Imaging and anesthesia protocol optimization in sedated clinical resting state fMRI.

Journal

AJNR. American journal of neuroradiology
ISSN: 1936-959X
Titre abrégé: AJNR Am J Neuroradiol
Pays: United States
ID NLM: 8003708

Informations de publication

Date de publication:
12 Aug 2024
Historique:
received: 23 06 2024
accepted: 31 07 2024
medline: 13 8 2024
pubmed: 13 8 2024
entrez: 12 8 2024
Statut: aheadofprint

Résumé

The quality of resting-state functional MRI (rs-fMRI) under anesthesia is variable and there are no guidelines on optimal image acquisition or anesthesia protocol. We aim to identify the factors that may lead to compromised clinical rs-fMRI under anesthesia. In this cross-sectional study, we analyzed clinical rs-fMRI data acquired under anesthesia from 2009-2023 at Massachusetts General Hospital. Independent component analysis driven resting state networks (RSN) of each patient were evaluated qualitatively and quantitatively and grouped as robust or weak. Overall networks were evaluated using the qualitative method, and motor and language networks were evaluated using the quantitative method. RSN robustness was analyzed in 4 outcome categories: overall, combined Motor-Language, individual motor, and language networks. Predictor variables included rs-fMRI acquisition parameters, anesthesia medications, underlying brain structural abnormalities, age, and sex. Logistic regression was used to examine the effect of the study variables on RSN robustness. Sixty-nine patients were identified. With qualitative assessment, 40 had robust and 29 had weak overall RSN. Quantitatively, 45 patients had robust, while 24 had weak Motor-Language networks. Among all the predictor variables, only sevoflurane significantly contributed to the outcomes, with sevoflurane administration reducing the odds of having robust RSN in overall (Odds Radio (OR)= 0.2, 95% Confidence Interval (CI) = [0.05;0.79], p = .02), Motor-Language (OR = 0.18, 95% CI = [0.04;0.80], p = .02) and individual motor (OR= 0.1, 95% CI = [0.02;0.64], p= .02) categories. Individual language network robustness was not associated with the tested predictor variables. Sevoflurane anesthesia may compromise the visibility of fMRI resting state networks, particularly impacting motor networks. This finding suggests that the type of anesthesia is a critical factor in rs-fMRI quality. We did not observe the association of the MR acquisition technique or underlying structural abnormality with the RSN robustness. BOLD = Blood Oxygen Level-Dependent; ICA = Independent Component Analysis; Rs-fMRI = Resting-State Functional Magnetic Resonance Imaging; RSN = Resting-State Networks; SNR = Signal-to-Noise Ratio.

Sections du résumé

BACKGROUND AND PURPOSE OBJECTIVE
The quality of resting-state functional MRI (rs-fMRI) under anesthesia is variable and there are no guidelines on optimal image acquisition or anesthesia protocol. We aim to identify the factors that may lead to compromised clinical rs-fMRI under anesthesia.
MATERIALS AND METHODS METHODS
In this cross-sectional study, we analyzed clinical rs-fMRI data acquired under anesthesia from 2009-2023 at Massachusetts General Hospital. Independent component analysis driven resting state networks (RSN) of each patient were evaluated qualitatively and quantitatively and grouped as robust or weak. Overall networks were evaluated using the qualitative method, and motor and language networks were evaluated using the quantitative method. RSN robustness was analyzed in 4 outcome categories: overall, combined Motor-Language, individual motor, and language networks. Predictor variables included rs-fMRI acquisition parameters, anesthesia medications, underlying brain structural abnormalities, age, and sex. Logistic regression was used to examine the effect of the study variables on RSN robustness.
RESULTS RESULTS
Sixty-nine patients were identified. With qualitative assessment, 40 had robust and 29 had weak overall RSN. Quantitatively, 45 patients had robust, while 24 had weak Motor-Language networks. Among all the predictor variables, only sevoflurane significantly contributed to the outcomes, with sevoflurane administration reducing the odds of having robust RSN in overall (Odds Radio (OR)= 0.2, 95% Confidence Interval (CI) = [0.05;0.79], p = .02), Motor-Language (OR = 0.18, 95% CI = [0.04;0.80], p = .02) and individual motor (OR= 0.1, 95% CI = [0.02;0.64], p= .02) categories. Individual language network robustness was not associated with the tested predictor variables.
CONCLUSIONS CONCLUSIONS
Sevoflurane anesthesia may compromise the visibility of fMRI resting state networks, particularly impacting motor networks. This finding suggests that the type of anesthesia is a critical factor in rs-fMRI quality. We did not observe the association of the MR acquisition technique or underlying structural abnormality with the RSN robustness.
ABBREVIATIONS BACKGROUND
BOLD = Blood Oxygen Level-Dependent; ICA = Independent Component Analysis; Rs-fMRI = Resting-State Functional Magnetic Resonance Imaging; RSN = Resting-State Networks; SNR = Signal-to-Noise Ratio.

Identifiants

DOI: 10.3174/ajnr.A8438 PMID: 39134370
pubmed: 39134370
pii: ajnr.A8438
doi: 10.3174/ajnr.A8438
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 by American Journal of Neuroradiology.

Auteurs

Elmira Hassanzadeh (E)

From the Department of Radiology (E.H., Z.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology (A.A., A.H., D.M.), Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Surgery (M.H.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Department of Radiology (S.K.W.) Boston Children's Hospital Harvard Medical School, Boston, MA, USA; and Comprehensive Epilepsy Center (T.G.), University of California San Diego, San Diego, Ca, USA; Department of Radiology (E.H, S.M.S, N.P.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Alyssa Ailion (A)

From the Department of Radiology (E.H., Z.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology (A.A., A.H., D.M.), Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Surgery (M.H.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Department of Radiology (S.K.W.) Boston Children's Hospital Harvard Medical School, Boston, MA, USA; and Comprehensive Epilepsy Center (T.G.), University of California San Diego, San Diego, Ca, USA; Department of Radiology (E.H, S.M.S, N.P.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Masoud Hassanzadeh (M)

From the Department of Radiology (E.H., Z.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology (A.A., A.H., D.M.), Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Surgery (M.H.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Department of Radiology (S.K.W.) Boston Children's Hospital Harvard Medical School, Boston, MA, USA; and Comprehensive Epilepsy Center (T.G.), University of California San Diego, San Diego, Ca, USA; Department of Radiology (E.H, S.M.S, N.P.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Alena Hornak (A)

From the Department of Radiology (E.H., Z.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology (A.A., A.H., D.M.), Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Surgery (M.H.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Department of Radiology (S.K.W.) Boston Children's Hospital Harvard Medical School, Boston, MA, USA; and Comprehensive Epilepsy Center (T.G.), University of California San Diego, San Diego, Ca, USA; Department of Radiology (E.H, S.M.S, N.P.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Noam Peled (N)

From the Department of Radiology (E.H., Z.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology (A.A., A.H., D.M.), Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Surgery (M.H.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Department of Radiology (S.K.W.) Boston Children's Hospital Harvard Medical School, Boston, MA, USA; and Comprehensive Epilepsy Center (T.G.), University of California San Diego, San Diego, Ca, USA; Department of Radiology (E.H, S.M.S, N.P.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Dana Martino (D)

From the Department of Radiology (E.H., Z.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology (A.A., A.H., D.M.), Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Surgery (M.H.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Department of Radiology (S.K.W.) Boston Children's Hospital Harvard Medical School, Boston, MA, USA; and Comprehensive Epilepsy Center (T.G.), University of California San Diego, San Diego, Ca, USA; Department of Radiology (E.H, S.M.S, N.P.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Simon K Warfield (SK)

From the Department of Radiology (E.H., Z.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology (A.A., A.H., D.M.), Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Surgery (M.H.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Department of Radiology (S.K.W.) Boston Children's Hospital Harvard Medical School, Boston, MA, USA; and Comprehensive Epilepsy Center (T.G.), University of California San Diego, San Diego, Ca, USA; Department of Radiology (E.H, S.M.S, N.P.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Zhou Lan (Z)

From the Department of Radiology (E.H., Z.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology (A.A., A.H., D.M.), Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Surgery (M.H.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Department of Radiology (S.K.W.) Boston Children's Hospital Harvard Medical School, Boston, MA, USA; and Comprehensive Epilepsy Center (T.G.), University of California San Diego, San Diego, Ca, USA; Department of Radiology (E.H, S.M.S, N.P.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Taha Gholipour (T)

From the Department of Radiology (E.H., Z.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology (A.A., A.H., D.M.), Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Surgery (M.H.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Department of Radiology (S.K.W.) Boston Children's Hospital Harvard Medical School, Boston, MA, USA; and Comprehensive Epilepsy Center (T.G.), University of California San Diego, San Diego, Ca, USA; Department of Radiology (E.H, S.M.S, N.P.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Steven M Stufflebeam (SM)

From the Department of Radiology (E.H., Z.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology (A.A., A.H., D.M.), Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Surgery (M.H.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Department of Radiology (S.K.W.) Boston Children's Hospital Harvard Medical School, Boston, MA, USA; and Comprehensive Epilepsy Center (T.G.), University of California San Diego, San Diego, Ca, USA; Department of Radiology (E.H, S.M.S, N.P.), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Classifications MeSH