Structural and BOLD-weighted hemodynamic imaging was performed in patients with intracranial steno-occlusion due to moyamoya disease before and after surgical revascularization. A novel data-driven time-delay analysis was performed using cross-correlation of functional imaging data to find the time at which maximum correlation occurs between the BOLD signal from each voxel and a reference regressor. This provides a novel metric of hemodynamic impairment (lagtime) that may be indicative of vascular smooth muscle dysfunction and therefore delayed reactivity. We found that in patients with successful revascularization on angiography, lagtimes decreased, and in patients with unsuccessful revascularization and progressive disease, lagtimes increased.
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