Cerebrovascular response dynamics to hypercapnia in healthy aging

Cerebrovascular dysfunction is an early and underrecognized contributor to cognitive decline. Standard measures such as cerebrovascular reactivity (CVR) during hypercapnia capture only the amplitude of flow responses, providing limited insight into the timing of vascular adaptation. Temporal features, such as delay (onset latency) and time constant (rate of adjustment), together with gain (response amplitude) may serve as more sensitive indicators of vascular health, but cannot be directly obtained from conventional imaging. Here, we investigated cerebral blood flow (CBF), cerebral blood volume (CBV), and blood oxygenation level dependent (BOLD) signal dynamics during hypercapnic challenge in healthy aging. Using a physiologically validated computational model, we estimated delay, time constant, and gain by optimizing the mapping of end-tidal gases to their arterial counterparts in a region-of-interest framework. Once parametrized using CBF, the model successfully predicted CBV and BOLD responses in independent experimental sessions. Across subjects, aging was associated with widespread heterogeneous region-specific changes in delay and substantial reductions in gain and time constant, indicating that cerebrovascular responses become weaker and less adaptable with age. These results demonstrate that calibrated simulations have the ability to track vascular aging, allowing the extraction of parameters that may represent novel biomarkers of cerebrovascular dysfunction. Unlike conventional CVR, temporal hemodynamic parameters capture the dynamics of vascular adaptation, providing a complementary dimension for early detection and therapeutic monitoring in aging and disease.