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Therefore, multimodal MRI\u2010based quantification of hemodynamic impairment could inform improved treatment decisions. While gross interhemispheric hemodynamic imbalances have been reported in ICAS, identifying more spatially resolved patterns of disease\u2010related alterations may be promising to harness the full potential of hemodynamic MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this feasibility study, we investigated the spatial topography of ICAS\u2010related impairments by applying scaled subprofile model principal component analysis (SSM\u2010PCA) to cerebral blood flow (CBF), relative oxygen extraction fraction (rOEF), and oxygen extraction capacity (OEF\n                      <jats:sup>max<\/jats:sup>\n                      ) data of 21 unilateral ICAS patients and 25 healthy controls (HC).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found spatially extended, partly overlapping disease\u2010related patterns for CBF and OEF\n                      <jats:sup>max<\/jats:sup>\n                      , but not rOEF. CBF (area under the curve [AUC]\u00a0=\u00a00.95) but not OEF\n                      <jats:sup>max<\/jats:sup>\n                      (AUC\u00a0=\u00a00.72) SSM\u2010PCA scores distinguished ICAS patients and HC better than interhemispheric lateralizations (AUC\u00a0=\u00a00.75\/0.73). SSM\u2010PCA scores were only partly explained by interhemispheric lateralization (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a0\u22120.27\/0.38), indicating complementary information. Critically, ICAS patients with higher OEF\n                      <jats:sup>max<\/jats:sup>\n                      SSM\u2010PCA scores (\n                      <jats:italic>z<\/jats:italic>\n                      \u00a0\u2265\u00a01) demonstrated higher stenotic degrees and lower cognitive performance (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05) without differing in interhemispheric lateralization (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We demonstrated the feasibility of SSM\u2010PCA in ICAS and obtained novel insights into complex hemodynamic impairment patterns and their association with cognitive function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jon.70084","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T03:36:39Z","timestamp":1757907399000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Multivariate Pattern Analysis of Perfusion and Oxygenation Impairment in Asymptomatic Carotid Artery Stenosis"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7923-3231","authenticated-orcid":false,"given":"Jan","family":"Kufer","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, TUM Klinikum Rechts Der Isar Technical University of Munich (TUM)  Munich Germany"},{"name":"TUM Neuroimaging Center (TUM\u2010NIC) Technical University of Munich (TUM)  Munich Germany"},{"name":"Magnetic Resonance Research Center (MRRC), Department of Radiology and Biomedical Imaging Yale University  New Haven Connecticut USA"},{"name":"Athinoula A. 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