Cerebrovascular reactivity response delays from time regression analysis are uniquely correlated to recent stroke symptomatology in moyamoya

Motivation: Moyamoya impairment is commonly assessed by anatomical MRI and angiography, yet these methods lack information on compensatory parenchymal behaviors. Goal(s): To evaluate whether cerebrovascular compliance measures reflect recent ischemic symptomology and may have relevance as biomarkers of stroke risk or as endpoints in interventional trials. Approach: We applied logistic regression analysis in 73 moyamoya participants to evaluate whether BOLD hypercapnia-induced reactivity or reactivity delays related to recent ischemic symptoms. Results: Reactivity delays in the flow territory of ischemic symptoms were found to be significantly lengthened compared to the asymptomatic territories. Maximum vasodilatory responses were less closely associated with symptoms. Impact: The sensitivity of the cerebrovascular reactivity timing profiles to recent ischemic symptomology suggests that the dynamics of vascular compliance may have clinical relevance as a diagnostic measurement of impairment or treatment response in moyamoya.