Superior sagittal sinus flow as a proxy for tracking global cerebral blood flow dynamics during wakefulness and sleep

Sleep, a state of reduced consciousness, affects brain oxygen metabolism and lowers cerebral metabolic rate of oxygen (CMRO(2)). Previously, we quantified CMRO(2) during sleep via Fick’s Principle, with a single-band MRI sequence measuring both hemoglobin O(2) saturation (SvO(2)) and superior sagittal sinus (SSS) blood flow, which was upscaled to obtain total cerebral blood flow (tCBF). The procedure involves a brief initial calibration scan to determine the upscaling factor (f(c)), assumed state-invariant. Here, we used a dual-band sequence to simultaneously provide SvO(2) in SSS and tCBF in the neck every 16 seconds, allowing quantification of f(c) dynamically. Ten healthy subjects were scanned by MRI with simultaneous EEG for 80 minutes, yielding 300 temporal image frames per subject. Four volunteers achieved slow-wave sleep (SWS), as evidenced by increased δ-wave activity (per American Academy of Sleep Medicine criteria). SWS was maintained for 13.5 ± 7.0 minutes, with CMRO(2) 28.6 ± 5.5% lower than pre-sleep wakefulness. Importantly, there was negligible bias between tCBF obtained by upscaling SSS-blood flow, and tCBF measured directly in the inflowing arteries of the neck (intra-class correlation 0.95 ± 0.04, averaged across all subjects), showing that the single-band approach is a valid substitute for quantifying tCBF, simplifying image data collection and analysis without sacrificing accuracy.