Cerebrovascular reactivity is associated with longitudinal white matter hyperintensity progression in small vessel disease on 7T MRI

We studied the association between cerebrovascular reactivity measured with blood oxygenation level-dependent (BOLD-CVR) to hypercapnia and progression of white matter hyperintensities (WMH) on 7T MRI in cerebral small vessel disease (SVD). BOLD-CVR was assessed in voxels of four different categories which represent the fate of a voxel after two-year follow-up. The BOLD-CVR in normal appearing white matter (NAWM) that converted into WMH was significantly lower than the BOLD-CVR of voxels that remained WMH (0.39 [0.16-0.63] vs 0.98 [0.75-1.21]) (p<0.0001). The association between BOLD-CVR and WMH progression signifies the potential of BOLD-CVR to be a predictor of disease progression in SVD.