Cerebral blood flow and energy demand: imaging insights into neurovascular function

The brain depends on highly regulated moment-to-moment changes in regional blood supply to support its energetically demanding cognitive function with a limited energy budget. To efficiently match energetic supply to demand, neural activity rapidly increases regional blood flow. This process, known as neurovascular coupling (NVC), represents a particularly sophisticated form of functional hyperemia in the central nervous system, distinguished by its exceptional spatial precision. This feature of the cerebral vasculature generates a spatial and temporal relationship between neuronal activity and vasomotion. Although NVC is widely accepted to be essential for normal brain function and health, it remains poorly understood how NVC supports neuronal function and cognition. This review describes the current understanding of molecular and cellular mechanisms underlying NVC. We will also discuss the potential physiological functions of neurovascular coupling in normal brain function with a focus on energy supply to neural cells. Finally, the impact of neurovascular dysregulation on neurological disorders and the future outlook will be discussed.