ORIGINAL RESEARCH article
Front. Neurol.
Sec. Stroke
This article is part of the Research TopicVascular Diseases of the Brain: Insights, Progress and Lessons LearnedView all 10 articles
Characterizing Cardioballistic Brain Dynamics and Vascular Hemodynamics in Patients with Chiari Malformation Using Advanced MRI
Provisionally accepted
- 1Stanford University, Stanford, United States
- 2Department of Neuroradiology, Western Lisbon Local Health Unit, Lisbon, Portugal
- 3Duke University, Durham, United States
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Chiari Malformation Type I is a neurological disorder involving cerebellar tonsillar herniation, affecting cerebrospinal fluid dynamics and brain biomechanics. Advanced neuroimaging techniques are critical for understanding the pathophysiology of these anatomical abnormalities to guide clinical decision-making. Cardioballistic brain motion, the displacement of brain tissue driven by cardiac pulsation, can be visualized using cardiac-gated balanced steady-state free precession (bSSFP) cine MRI. Cerebellar hemodynamics can be measured using arterial spin labeling (ASL) MRI. Here, we present cerebellar cardioballistic dynamics and cerebellar hemodynamics in a retrospective cohort of 10 pediatric Chiari patients and 10 normal subjects. Cardioballistic brain motion was measured using a phase-based motion amplification algorithm applied to bSSFP cine MRI, yielding a novel scalar metric-the Cerebellar Dynamic Index (CDI). Cerebral blood flow (CBF) was quantified using ASL. CDI was significantly higher in Chiari patients compared to controls (by 39%±26%, p<0.01), indicating greater arterial-driven brain motion. Cerebellar CBF values, however, did not differ significantly between groups (median: 55.5 vs. 51.5 ml/100g/min, p=0.48). These findings suggest that cardioballistic brain dynamics may serve as a sensitive biomechanical biomarker for Chiari Malformation and support the integration of motion and perfusion imaging into a multimodal framework for diagnosis and monitoring.
Keywords: chiari malformation, Cerebellum, cardioballistic dynamics, Hemodynamics, Arterial Spin Labeling
Received: 16 Jun 2025; Accepted: 03 Oct 2025.
Copyright: © 2025 Zhao, Duarte, Tong, Prolo, Grant, Moseley and Yeom. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Moss Zhao, mosszhao@stanford.edu
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