Individualized treatment of acute stroke depends on the timely detection of ischemia and potentially salvageable tissue in the brain. Using functional MRI (fMRI), it is possible to characterize cerebral blood flow from blood-oxygen-level-dependent (BOLD) signals without the administration of exogenous contrast agents. In this study, we applied spatial independent component analysis to resting-state fMRI data of 37 stroke patients scanned within 24 hr of symptom onset, 17 of whom received follow-up scans the next day. Our analysis revealed “Hypoperfusion spatially-Independent Components” (HICs) whose spatial patterns of BOLD signal resembled regions of delayed perfusion depicted by dynamic susceptibility contrast MRI. These HICs were detected even in the presence of excessive patient motion, and disappeared following successful tissue reperfusion. The unique spatial and temporal features of HICs allowed them to be distinguished with high accuracy from other components in a user-independent manner (area under the curve = 0.93, balanced accuracy = 0.90, sensitivity = 1.00, and specificity = 0.85). Our study therefore presents a new, noninvasive method for assessing blood flow in acute stroke that minimizes interpretative subjectivity and is robust to severe patient motion.
Bibliographical noteFunding Information:
The authors thank Prof. Dr. med. Andreas Meisel for providing feedback on the manuscript. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: A.A.K. received funding from the NeuroCure Cluster of Excellence and the Berlin Institute of Health Junior Clinician–Scientist Programme. The funding sources played no role in this study's design, in data collection, in the analysis or interpretation of the data, in writing this article, or in the decision to submit this article for publication.
© 2021 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.
- blood oxygenation level dependent signal
- resting-state functional magnetic resonance imaging
- spatial independent component analysis
ASJC Scopus subject areas
- Radiological and Ultrasound Technology
- Radiology Nuclear Medicine and imaging
- Clinical Neurology