Brain oxygenation responses to an autonomic challenge

a quantitative fMRI investigation of the Valsalva manoeuvre

Iwo Bohr, Claire McDonald, Jiabao He, Simon Kerr, Julia L Newton, Andrew M Blamire

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

In late age, the autonomic nervous system (ANS) has diminished ability to maintain physiological homeostasis in the brain in response to challenges such as to systemic blood pressure changes caused by standing. We devised an fMRI experiment aiming to map the cerebral effects of an ANS challenge (Valsalva manoeuvre (VM)). We used dual-echo fMRI to measure the effective transverse relaxation rate (R2*, which is inversely proportional to brain tissue oxygenation levels) in 45 elderly subjects (median age 80 years old, total range 75-89) during performance of the VM. In addition, we collected fluid-attenuated inversion recovery (FLAIR) data from which we quantified white matter hyperintensity (WMH) volumes. We conducted voxelwise analysis of the dynamic changes in R2* during the VM to determine the distribution of oxygenation changes due to the autonomic stressor. In white matter, we observed significant decreases in oxygenation levels. These effects were predominantly located in posterior white matter and to a lesser degree in the right anterior brain, both concentrated around the border zones (watersheds) between cerebral perfusion territories. These areas are known to be particularly vulnerable to hypoxia and are prone to formation of white matter hyperintensities. Although we observed overlap between localisation of WMH and triggered deoxygenation on the group level, we did not find significant association between these independent variables using subjectwise statistics. This could suggest other than recurrent transient hypoxia mechanisms causing/contributing to the formation of WMH.

Original languageEnglish
Pages (from-to)91 - 101
Number of pages11
JournalAge
Volume37
Issue number5
Early online date29 Aug 2015
DOIs
Publication statusPublished - Oct 2015

Fingerprint

Valsalva Maneuver
Magnetic Resonance Imaging
Brain
Autonomic Nervous System
White Matter
Homeostasis
Perfusion
Blood Pressure

Keywords

  • autonomic nervous system
  • brain aging
  • Valsalva manoeuvre
  • hypoxia
  • watershed zones
  • fMRI
  • Effective transverse relaxation rate (R2*)

Cite this

Brain oxygenation responses to an autonomic challenge : a quantitative fMRI investigation of the Valsalva manoeuvre. / Bohr, Iwo; McDonald, Claire; He, Jiabao; Kerr, Simon; Newton, Julia L; Blamire, Andrew M.

In: Age, Vol. 37, No. 5, 10.2015, p. 91 - 101.

Research output: Contribution to journalArticle

Bohr, Iwo ; McDonald, Claire ; He, Jiabao ; Kerr, Simon ; Newton, Julia L ; Blamire, Andrew M. / Brain oxygenation responses to an autonomic challenge : a quantitative fMRI investigation of the Valsalva manoeuvre. In: Age. 2015 ; Vol. 37, No. 5. pp. 91 - 101.
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abstract = "In late age, the autonomic nervous system (ANS) has diminished ability to maintain physiological homeostasis in the brain in response to challenges such as to systemic blood pressure changes caused by standing. We devised an fMRI experiment aiming to map the cerebral effects of an ANS challenge (Valsalva manoeuvre (VM)). We used dual-echo fMRI to measure the effective transverse relaxation rate (R2*, which is inversely proportional to brain tissue oxygenation levels) in 45 elderly subjects (median age 80 years old, total range 75-89) during performance of the VM. In addition, we collected fluid-attenuated inversion recovery (FLAIR) data from which we quantified white matter hyperintensity (WMH) volumes. We conducted voxelwise analysis of the dynamic changes in R2* during the VM to determine the distribution of oxygenation changes due to the autonomic stressor. In white matter, we observed significant decreases in oxygenation levels. These effects were predominantly located in posterior white matter and to a lesser degree in the right anterior brain, both concentrated around the border zones (watersheds) between cerebral perfusion territories. These areas are known to be particularly vulnerable to hypoxia and are prone to formation of white matter hyperintensities. Although we observed overlap between localisation of WMH and triggered deoxygenation on the group level, we did not find significant association between these independent variables using subjectwise statistics. This could suggest other than recurrent transient hypoxia mechanisms causing/contributing to the formation of WMH.",
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