Dynamic forcing of end-tidal carbon dioxide and oxygen applied to functional magnetic resonance imaging

Investigations into the blood oxygenation level-dependent (BOLD) functional MRI signal have used respiratory challenges with the aim of probing cerebrovascular physiology. Such challenges have altered the inspired partial pressures of either carbon dioxide or oxygen, typically to a fixed and constant level (fixed inspired challenge (FIC)). The resulting end-tidal gas partial pressures then depend on the subject's metabolism and ventilatory responses. In contrast, dynamic end-tidal forcing (DEF) rapidly and independently sets end-tidal oxygen and carbon dioxide to desired levels by altering the inspired gas partial pressures on a breath-by-breath basis using computer-controlled feedback. This study implements DEF in the MRI environment to map BOLD signal reactivity to CO2. We performed BOLD (T2*) contrast FMRI in four healthy male volunteers, while using DEF to provide a cyclic normocapnic-hypercapnic challenge, with each cycle lasting 4 mins (PETCO2 mean +/- s.d., from 40.9 +/- 1.8 to 46.4 +/- 1.6 mm Hg). This was compared with a traditional fixed-inspired (FICO2 = 5%) hypercapnic challenge (PETCO2 mean +/- s.d., from 38.2 +/- 2.1 to 45.6 +/- 1.4 mm Hg). Dynamic end-tidal forcing achieved the desired target PETCO2 for each subject while maintaining PETO2 constant. As a result of CO2-induced increases in ventilation, the FIC showed a greater cyclic fluctuation in PETO2. These were associated with spatially widespread fluctuations in BOLD signal that were eliminated largely by the control of PETO2 during DEF. The DEF system can provide flexible, convenient, and physiologically well-controlled respiratory challenges in the MRI environment for mapping dynamic responses of the cerebrovasculature.