- Small vessel disease is associated with white-matter (WM) magnetic resonance imaging (MRI) hyperintensities (WMHs) in patients with vascular cognitive impairment (VCI) and subsequent damage to the WM. Although WM is vulnerable to hypoxic-ischemic injury and O2 is critical in brain physiology, tissue O2 level in the WM has not been measured and explored in vivo. We hypothesized that spontaneously hypertensive stroke-prone rat (SHR/SP) fed a Japanese permissive diet (JPD) and subjected to unilateral carotid artery occlusion (UCAO), a model to study VCI, would lead to reduced tissue oxygen (pO2) in the deep WM. We tested this hypothesis by monitoring WM tissue pO2 using in vivo electron paramagnetic resonance (EPR) oximetry in SHR/SP rats over weeks before and after JPD/UCAO. The SHR/SP rats experienced an increase in WM pO2 from 9 to 12 weeks with a maximal 32% increase at week 12, followed by a dramatic decrease in WM pO2 to near hypoxic conditions during weeks 13 to 16 after JPD/UCAO. The decreased WM pO2 was accompanied with WM damage and hemorrhages surrounding microvessels. Our findings suggest that changes in WM pO2 may contribute to WM damage in SHR/SP rat model, and that EPR oximetry can monitor brain pO2 in the WM of small animals.