Cocaine-induced stroke is among the most serious medical complications associated with its abuse. However the extent to which acute cocaine may induce silent microischemia predisposing the cerebral tissue to neurotoxicity has not been investigated; in part, because of limitations of current neuroimaging tools, i.e., lack of high spatiotemporal resolution and sensitivity to simultaneously measure cerebral blood flow (CBF) in vessels of different calibers (including capillaries) quantitatively and over a large field of view. Here we combine ultrahigh-resolution optical coherence tomography to enable tracker-free 3D microvascular angiography (μOCA) and a new phase-intensity-mapping algorithm to enhance the sensitivity of 3D optical Doppler tomography (μODT) for simultaneous capillary CBF quantization. We apply the technique to study the responses of cerebral microvascular networks to single and repeated cocaine administration in the mouse somatosensory cortex. We show that within 2–3 minutes after cocaine administration CBF markedly decreased (e.g., ~70%) but the magnitude and recovery differed for the various types of vessels; arterioles had the fastest recovery (~5min), capillaries varied drastically (from 4–20min) and venules showed relatively slower recovery (~12min). More importantly, we showed that cocaine interrupted CBF in some arteriolar branches for over 45min and this effect was exacerbated with repeated cocaine administration. These results provide evidence that cocaine doses within the range administered by drug abusers induces cerebral microischemia and that these effects are exacerbated with repeated use. Thus cocaine-induced microischemia is likely to be a contributor to its neurotoxic effects.

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Despite widespread applications of multiphoton microscopy in microcirculation, its small field of view and inability to instantaneously quantify cerebral blood flow velocity (CBFv) in vascular networks limit its utility in investigating the heterogeneous responses to brain stimulations. Optical Doppler tomography (ODT) provides 3D images of CBFv networks, but it suffers poor sensitivity for measuring capillary flows. Here we report a new method, contrast-enhanced ODT with intralipid that significantly improves quantitative CBFv imaging of capillary networks by obviating the errors from long latency between flowing red blood cells (low hematocrit ~20% in capillaries). This enhanced sensitivity allowed us to measure the ultraslow microcirculation surrounding a brain tumor and the abnormal ingrowth of capillary flows in the tumor as well as in ischemia triggered by chronic cocaine in the mouse brain that could not be detected by regular ODT. It also enabled significantly enhanced sensitivity for quantifying the heterogeneous CBFv responses of vascular networks to acute cocaine. Inasmuch as intralipids are widely used for parenteral nutrition the intralipid contrast method has translational potential for clinical applications.