Synopsis
Recovery of motor
function following neurological damage is dependent on functional
neuroplasticity. Mechanisms of adaptive plasticity are not well understood,
thus limiting the ability to predict recovery following rehabilitation. This
study examined the suitability of calibrated fMRI to study cerebrovascular changes
during motor learning, as cerebrovascular function plays an important role in
neuroplasticity. Results showed cerebral blood flow, BOLD and oxygen metabolism
increases from rest with task but decreases with task-learning. However, high
inter-subject response variability was observed. Calibrated fMRI shows promise
for studying cerebrovascular changes during learning but the repeatability and
stability of measurements requires further investigation.
Purpose
Functional recovery
following stroke or neuroinflammatory related damage is dependent on adaptive
plasticity. Neuroplasticity has been studied using BOLD fMRI1 but,
due to ambiguity of interpretation of BOLD signals, understanding the
mechanisms of functional changes has been limited. Here, we used calibrated
fMRI2 to obtain additional direct quantification of cerebral blood
flow (CBF) and the cerebral metabolic rate of oxygen consumption (CMRO2)
during motor learning. The objective of the study was to evaluate the
suitability of calibrated fMRI to measure group-level BOLD, CBF and CMRO2
responses to a short visuomotor sequence learning task, and subsequent changes
in these parameters over the task duration with sequence learning. Methods
Simultaneous
BOLD and CBF data were acquired for 20 subjects at 3T using a PICORE QUIPSS II3
dual-echo4 ASL sequence (14 slices, 64 spiral, TE1= 2.7ms, TE2=
29ms, TR= 2.4s, TI1= 700ms, TI2= 1.5s, FOV= 19.8cm, flip angle= 20°,
resolution 3.1x3.1x8.44mm) during an adapted serial reaction time (SRT) task5.
This was followed by a reference hypercapnia scan where PETCO2 levels were raised (target +7
mmHg PETCO2) for 2 minute intervals separated by 2
minutes of baseline. CBF timeseries were calculated for the SRT and hypercapnia
tasks from the first echo and BOLD from the second echo. ROIs were determined
from the group level BOLD and CBF task responses and mean signal changes over
time, modelled using FSL FEAT6. CBF was quantified using
a single compartment model7 for these ROIs and percentage BOLD
change calculated as a % change from the mean. BOLD and CBF CVR to CO2 was
calculated for each task ROI using methods described previously8 and
CMRO2 for each ROI was obtained using the Davis model2 (Figure
1) with α= 0.2 and β= 1.39.
BOLD, CBF, CVR, M and relative CMRO2 changes were calculated
for 6 ROIs; total CBF, BOLD and CBF-BOLD intersecting task-related increases and
task-related activity decreases over time.Results
A one-way repeated measures ANOVA showed a
significant effect of time on performance; response accuracy improved over
time; F(2.2, 38.3) = 12.47, p < 0.001. BOLD and
CBF task-related activity increases were observed in regions of the motor and
supplementary motor cortices, cerebellum, insula, lateral occipital cortex
(LOC) and thalamus; areas previously associated with visuomotor
learning. There were no areas where BOLD increased and
CBF decreased or vice versa. Paired t-tests showed that the CMRO2
change from baseline was significant across the group for the CBF ROI; t= 6.04, df = 18, p < 0.001, BOLD ROI before corrections; t= 2.3, df = 18, p = 0.034, p’ = 0.1, and the BOLD-CBF intersection ROI, t= 4.39, df = 17, p = 0.001,
p’ = 0.003, Bonferroni corrected. Clusters of mean BOLD and CBF signal reductions over task blocks
were observed in the cerebellum, insula, inferior temporal gyrus (ITG),
temporal fusiform cortex (TFC), and the precentral and postcentral gyri representing decreasing energy demand with task progression. Paired T-tests
on the relative CMRO2 changes showed significant CMRO2
decreases for the CBF ROI; t= 4.88, df = 17, p < .001, and the BOLD-CBF
intersection ROI; t= 4.05, df= 16, p = 0.001 but not the BOLD ROI; t= 1.5,
df = 17, p = .148. High inter-subject variability may explain
this result. Variability was highest in the BOLD ROI resulting in a mean positive signal despite a significant decreasing
signal trend.
Conclusions
Using calibrated fMRI, we have shown cortical and
subcortical increases in BOLD, CBF and relative CMRO2 during
performance of a sequence learning task. Secondly, in many of the regions
recruited during the task, we have shown statistically significant decreases in
BOLD, CBF and oxygen metabolism over time by modelling the signal trend over
all task blocks. These decreases could be attributed to increased neural
efficiency with task learning, resulting in lower energy demands despite higher
response accuracy. High inter-subject variability was observed,
especially in the BOLD ROI, and this may be partially due to noise
inherent in ASL data. One limitation of the Davis model is that any noise
present affects M causing
error propagation through the CMRO2 calculation. However, results could
also reflect individual differences in functional changes with learning,
despite similar performance improvements across the group. The results demonstrate
the feasibility of measuring neural energetics during motor learning when
considering simple task vs. rest activity. Calibrated fMRI is a promising
technique for studying functional neuroplastic changes during learning but
follow up studies with longer tasks and a larger sample size are needed to
maximise SNR and establish whether changes over time during complex cognitive
tasks are repeatable.Acknowledgements
This work was supported by the Wellcome Trust and Cardiff University.References
1. Pelletier, J.,
Audoin, B., Reuter, F., & Ranjeva, J. P. (2009). Plasticity in MS: from
functional imaging to rehabilitation. The
International MS Journal, 16(1),
26-32.
2. Davis, T. L., Kwong, K. K., Weisskoff, R. M., &
Rosen, B. R. (1998). Calibrated functional MRI: mapping the dynamics of
oxidative metabolism. Proceedings of the National Academy of Sciences, 95(4), 1834-1839.
3. Wong, E. C., Buxton, R. B., & Frank, L. R.
(1998). Quantitative imaging of perfusion using a single subtraction (QUIPSS
and QUIPSS II). Magnetic resonance in medicine, 39(5), 702-708.
4. Liu, T. T., Wong, E. C., Frank, L. R., & Buxton,
R. B. (2002). Analysis and design of perfusion-based event-related fMRI
experiments. NeuroImage,16(1), 269-282.
5. Nissen, M. J., & Bullemer, P. (1987).
Attentional requirements of learning: Evidence from performance measures. Cognitive psychology, 19(1), 1-32.
6. Wong, E. C., Buxton, R. B., & Frank, L. R.
(1999). Quantitative perfusion imaging using arterial spin labeling. Neuroimaging Clinics of North America,9(2), 333-342.
7. Murphy, K., Harris, A., & Wise, R. (2013).
Measuring the influence of hypercapnia on absolute CMRO2 in humans. In Proc. Intl. Soc. Mag. Reson. Med, Vol. 21, p. 3343
8. Bright, M. G., & Murphy, K. (2013). Reliable
quantification of BOLD fMRI cerebrovascular reactivity despite poor breath-hold
performance. NeuroImage, 83, 559-568.
9. Bulte, D.P., Kelly, M., Germuska, M., Xie, J.,
Chappell, M.A., Okell, T.W., Bright, M.G. and Jezzard, P., (2012). Quantitative
measurement of cerebral physiology using respiratory-calibrated MRI. Neuroimage, 60(1), pp.582-591.