Cerebral blood flow-related signal changes during breath-holding

In the past, functional MR imaging techniques have been used successfully to determine cerebrovascular reactivity (CVR) to various stimuli, complementing the arsenal of functional brain investigations feasible with MR imaging. While previous studies have focused on blood oxygenation changes under vasodilatory stress, the aim of this study was to assess regional cerebral blood flow (rCBF) changes during breath-holding by using a flow-sensitive alternating inversion recovery (FAIR) imaging technique.

In six healthy volunteers, FAIR images were acquired during alternating periods of breath-holding and breathing at 40-second intervals after inspiration and at 30-second intervals after expiration, for a total dynamic scanning time of 10 minutes. To quantify the rCBF changes, we obtained 2.5-minute baseline samples during normal breathing.

Repeated challenges of breath-holding induced an overall rise in rCBF. In general, rCBF changes were greatest in gray matter and were insignificant in white matter. Using the mean values of the baseline images collected before breath-holding to calculate the rCBF changes, we found that quantitative analysis yielded an rCBF increase of 47% to 87% after breath-holding. The rCBF changes clearly depended on the breath-holding duration and technique; however, for one given breath-holding paradigm the results showed relatively small interindividual variability.

rCBF changes during a simple vascular challenge can be detected and quantified by means of functional MR imaging at 1.5 T. Noninvasive assessment of CVR could become a useful clinical tool to identify persons with impaired CVR.