Breath holding for 20 s following extended expiration is a practical, effective and robust standard when measuring cerebrovascular reactivity in healthy adults using BOLD fMRI at 3 T
Background and Purpose: BOLD fMRI is becoming the preferred modality to study cerebrovascular reactivity. Amongst the vasoactive stimuli to induce it, breath holding is considered equal to other methods but both cerebrovascular reserve measures and breath holding designs lack standardization. We hav...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | Neuroimage: Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666956021000192 |
| _version_ | 1818448852195213312 |
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| author | Jörg Larsen Kai Kallenberg Johanna Rühlmann Jürgen Baudewig Eike A. Nickel Michael Knauth Peter Dechent |
| author_facet | Jörg Larsen Kai Kallenberg Johanna Rühlmann Jürgen Baudewig Eike A. Nickel Michael Knauth Peter Dechent |
| author_sort | Jörg Larsen |
| collection | DOAJ |
| description | Background and Purpose: BOLD fMRI is becoming the preferred modality to study cerebrovascular reactivity. Amongst the vasoactive stimuli to induce it, breath holding is considered equal to other methods but both cerebrovascular reserve measures and breath holding designs lack standardization. We have systematically considered whether breath holding paradigms at short time periods are both a practical as well as equally effective and robust alternative to the elaborate CO2-inhalation in estimating cerebrovascular reactivity. Subjects, Materials and Methods: Using BOLD fMRI, eleven healthy subjects were examined with dynamic T2*-weighted echo planar imaging at 3 T. Cerebrovascular reactivity was measured during episodes of breath holding for 10 s and 20 s, both after deep inspiration and after extended expiration, and compared to the reactivity following inhalation of an air mixture with 5% CO2-content. Results: 20 s breath holding challenges yielded higher reactivities represented by corresponding higher BOLD-signal changes when compared to 10 s ones, as did expiratory paradigms when compared to inspiratory ones. Mean signal changes ranged from 2% (10 s breath holding after inspiration) to 3% (20 s breath holding after expiration). The CO2-challenge yielded an about threefold higher reactivity (6%). Conclusion: The breath holding tasks evoked BOLD-signal increases which compare favorably to published data. A 20 s breath holding period appears to be ideal and is tolerated well. This experimental design is thus practical, effective and robust. To further standardize the breath holding design and the measurement of cerebrovascular reserve, controlled breathing during resting periods as well as modelling of the fMRI-signal to end-tidal CO2-levels should be employed in future studies. |
| first_indexed | 2024-12-14T20:26:06Z |
| format | Article |
| id | doaj.art-52d62f9216f04362b94acf0785749dd4 |
| institution | Directory Open Access Journal |
| issn | 2666-9560 |
| language | English |
| last_indexed | 2024-12-14T20:26:06Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Neuroimage: Reports |
| spelling | doaj.art-52d62f9216f04362b94acf0785749dd42022-12-21T22:48:37ZengElsevierNeuroimage: Reports2666-95602021-06-0112100021Breath holding for 20 s following extended expiration is a practical, effective and robust standard when measuring cerebrovascular reactivity in healthy adults using BOLD fMRI at 3 TJörg Larsen0Kai Kallenberg1Johanna Rühlmann2Jürgen Baudewig3Eike A. Nickel4Michael Knauth5Peter Dechent6Department of Diagnostic and Interventional Radiology, Universitymedicine Göttingen, Georg-August-University, Göttingen, Germany; Corresponding author. Department of Diagnostic and Interventional Radiology, Robert-Koch-Str. 40, D-37075, Göttingen, Germany.Department of Diagnostic and Interventional Neuroradiology, Klinikum Fulda, Fulda, GermanyDepartment of Anesthesiology, St. Joseph-Stift, Bremen, GermanyDepartment of Functional Imaging, Deutsches Primatenzentrum, Göttingen, GermanyDepartment of Anesthesiology, Helios Klinikum Emil von Behring, Berlin, GermanyPraxis für Moderne Schnittbild Diagnostik, Göttingen, Germany; Department of Neuroradiology, Universitymedicine Göttingen, Georg-August-University, Göttingen, GermanyMR-Research in Neurosciences, Cognitive Neurology, Universitymedicine Göttingen, Georg-August-University, Göttingen, GermanyBackground and Purpose: BOLD fMRI is becoming the preferred modality to study cerebrovascular reactivity. Amongst the vasoactive stimuli to induce it, breath holding is considered equal to other methods but both cerebrovascular reserve measures and breath holding designs lack standardization. We have systematically considered whether breath holding paradigms at short time periods are both a practical as well as equally effective and robust alternative to the elaborate CO2-inhalation in estimating cerebrovascular reactivity. Subjects, Materials and Methods: Using BOLD fMRI, eleven healthy subjects were examined with dynamic T2*-weighted echo planar imaging at 3 T. Cerebrovascular reactivity was measured during episodes of breath holding for 10 s and 20 s, both after deep inspiration and after extended expiration, and compared to the reactivity following inhalation of an air mixture with 5% CO2-content. Results: 20 s breath holding challenges yielded higher reactivities represented by corresponding higher BOLD-signal changes when compared to 10 s ones, as did expiratory paradigms when compared to inspiratory ones. Mean signal changes ranged from 2% (10 s breath holding after inspiration) to 3% (20 s breath holding after expiration). The CO2-challenge yielded an about threefold higher reactivity (6%). Conclusion: The breath holding tasks evoked BOLD-signal increases which compare favorably to published data. A 20 s breath holding period appears to be ideal and is tolerated well. This experimental design is thus practical, effective and robust. To further standardize the breath holding design and the measurement of cerebrovascular reserve, controlled breathing during resting periods as well as modelling of the fMRI-signal to end-tidal CO2-levels should be employed in future studies.http://www.sciencedirect.com/science/article/pii/S2666956021000192BrainBreath holdingCerebrovascular reactivityFunctional MRIHypercapniaStandardization |
| spellingShingle | Jörg Larsen Kai Kallenberg Johanna Rühlmann Jürgen Baudewig Eike A. Nickel Michael Knauth Peter Dechent Breath holding for 20 s following extended expiration is a practical, effective and robust standard when measuring cerebrovascular reactivity in healthy adults using BOLD fMRI at 3 T Neuroimage: Reports Brain Breath holding Cerebrovascular reactivity Functional MRI Hypercapnia Standardization |
| title | Breath holding for 20 s following extended expiration is a practical, effective and robust standard when measuring cerebrovascular reactivity in healthy adults using BOLD fMRI at 3 T |
| title_full | Breath holding for 20 s following extended expiration is a practical, effective and robust standard when measuring cerebrovascular reactivity in healthy adults using BOLD fMRI at 3 T |
| title_fullStr | Breath holding for 20 s following extended expiration is a practical, effective and robust standard when measuring cerebrovascular reactivity in healthy adults using BOLD fMRI at 3 T |
| title_full_unstemmed | Breath holding for 20 s following extended expiration is a practical, effective and robust standard when measuring cerebrovascular reactivity in healthy adults using BOLD fMRI at 3 T |
| title_short | Breath holding for 20 s following extended expiration is a practical, effective and robust standard when measuring cerebrovascular reactivity in healthy adults using BOLD fMRI at 3 T |
| title_sort | breath holding for 20 s following extended expiration is a practical effective and robust standard when measuring cerebrovascular reactivity in healthy adults using bold fmri at 3 t |
| topic | Brain Breath holding Cerebrovascular reactivity Functional MRI Hypercapnia Standardization |
| url | http://www.sciencedirect.com/science/article/pii/S2666956021000192 |
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