FAST BOLD FMRI REVEALS THE SPATIOTEMPORAL COMPLEXITY OF NEUROVASCULAR COUPLING ALTERATIONS IN CEREBRAL SMALL VESSEL DISEASE

Recent advances in neurophysiology highlighted the potential of high temporal resolution in Blood-Oxygen Level Dependent (BOLD) functional MRI (fMRI), although it is not yet standard practice. We demonstrated that fast BOLD fMRI can detect single-subject, single-stimulus visually evoked responses to brief stimuli at 3T. We used fast fMRI in patients with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL), a genetic form of cerebral small vessel disease (cSVD). Using 2- and 10-second visual stimuli, we probed different neurovascular coupling regimes and showed that different regions of interest detect different facets of vascular dynamics. CADASIL patients showed significant changes in the amplitude and timing of the BOLD response, indicating early-age neurovascular impairment unrelated to anatomical lesions, and providing strong discriminative and generalization performance. These findings resolve prior inconsistencies in fMRI studies of CADASIL, supporting the use of fast fMRI to develop non-invasive biomarkers for cSVD and other neurodegenerative disorders.