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The Problem of Neurovascular Uncoupling.

Shruti Agarwal1, Haris I Sair2, Jay J Pillai3

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Neurovascular uncoupling (NVU) confounds blood oxygen level dependent (BOLD) functional MRI in brain lesions. This review covers NVU detection methods and using low-frequency fluctuations to improve fMRI activation analysis.

Keywords:
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Area of Science:

  • Neuroimaging
  • Neuroscience
  • Medical Physics

Background:

  • Neurovascular uncoupling (NVU) is a significant confound in functional magnetic resonance imaging (fMRI).
  • It particularly affects BOLD fMRI studies involving focal brain lesions like tumors.
  • Understanding and mitigating NVU is crucial for accurate fMRI interpretation.

Purpose of the Study:

  • To review methods for assessing NVU in the context of focal brain lesions.
  • To highlight the utility of cerebrovascular reactivity mapping and resting-state BOLD fMRI metrics for NVU detection.
  • To explore the application of amplitude of low-frequency fluctuation (ALFF) metrics for reducing NVU's impact on clinical fMRI.

Main Methods:

  • Review of existing literature on NVU assessment in focal brain lesions.
  • Discussion of cerebrovascular reactivity mapping techniques.
  • Evaluation of resting-state BOLD fMRI metrics, including ALFF, for NVU detection and mitigation.

Main Results:

  • NVU is a primary challenge for BOLD fMRI in patients with brain tumors.
  • Cerebrovascular reactivity mapping and resting-state BOLD metrics are effective in detecting NVU.
  • ALFF metrics show promise in correcting for NVU effects in clinical fMRI activation.

Conclusions:

  • Accurate assessment and mitigation of NVU are essential for reliable fMRI in focal brain lesion patients.
  • Cerebrovascular reactivity and resting-state metrics offer valuable tools for NVU analysis.
  • ALFF-based approaches can improve the clinical utility of fMRI by addressing NVU.