Synopsis
Due to the potential of using hyperoxia as a treatment for
cerebral ischemic diseases, including stroke, it is important to fully understand
the effects of hyperoxia on the cerebrovasculature. Although it is known that
breathing of 100% O2 leads to a decrease in cerebral blood flow, it
is unclear where along the cerebral arterial tree vasoconstriction occurs. Here
we show that, while there is expected constriction of the large arteries,
smaller and more distal arteries actually show vasodilation upon hyperoxia.Introduction
Although
it is well-documented that hyperoxia at 100% inspired O
2 leads to
decreased cerebral blood flow in humans
1, reports on where vasoconstriction occurs along the cerebrovascular
tree are limited
2,3. Due to the potential of hyperoxia as treatment for cerebral ischaemia
4, it is important to fully understand its effects on the human
cerebrovasculature. Therefore, we aim to investigate the effect of hyperoxia
along the cerebrovascular tree with short inversion time (TI) arterial spin
labelling (ASL)
Data acquisition
5 healthy volunteers (2 F, 27.2 ± 1.6 years)
underwent a MRI scan session (3 T, GE HDx, Milwaukee, USA). Single slice PICORE
ASL images were acquired: single inversion time (TI = 450ms), TR = 600ms, TE =
3 ms, number of time points = 3200, slice along the anterior-posterior
cingulate line, resolution = 3x3x7 mm
3, FOV = 198 mm, label
thickness = 50 mm (10 mm below the imaging plane). Images were acquired for 8
different levels of fixed inspired O
2 (FiO
2) ranging from
21% (normoxia) to 42% in 3% increments. Each level lasted 4 minutes and was
created by mixing medical air and 100% O
2. Automated flow controllers
driven by in-house Matlab (R2012b) scripts ensured a randomized order. Gases
were delivered via a tight fitting facemask. To determine baseline arterial
blood volume (aBV), a multi-TI PICORE ASL scan was acquired at normoxia. Parameters:
imaging and labelling planes identical to the above scan; 8 TIs (150ms to
850ms, spacing 100ms); variable TR (minimized); single TE = 3ms; 320 time
points (20 tag-control pairs per TI). Throughout the scans, physiological
monitoring measured end-tidal partial pressures of O
2 and CO
2
(P
ETO
2 and P
ETCO
2), and cardiac and
respiratory cycles.
Data analysis
A running subtraction (ΔM) of tag and control
images was performed for the short TI time series. Note that, due to the short
TI, we assumed that all arterial blood is labelled and therefore ΔM is
proportional to the aBV in the voxel. To obtain average ΔM per FiO
2
the parameter maps were averaged over the last minute of each hyperoxia level,
i.e. when P
ETO
2 was stable. Maps of aBV were created by
voxelwise fitting of an arterial input function
5 to
the average tag-control subtraction images from the multi TI baseline scan at
normoxia. Masks of large (aBV
Large = aBV > 5 %
v),
medium (aBV
Medium: 2 %
v < aBV < 5 %
v),
and small arteries (aBV
Small: 0.5 %
v < aBV < 2%
v)
were created (see Fig 1). Repeated measures ANOVA (RM-ANOVA) was used to
investigate the effect of
Hyperoxia and
Artery Size on ΔM.
Results
The RM-ANOVA showed a significant interaction
between
Hyperoxia and
Artery Size,
across all voxels (F(14,56) = 8.3, p < .001). Separate RM-ANOVA for
different artery sizes showed that there was a significant decrease in ΔM with
oxygenation level for the large arteries (F(7,28) = 7.8 , p < .001), while
there was no effect of oxygenation on ΔM for aBV
Medium (F(7,28) =
2.4, p = 0.07), and a significant increase in ΔM for aBV
Small
(F(7,28) = 6.1, p < .001). Fig 2 illustrates these results. Note that the
decrease in ΔM in aBV
Large at FiO
2 = 42% (16.4 ± 8.4 %) is greater than the 2%
decrease in ΔM expected based on shortening of T
1 with increased
oxygenation
1. There
was no significant effect of oxygenation level on P
ETCO
2 F(7,35) = 0.9, p = 0.47), which rules out hypocapnia affecting vascular tone.
Discussion
Our results suggest that the effect of hyperoxia
on cerebral vascular tone is dependent on the size of the artery. The induced
vasoconstriction in large cerebral arteries is in line with the role of oxygen
in the signalling pathway between glial and smooth muscle cells
2. The
absent response in aBV
Medium and apparent vasodilation in aBV
Small
are not easily explained by current literature, although this work does match
previous results of not finding a change in aBV with isocapnic hyperoxia in
whole brain grey matter, effectively summing the response seen here across all arteries
3. A
possible explanation is an autoregulatory mechanism to maintain cerebral blood
flow; in response to the increased resistance of the larger arteries, the more
distal small arteries dilate to maintain perfusion (assuming that at moderate
hyperoxia changes in perfusion are negligible
1). Further
investigation of the differential response of the cerebrovasculature to
hyperoxia is required to fully understand the effects of oxygen on cerebral
vascular tone.
Acknowledgements
No acknowledgement found.References
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et al. Magn Reson Med. 2010;63(5):1357–65.