Structural and Functional Brain Changes in Acute Takotsubo Syndrome
Hilal Khan1, David T Gamble1, Amelia Rudd1
1University of Aberdeen, Aberdeen, United Kingdom.
JACC. Heart Failure
|February 8, 2023
Summary
Takotsubo syndrome, which mimics heart attacks after stress, shows distinct brain structure differences. Patients have smaller gray and white matter volumes but altered cortical thickness and connectivity, suggesting new rehabilitation targets.
Area of Science:
- Neuroscience
- Cardiology
- Psychiatry
Background:
- Takotsubo syndrome (TTS) presents as a myocardial infarction, often triggered by emotional or physical stress.
- The precise mechanisms linking stress-induced emotional processing to cardiac injury in TTS remain unclear.
Purpose of the Study:
- To investigate brain structure and function in patients with TTS.
- To explore the relationship between emotional processing, stress, and cardiac injury in TTS.
Main Methods:
- Cross-sectional study of 25 TTS patients and 25 controls using magnetic resonance imaging (MRI).
- Surface-based morphometry (Freesurfer) analyzed cortical volume, thickness, and surface area.
- Resting-state functional MRI and diffusion tensor tractography (DTI) assessed brain connectivity.
Main Results:
- TTS patients exhibited smaller total white matter and subcortical gray matter volumes (P < .001).
- Cortical surface area was reduced, while cortical thickness increased (P < .001).
- Significant alterations in functional connectivity (hyper/hypo) and increased structural tractography connections were observed (P < .05).
Conclusions:
- TTS is associated with widespread structural brain changes, including reduced gray/white matter volume and altered cortical morphology.
- Bidirectional functional connectivity changes in emotion, language, and autonomic control networks are linked to TTS.
- Identified brain alterations offer potential interventional targets for TTS patient rehabilitation.
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