Steal physiology is spatially associated with cortical thinning

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 81; no. 3; pp. 290 - 293
• Main Authors: Fierstra, Jorn, Poublanc, Julien, Han, Jay Shou, Silver, Frank, Tymianski, Michael, Crawley, Adrian Phillip, Fisher, Joseph Arnold, Mikulis, David John
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.03.2010; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adolescent; Adult; Aged; Atrophy; Biological and medical sciences; Brain Ischemia - pathology; Brain Ischemia - physiopathology; Brain mapping; Carbon Dioxide - blood; Carotid arteries; Cell Death - physiology; cerebral blood flow; Cerebral Cortex - blood supply; Cerebral Cortex - pathology; cerebrovascular; cerebrovascular disease; Child; Dominance, Cerebral - physiology; Female; Homeostasis - physiology; Human viral diseases; Humans; Image Enhancement - methods; Image Processing, Computer-Assisted - methods; Infectious diseases; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Muscle, Smooth, Vascular - physiopathology; Neurology; Neurons - pathology; neuroradiology; Oxygen - blood; Physiology; Rodents; Software; Studies; Vasodilation - physiology; Viral diseases; Viral diseases of the nervous system; Young Adult; Nervous system diseases; Physiology
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2009.188078

BackgroundThe physiological impact of severely impaired cerebral autoregulatory vascular reactivity on cortical integrity is unknown. The purpose of this study is to determine the relationship between severe impairment of autoregulatory flow control associated with steal phenomenon and its impact on cortical thickness.Methods250 blood oxygen level dependent (BOLD) MRI cerebrovascular reactivity (CVR) studies were reviewed in order to identify subjects with severe unilateral exhausted cerebrovascular reserve demonstrating steal physiology but with normal appearing cortex on fluid attenuated inversion recovery imaging. 17 patients meeting the inclusion criteria were identified. A reconstructed inflated cortical surface map was created for every subject using Freesurfer software (http://surfer.nmr.mgh.harvard.edu/). The region of interest (ROI) reflecting the steal physiology was determined by overlaying the subject's CVR map on to the cortical surface map. This ROI was compared with the corresponding area in the healthy hemisphere which provided control cortical thickness measurement in each subject.ResultsThe hemisphere with steal physiology showed an 8% thinner cortex (2.23±0.28 mm) than the corresponding healthy hemisphere (2.42±0.23 mm) (p=0.0005).ConclusionsOur findings indicate that a spatial correspondence exists between impairment of autoregulatory capacity with steal physiology and cortical thinning.