Arterial Spin Labeling and Phase-Contrast MRI suggest impaired cerebral blood flow autoregulation in cerebral small vessel disease

Motivation: Largely unidentified pathophysiological mechanisms in cerebral small vessel disease (cSVD) hamper treatment development. One of the potentially affected functions is cerebral blood flow (CBF) autoregulation. Goal(s): Establish whether brain tissue perfusion is (in)dependent of macrovascular blood supply in cSVD patients. Approach: The relationship between internal carotid artery blood flow (blood supply), measured with phase-contrast MRI, and gray matter CBF (CBFGM), measured with arterial spin labeling, was determined separately for cSVD patients (n=41) and controls (n=18). Results: A significant, positive relationship between CBFGM and blood supply was found in cSVD patients, but not in controls, suggesting impaired autoregulation in cSVD. Impact: We revealed a positive relationship between internal carotid artery blood supply and the cerebral blood flow in gray matter in cerebral small vessel disease patients, but not in controls, which could indicate compromised autoregulatory capacity.