Assessing test-retest reliability of phase contrast MRI for measuring cerebrospinal fluid and cerebral blood flow dynamics.

PURPOSE: Pathological states occur when cerebrospinal fluid (CSF) and cerebral blood flow (CBF) dynamics become dysregulated in the brain. Phase-contrast MRI (PC-MRI) is a noninvasive imaging technique that enables quantitative measurements of CSF and CBF flow. While studies have validated PC-MRI as an imaging technique for flow, few studies have evaluated its reliability for CSF and CBF flow parameters commonly associated with neurological disease. The purpose of this study was to evaluate test-retest reliability at the cerebral aqueduct (CA) and C2-C3 area using PC-MRI to assess the feasibility of investigating CSF and CBF flow dynamics. METHODS: This study was performed on 27 cognitively normal young adults (ages 20-35 years). Flow data was acquired on a 3T Siemens Prisma using a 2D cine-PC pulse sequence. Three consecutive flow measurements were acquired at the CA and C2-C3 area. Intraclass correlation coefficient (ICC) and coefficient of variance (CV) were used to evaluate intrarater, inter-rater, and test-retest reliability. RESULTS: Among the 26 flow parameters analyzed, 22 had excellent reliability (ICC > 0.80), including measurements of CSF stroke volume, flush peak, and fill peak, and 4 parameters had good reliability (ICC 0.60-0.79). 16 flow parameters had a mean CV ≤ 10%, 7 had a CV ≤ 15%, and 3 had a CV ≤ 30%. All CSF and CBF flow measurements had excellent inter-rater and intrarater reliability (ICC > 0.80). CONCLUSION: This study shows that CSF and CBF flow can be reliably measured at the CA and C2-C3 area using PC-MRI, making it a promising tool for studying flow dynamics in the central nervous system.

Cycling and Spatial Navigation in an Enriched, Immersive 3D Virtual Park Environment: A Feasibility Study in Younger and Older Adults.

BACKGROUND: Cognitive decline is a significant public health concern in older adults. Identifying new ways to maintain cognitive and brain health throughout the lifespan is of utmost importance. Simultaneous exercise and cognitive engagement has been shown to enhance brain function in animal and human studies. Virtual reality (VR) may be a promising approach for conducting simultaneous exercise and cognitive studies. In this study, we evaluated the feasibility of cycling in a cognitively enriched and immersive spatial navigation VR environment in younger and older adults. METHODS: A total of 20 younger (25.9 ± 3.7 years) and 20 older (63.6 ± 5.6 years) adults participated in this study. Participants completed four trials (2 learning and 2 recall) of cycling while wearing a head-mounted device (HMD) and navigating a VR park environment. Questionnaires were administered to assess adverse effects, mood, presence, and physical exertion levels associated with cycling in the VR environment. RESULTS: A total of 4 subjects withdrew from the study due to adverse effects, yielding a 90% completion rate. Simulator sickness levels were enhanced in both age groups with exposure to the VR environment but were within an acceptable range. Exposure to the virtual environment was associated with high arousal and low stress levels, suggesting a state of excitement, and most participants reported enjoyment of the spatial navigation task and VR environment. No association was found between physical exertion levels and simulator sickness levels. CONCLUSION: This study demonstrates that spatial navigation while cycling is feasible and that older adults report similar experiences to younger adults. VR may be a powerful tool for engaging physical and cognitive activity in older adults with acceptable adverse effects and with reports of enjoyment. Future studies are needed to assess the efficacy of a combined exercise and cognitive VR program as an intervention for promoting healthy brain aging, especially in older adults with increased risk of age-related cognitive decline.