This repeated-measures study sought to determine whether hypercapnic normalization can be used to address caffeine-induced vascular changes affecting BOLD responses. Visual/motor BOLD activation and cerebrovascular reactivity (CVR) under caffeine and placebo conditions were examined. CVR-correction was performed by dividing the task BOLD signal by CVR. Prior to CVR-correction, peak BOLD responses for both caffeine and placebo conditions were found in the visual cortex. After CVR-correction, peak responses were in the subcortical regions. Caffeine produced larger responses in the cerebellum compared to placebo, while subcortical activation was larger under placebo conditions. These results show that CVR-correction may benefit subcortical signal detection.
13 healthy adults (5 males, age = 28.0 ± 10.09 yrs) participated in this study. Imaging was performed on a 3.0 Tesla GE scanner with a 32-channel head coil. BOLD-weighted scans (including the visual-motor task and hypercapnia scans) were acquired (TR/TE = 1800/30ms, 2x2x2mm3, multiband factor = 3). A structural 3D T1-weighted BRAVO scan was collected for anatomical reference.
Participants completed two scans held 48 hours apart and were asked to abstain from caffeine for a minimum of 12 hours before both scans. Each participant consumed one of each type of pill, a caffeine (200 mg3–5) and a placebo (lactose), 30 minutes prior to scanning. Participants were blinded to the pill manipulation, and pill order was controlled and pseudo-randomized.
During the scan, participants completed a visual/motor task and hypercapnia challenge. The visual motor task consisted of fixating on a centrally located dot while tapping each finger to thumb, on both hands, simultaneously with a flashing black and white checkerboard (8Hz). This block design consisted of 21 second epochs, with the checkerboard interspersed with a uniform grey baseline. For the hypercapnia gas challenge, a gas mixture consisting of 5% CO2 and 95% medical air was delivered for two minutes, interleaved with two minutes of medical air only, through an MR-compatible breathing circuit.
The fMRI data analysis and pre-processing were performed using Statistical Parametric Mapping 12 (SPM12) implemented in MATLAB R2017a and FMRIB Software Library v5 (FSL)6. Smoothing with a full width at half maximum (FWHM) of 4mm was applied to all fMRI images. First-level analyses modelled BOLD activation with a canonical hemodynamic response function while group-level analyses were carried out using analysis of variance (ANOVA) tests. Hypercapnic normalization was performed by dividing the task-fMRI BOLD signal by the CVR maps (Figure 1) in a voxel-wise fashion7. Mean percent signal change (PSC) of the task-induced BOLD responses (before CVR-correction) and mean CVR (%BOLD/mmHg) were calculated for the motor cortex, visual cortex and visual/motor thalamic regions, determined by FSL’s Harvard-Oxford atlas8,9.
Figure 2 demonstrates an example of an individual subject’s visual/motor activation and BOLD response to CO2 under both conditions.
Figure 3 provides the second-level group analyses of the caffeine and placebo conditions before and after applying CVR-correction. The peak voxel in both conditions, pre CVR-correction, is in the visual areas (MNI coordinates for caffeine: [8 -78 -6], placebo = [8 -76 -6]). Post-correction, the peak voxels are found in the subcortical regions (caffeine = [-22 -2 12], placebo = [24 4 8]). The mean percent signal changes (pre CVR-correction) in the motor cortex (Caffeine ∆S = 1.15 ± 0.25%, Placebo ∆S = 1.11 ± 0.25%), visual cortex (Caffeine ∆S = 1.78 ± 0.29%, Placebo ∆S = 1.79 ± 0.30%) and thalamus (Caffeine ∆S = 0.81 ± 0.29%, Placebo ∆S = 0.90 ± 0.23%) were found. Paired t-tests revealed no significant magnitude differences between placebo and caffeine conditions.
Figure 4 demonstrates the differences between placebo and caffeine conditions, before and after CVR-correction. Group comparison revealed that prior to CVR-correction the differences are minimal, however after CVR-correction, significant clusters are evident.
CVR-correction of task activation maps increased subcortical responses for both placebo and caffeine conditions. Furthermore, inter-subject variability induced by caffeine consumption may be reduced with CVR-correction.
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