The interpretation of regional blood flow and blood oxygenation changes during functional activation has evolved from the concept of 'neurovascular coupling', and hence the regulation of arteriolar tone to meet metabolic demands. The efficacy of oxygen extraction was recently shown to depend on the heterogeneity of capillary flow patterns downstream. Existing compartment models of the relation between tissue metabolism, blood flow, and blood oxygenation, however, typically assume homogenous microvascular flow patterns. To take capillary flow heterogeneity into account, we modeled the effect of capillary transit time heterogeneity (CTH) on the 'oxygen conductance' used in compartment models. We show that the incorporation of realistic reductions in CTH during functional hyperemia improves model fits to dynamic blood flow and oxygenation changes acquired during functional activation in a literature animal study. Our results support earlier observations that oxygen diffusion properties seemingly change during various physiologic stimuli, and posit that this phenomenon is related to parallel changes in capillary flow patterns. Furthermore, our results suggest that CTH must be taken into account when inferring brain metabolism from changes in blood flow-or blood oxygenation-based signals. Keywords: blood oxygen level-dependent contrast; capillaries; capillary transit time heterogeneity; hemodynamics; neurovascular coupling INTRODUCTION Brain function depends critically on a steady supply of oxygen. During rest, the central nervous system receives 420% of the cardiac output, and consciousness is lost within seconds after circulatory arrest. Although functional activation is typically associated with a modest 10% to 30% increase in local cerebral metabolic rate of oxygen (CMRO 2 ), regional cerebral blood flow (CBF) typically increases by 20% to 80%, with δCBF/δCMRO 2 coupling ratios consistently larger than unity. 1,2 This functional hyperemia permits the localization of brain activity by imaging techniques such as positron emission tomography and functional magnetic resonance imaging. Today, arterial spin labeling functional magnetic resonance imaging and blood oxygen leveldependent (BOLD) functional magnetic resonance imaging are the preferred tools in human brain mapping. 3,4 The interpretation of regional blood flow and blood oxygenation changes during functional activation has evolved from the concept of 'neurovascular coupling': mechanisms that converge on cerebral arterioles to adjust CBF according to changing metabolic needs. The subsequent distribution of blood across the capillary bed, and the oxygen diffusion from the microcirculation to active cells, is extremely complex, and so far biophysical models have been unable to establish with certainty whether the increase in oxygen supply during functional hyperemia is matched to the increased metabolic demands. 5 Buxton and Frank 6 derived the so-called 'oxygen limitation model', which relates CBF and CMRO 2 through the flow diffusion