusion of both common carotid arteries in half of the animals. SDs were triggered by the topical application of 1M KCl. SD occurrence was confirmed by the acquisition of DC potential, and CBF variations were recorded by laser-Doppler flowmetry. EP4 receptor antagonism significantly decreased peak hyperemia and augmented post-SD oligemia in the intact but not in the ischemic cortex. COX-1 inhibition and EP4 receptor blockade markedly delayed repolarization after SD in the ischemic but not in the intact brain. COX-2 inhibition achieved no significant effect on any of the end points taken. The data suggest, that activation of EP4 receptors initiates vasodilation in response to SD in the intact brain, and – together with COX-1 derived prostanoids – shortens SD duration in the acute phase of ischemia.

Nonlinear analyses applied in cerebral autoregulation and blood flow changes in patients with acute intracerebral hemorrhage

Abstract Cerebral autoregulation (CA) is an important mechanism for maintaining constant cerebral blood flow during changes in blood pressure. Although previous studies have shown that CA may be impaired in patients with intracerebral hemorrhage (ICH), the variability of cerebral blood flow (CBF) in response to changes in CA has not been investigated. In the present study, we recruited twelve patients presenting with acute subcortical ICH and seven non-stroke controls. The status of CA was determined by assessing Pearson’s moving correlation coefficient between arterial blood pressure and cerebral blood flow velocity (CBFV) of the middle cerebral artery (MCA). The variability of CBFV was calculated using nonlinear sample entropy analyses. The results indicated that ICH patients significantly showed poorer CA than controls, particularly localized to the MCA ipsilateral to the ICH (controls 0.17 ± 0.13 versus ICH side 0.41 ± 0.27 and non-ICH side 0.34 ± 0.26, p = 0.044 and 0.120, respectively). Moreover, the variability of CBFV in the hemisphere ipsilateral to the ICH was significantly increased in ICH patients when compared to controls (1.145 ± 0.26 versus 1.66 ± 0.193 and 1.595 ± 0.43, p

Advancing age and ischemia elevate the electric threshold to elicit spreading depolarization in the cerebral cortex of young adult rats

Spreading depolarizations of long cumulative duration have been implicated in lesion development and progression in patients with stroke and traumatic brain injury. Spreading depolarizations evolve less likely in the aged brain, but it remains to be determined at what age the susceptibility to spreading depolarizations starts to decline, especially in ischemia. Spreading depolarizations were triggered by epidural electric stimulation prior and after ischemia induction in the cortex of 7–30 weeks old anesthetized rats (n = 38). Cerebral ischemia was achieved by occlusion of both common carotid arteries. Spreading depolarization occurrence was confirmed by the acquisition of DC potential and electrocorticogram. Cerebral blood flow variations were recorded by laser-Doppler flowmetry. Dendritic spine density in the cortex was determined in Golgi-COX stained sections. Spreading depolarization initiation required increasingly greater electric charge with older age, a potential outcome of consolidation of cortical connections, indicated by altered dendritic spine distribution. The threshold of spreading depolarization elicitation increased with ischemia in all age groups, which may be caused by tissue acidosis and increased K+ conductance, among other factors. In conclusion, the brain appears to be the most susceptible to spreading depolarizations at adolescent age; therefore, spreading depolarizations may occur in young patients of ischemic or traumatic brain injury at the highest probability.

Effects of arterial transit delay on cerebral blood flow quantification using arterial spin labeling in an elderly cohort.

To investigate whether measurement of arterial transit time (ATT) can improve the accuracy of arterial spin labeling (ASL) cerebral blood flow (CBF) quantification in an elderly cohort due to the potentially prolonged ATT in the cohort. We employed a 1-minute, low-resolution (12 mm in-plane), sequential multidelay ATT measurement (both with and without vessel suppression) approach to characterize and correct ATT errors in CBF imaging of an elderly, clinical cohort. In all, 140 nondemented subjects greater than 70 years old were imaged at 3T with a single delay, volumetric continuous ASL sequence and also with the fast ATT measurement method. Nine healthy young subjects (28 ± 6 years old) were also imaged. ATTs measured without vessel suppression (superior frontal: 1.51 ± 0.27 sec) in the elderly were significantly shorter than those with suppression (P < 0.0001). Correction of CBF for ATT significantly increased average CBF in multiple brain regions where ATT was longer than the postlabeling delay (P < 0.01) and decreased intersubject variability of CBF in frontal, parietal, and occipital regions (P < 10-8 ). Measured ATT with vessel suppression was significantly longer in the elderly subjects (eg, superior frontal: 1.76 ± 0.25 sec) compared to the younger adults (superior frontal: 1.59 ± 0.19 sec) in basal ganglia and frontal cortical regions (P < 0.05). The ATT measurement is beneficial for imaging of elderly clinical populations. If ATT mapping is not feasible or available, postlabeling delays of 2-2.3 seconds should be used for elderly populations based on longest measured regional ATTs. 1 J. Magn. Reson. Imaging 2017;45:472-481.

PS179. A depressive patient who achieved remission by escitalopram: cerebral blood flow variation during pleasant/unpleasant image tasks.

PS179. A depressive patient who achieved remission by escitalopram: cerebral blood flow variation during pleasant/unpleasant image tasks.

Developmental Dynamics and Seasonal Variation of Measures of Cerebral Circulation in Children and Adolescents in the European North

Transcranial Doppler sonography was used to study the developmental dynamics and seasonal variation in cerebral blood flow in 95 middle school students aged 7–18 years, natives of Arkhangelsk District. Results obtained from long-term (2005–2014) monitoring of schoolchildren are presented. Linear blood flow velocity (LBF) was found to decrease gradually from junior to senior school age, mean levels in the middle cerebral artery were lower and those in the basilar arteries were higher than normal for the mid latitudes. The influence of the seasonal factor was greater in children of the younger (in boys) and intermediate (in girls) age groups and disappeared in the older group. The largest seasonal variations in LBF were seen in the arteries of the carotid basin and the most constant LBF was seen in the basilar artery. Assessment of the index of resistivity of circulatory resistance in schoolchildren of the younger and intermediate age groups decreased in the arteries of the carotid basin in spring and summer and in the basin of the posterior cerebral artery in winter. Levels of LBF variability identified groups of children with different levels of “sensitivity” to the effects of the seasonal factor.

High incidence of adverse cerebral blood flow responses to spreading depolarization in the aged ischemic rat brain

Spreading depolarizations (SDs) occur spontaneously in the brain after stroke, exacerbate ischemic injury, and thus emerge as a potential target of intervention. Aging predicts worse outcome from stroke; yet, the impact of age on SD evolution is not clear. Cerebral ischemia was induced by bilateral common carotid artery occlusion in young (8–9 weeks old, n = 8) and old (2 year olds, n = 6) anesthetized rats. Sham-operated animals of both age groups served as control (n = 12). Electrocorticogram, direct current potential, and cerebral blood flow (CBF) variations were acquired via a small craniotomy above the parietal cortex. SDs were elicited by KCl through a second craniotomy distal to the recording site. Ischemia and age delayed the recovery from SD. CBF decreased progressively during ischemia in the old animals selectively, and inverse neurovascular coupling with SD evolved in the old but not in the young ischemic group. We propose that (mal)adaptation of cerebrovascular function with aging impairs the SD-related CBF response, which is implicated in the intensified expansion of ischemic damage in the old brain.

Pressure modulation algorithm to separate cerebral hemodynamic signals from extracerebral artifacts.

We introduce and validate a pressure measurement paradigm that reduces extracerebral contamination from superficial tissues in optical monitoring of cerebral blood flow with diffuse correlation spectroscopy (DCS). The scheme determines subject-specific contributions of extracerebral and cerebral tissues to the DCS signal by utilizing probe pressure modulation to induce variations in extracerebral blood flow. For analysis, the head is modeled as a two-layer medium and is probed with long and short source-detector separations. Then a combination of pressure modulation and a modified Beer-Lambert law for flow enables experimenters to linearly relate differential DCS signals to cerebral and extracerebral blood flow variation without a priori anatomical information. We demonstrate the algorithm's ability to isolate cerebral blood flow during a finger-tapping task and during graded scalp ischemia in healthy adults. Finally, we adapt the pressure modulation algorithm to ameliorate extracerebral contamination in monitoring of cerebral blood oxygenation and blood volume by near-infrared spectroscopy.

Algorithms for the inference of causality in dynamic processes: Application to cardiovascular and cerebrovascular variability.

This study faces the problem of causal inference in multivariate dynamic processes, with specific regard to the detection of instantaneous and time-lagged directed interactions. We point out the limitations of the traditional Granger causality analysis, showing that it leads to false detection of causality when instantaneous and time-lagged effects coexist in the process structure. Then, we propose an improved algorithm for causal inference that combines the Granger framework with the approach proposed by Pearl for the study of causality among multiple random variables. This new approach is compared with the traditional one in theoretical and simulated examples of interacting processes, showing its ability to retrieve the correct structure of instantaneous and time-lagged interactions. These approaches for causal inference are then tested on the physiological variability series of heart period, arterial pressure and cerebral blood flow variability obtained in subjects with postural-related syncope during a tilt-test protocol.

The disturbances of cerebral microcirculation in severe head injury

The aim of the literature review was to present modern views on the possible mechanisms of the disturbances of capillary blood flow in severe brain injury (TBI). The critical analysis of the concept of secondary brain damage and possible mechanisms of the disturbances of cerebral microcirculation in TBI are presented. We also discuss modern methodologies for assessing capillary blood flow in patients with brain damage. The attention is focused on the causes of the disturbances of cerebral microcirculation in TBI, as well as in various forms of fat embolism in severe combined TBI. Possibilities of prevention and early correction of damaged capillary blood flow in brain injury, as well as the supposed reasons for the failure of some clinical trials, including the widely known CRASH, are analyzed. It is noted that an integrative approach to the assessment of cerebral microcirculation in conjunction with brain metabolism reflects not just the variability of cerebral blood flow and functional disorders of perfusion and metabolism coupling in traumatic brain injury. It is emphasized that ischemia is not the only cause of post-traumatic disorders of pial circulation. We highlight directions for future research of posttraumatic disturbances of cerebral microcirculation as a leading factor of secondary brain insults. The possibility of pharmacological and non-pharmacological correction of microcirculatory disorders in TBI is outlined.

Coupling between arterial pressure, cerebral blood velocity, and cerebral tissue oxygenation with spontaneous and forced oscillations

We tested the hypothesis that transmission of arterial pressure to brain tissue oxygenation is low under conditions of arterial pressure instability. Two experimental models of hemodynamic instability were used in healthy human volunteers; (1) oscillatory lower body negative pressure (OLBNP) (N = 8; 5 male, 3 female), and; (2) maximal LBNP to presyncope (N = 21; 13 male, 8 female). Mean arterial pressure (MAP), middle cerebral artery velocity (MCAv), and cerebral tissue oxygen saturation (ScO2) were measured non-invasively. For the OLBNP protocol, between 0 and −60 mmHg negative pressure was applied for 20 cycles at 0.05 Hz, then 20 cycles at 0.1 Hz. For the maximal LBNP protocol, progressive 5 min stages of chamber decompression were applied until the onset of presyncope. Spectral power of MAP, mean MCAv, and ScO2 were calculated within the VLF (0.04–0.07 Hz), and LF (0.07–0.2 Hz) ranges, and cross-spectral coherence was calculated for MAP-mean MCAv, MAP-ScO2, and mean MCAv-ScO2 at baseline, during each OLBNP protocol, and at the level prior to pre-syncope during maximal LBNP (sub-max). The key findings are (1) both 0.1 Hz OLBNP and sub-max LBNP elicited increases in LF power for MAP, mean MCAv, and ScO2 (p ≤ 0.08); (2) 0.05 Hz OLBNP increased VLF power in MAP and ScO2 only (p ≤ 0.06); (3) coherence between MAP-mean MCAv was consistently higher (≥0.71) compared with MAP-ScO2, and mean MCAv-ScO2 (≤0.43) during both OLBNP protocols, and sub-max LBNP (p ≤ 0.04). These data indicate high linearity between pressure and cerebral blood flow variations, but reduced linearity between cerebral tissue oxygenation and both arterial pressure and cerebral blood flow. Measuring arterial pressure variability may not always provide adequate information about the downstream effects on cerebral tissue oxygenation, the key end-point of interest for neuronal viability.

Hemispheric asymmetry in cerebrovascular reactivity of the human primary motor cortex: an in vivo study at 7 T.

Current functional MRI (fMRI) approaches assess underlying neuronal activity through monitoring the related local variations in cerebral blood oxygenation, blood volume and blood flow. This vascular response is likely to vary across brain regions and across individuals, depending on the composition of the local vascular bed and on the vascular capacity to dilate. The most widely used technique uses the blood oxygen level dependent (BOLD) fMRI signal, which arises from a complex combination of all of these factors. The model of handedness provides a case where one brain region (dominant motor cortex) is known to have a stronger BOLD response over another (non-dominant motor cortex) during hand motor task performance. We predict that this is accompanied by a higher vascular reactivity in the dominant motor cortex, when compared with the non-dominant motor cortex. Precise measurement of end-tidal CO2 and a novel sinusoidal CO2 respiratory challenge were combined with the high sensitivity and finer spatial resolution available for fMRI at 7 T to measure BOLD cerebrovascular reactivity (CVR) in eight healthy male participants. BOLD CVR was compared between the left (dominant) and right (non-dominant) primary motor cortices of right-handed adults. Hemispheric asymmetry in vascular reactivity was predicted and observed in the primary motor cortex (left CVR = 0.60 ± 0.15%/mm Hg; right CVR = 0.47 ± 0.08%/mm Hg; left CVR > right CVR, P = 0.04), the first reported evidence of such a vascular difference. These findings demonstrate a cerebral vascular asymmetry between the left and right primary motor cortex. The origin of this asymmetry largely arises from the contribution of large draining veins. This work has implications for future motor laterality studies that use BOLD, and it is also suggestive of a vascular plasticity in the human primary motor cortex.

Comparing segmented ASL perfusion of vascular territories using manual versus semiautomated techniques in children with sickle cell anemia

PurposeElevated cerebral blood flow (CBF) in sickle cell anemia (SCA) is an adaptive pathophysiologic response associated with decreased vascular reserve and increased risk for ischemia. We compared manual (M) and semiautomated (SA) vascular territory delineation to facilitate standardized evaluation of CBF in children with SCA.Materials and MethodsASL perfusion values from 21 children were compared for gray matter and white matter (WM) in vascular territories defined by M and SA delineation. SA delineated CBF was compared with clinical and hematologic variables acquired within 4 weeks of the MRI.ResultsCBF measurements from M (MCA 82 left, 79 right) and SA (MCA 81 left, 81 right) delineated territories were highly correlated (R = 0.99, P &lt; 0.0001). Bland‐Altman plots had close‐fitting limits of agreement of −1.8 to −3.5 lower limit and 0 to 1.8 upper limit. SA vascular territory delineation was comparable to the expert delineation with a kappa index of 0.62–0.85 and was considerably faster. Median territorial CBF values did not differ by gender or age. WM perfusion in the posterior cerebral artery territories was positively correlated with degree of hemolysis (R = 0.58, P = 0.01 left, 0.73, P &lt; 0.001 right) and negatively correlated with hemoglobin (R = −0.48; P = 0.03 left; −0.47; P = 0.04 right) and hemoglobin F (R = −0.42; P = .09 left; −0.47; P = 0.049 right).ConclusionWe established the validity of the SA method, which in our experience was much faster than the M method for delineation of vascular territories. Associations between CBF and hematologic variables may demonstrate pathophysiologic changes that contribute to clinical variation in CBF. J. Magn. Reson. Imaging 2015;41:439–446.© 2013 Wiley Periodicals, Inc.

Cerebral oxygenation in health and disease.

Monitoring cerebral blood flow (CBF) and oxygenation has implications for both clinical practice and research interests; e.g., to provide insight into functional neurovascular coupling, to better understand orthostatic hypotension, and to evaluate the influence of vasopressors on cerebral oxygenation during anesthesia and/or surgery. These topics, and others, are addressed in this e-book by presenting original research, reviews, and opinion papers covering new, exciting but also controversial issues related to cerebral oxygenation in health and disease as evaluated by near-infrared spectroscopy (NIRS).