White Matter Reactivity to Hemodynamic Stimuli: Insights from Dynamic and Maximal Cerebrovascular Reserve after Acetazolamide Provocation

We explored cerebrovascular reactivity (CVR) of white matter in patients with evidence for micro- and macrovascular disease using our previously described Blood Oxygen Level Dependent – acetazolamide paradigm. Subjects consistently demonstrated lower CVR in voxels with microangiopathic white matter when present in hemispheres with coexistent proximal, large-vessel steno-occlusive disease (SOD). The relationship of CVR values in normal appearing white matter and contralateral white matter lesions in patients with unilateral SOD is more complex and warrants further investigation.