Cerebrovascular Reactivity and Concussion

Erin T Wong; Anish Kapadia; Venkatagiri Krishnamurthy; David J Mikulis

doi:10.1016/j.nic.2023.01.008

Cerebrovascular Reactivity and Concussion

Neuroimaging Clin N Am. 2023 May;33(2):335-342. doi: 10.1016/j.nic.2023.01.008. Epub 2023 Feb 26.

Authors

Erin T Wong¹, Anish Kapadia¹, Venkatagiri Krishnamurthy², David J Mikulis³

Affiliations

¹ Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; Department of Medical Imaging, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
² Department of Medicine, Division of Geriatrics and Gerontology, Emory University, Atlanta, GA, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Medical Center (VAMC), 1670 Clairmont Road, Suite # 12C 141, Decatur, GA 30033, USA; Department of Neurology, Emory University, Atlanta, GA, USA.
³ Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; Department of Medical Imaging, University Health Network, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada. Electronic address: david.mikulis@uhn.ca.

PMID: 36965950
DOI: 10.1016/j.nic.2023.01.008

Abstract

Cerebrovascular reactivity (CVR) reflects the change in cerebral blood flow in response to vasodilatory stimuli enabling assessment of the health of the cerebral vasculature. Recent advances in the quantitative delivery of CO2 stimuli with computer-controlled sequential gas delivery have enabled mapping of the speed and magnitude of response to flow stimuli. These CVR advances when applied to patients with acute concussion have unexpectedly shown faster speed and greater magnitude of responses unseen in other diseases that typically show the opposite effects. The strength of the CVR alterations have diagnostic potential in single subjects with AUC values in the 0.90-0.94 range.

Keywords: Cerebral blood flow; Cerebrovascular reactivity; Concussion; Traumatic brain injury.

Publication types

Review

MeSH terms

Brain / blood supply
Brain / diagnostic imaging
Brain Concussion* / diagnostic imaging
Cerebrovascular Circulation / physiology
Humans
Magnetic Resonance Imaging*

Grants and funding

IK2 RX002934/RX/RRD VA/United States