Association Between Mental Stress-Induced Inferior Frontal Cortex Activation and Angina in Coronary Artery Disease

被引:15
作者
Moazzami, Kasra [1 ,2 ]
Wittbrodt, Matthew T. [3 ]
Alkhalaf, Mhmtjamil [2 ]
Lima, Bruno B. [1 ,2 ]
Nye, Jonathon A. [4 ]
Mehta, Puja K. [2 ]
Quyyumi, Arshed A. [2 ]
Vaccarino, Viola [1 ]
Bremner, J. Douglas [3 ,4 ,5 ]
Shah, Amit J. [1 ,2 ,5 ]
机构
[1] Emory Univ, Dept Epidemiol, Rollins Sch Publ Hlth, 1518 Clifton Rd NE,Room 3053, Atlanta, GA 30322 USA
[2] Emory Univ, Sch Med, Dept Med, Emory Clin Cardiovasc Res Inst,Div Cardiol, Atlanta, GA USA
[3] Emory Univ, Sch Med, Dept Psychiat & Behav Sci, Atlanta, GA USA
[4] Emory Univ, Sch Med, Dept Radiol & Imaging Sci, Atlanta, GA USA
[5] Atlanta VA Med Ctr, Decatur, GA USA
关键词
angina pectoris; coronary artery disease; myocardial ischemia; stress; psychological; QUALITY-OF-LIFE; CHEST-PAIN; PSYCHOMETRIC PROPERTIES; MYOCARDIAL-ISCHEMIA; BRAIN; DEPRESSION; QUESTIONNAIRE; INTERVENTION; METAANALYSIS; PERCEPTION;
D O I
10.1161/CIRCIMAGING.120.010710
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND: The inferior frontal lobe is an important area of the brain involved in the stress response, and higher activation with acute mental stress may indicate a more severe stress reaction. However, it is unclear if activation of this region with stress correlates with angina in individuals with coronary artery disease. METHODS: Individuals with stable coronary artery disease underwent acute mental stress testing using a series of standardized speech/arithmetic stressors in conjunction with high resolution positron emission tomography imaging of the brain. Blood flow to the inferior frontal lobe was evaluated as a ratio compared with whole brain flow for each scan. Angina was assessed with the Seattle Angina Questionnaire's angina frequency subscale at baseline and 2 years follow-up. RESULTS: We analyzed 148 individuals with coronary artery disease (mean age [SD] 62 [8] years; 69% male, and 35.8% Black). For every doubling in the inferior frontal lobe activation, angina frequency was increased by 13.7 units at baseline (, 13.7 [95% CI, 6.3-21.7];P=0.008) and 11.6 units during follow-up (, 11.6 [95% CI, 4.1-19.2];P=0.01) in a model adjusted for baseline demographics. Mental stress-induced ischemia and activation of other brain pain processing regions (thalamus, insula, and amygdala) accounted for 40.0% and 13.1% of the total effect of inferior frontal lobe activation on angina severity, respectively. CONCLUSIONS: Inferior frontal lobe activation with mental stress is independently associated with angina at baseline and during follow-up. Mental stress-induced ischemia and other pain processing brain regions may play a contributory role.
引用
收藏
页数:9
相关论文
共 44 条
[1]  
[Anonymous], 1973, The State-Trait Anxiety Inventory for Children (STAIC)
[2]  
[Anonymous], 2011, CARDIOVASC PSYCHIAT, DOI [DOI 10.1155/2011/134040, 10.1155/2011/134040]
[3]   Human brain mechanisms of pain perception and regulation in health and disease [J].
Apkarian, AV ;
Bushnell, MC ;
Treede, RD ;
Zubieta, JK .
EUROPEAN JOURNAL OF PAIN, 2005, 9 (04) :463-484
[4]   Patterns and Predictors of Subjective Units of Distress in Anxious Youth [J].
Benjamin, Courtney L. ;
O'Neil, Kelly A. ;
Crawley, Sarah A. ;
Beidas, Rinad S. ;
Coles, Meredith ;
Kendall, Philip C. .
BEHAVIOURAL AND COGNITIVE PSYCHOTHERAPY, 2010, 38 (04) :497-504
[5]   Psychometric properties of the PTSD checklist (PCL) [J].
Blanchard, EB ;
JonesAlexander, J ;
Buckley, TC ;
Forneris, CA .
BEHAVIOUR RESEARCH AND THERAPY, 1996, 34 (08) :669-673
[6]   Brain Correlates of Mental Stress-Induced Myocardial Ischemia [J].
Bremner, J. Douglas ;
Campanella, Carolina ;
Khan, Zehra ;
Shah, Majid ;
Hammadah, Muhammad ;
Wilmot, Kobina ;
Al Mheid, Ibhar ;
Lima, Bruno B. ;
Garcia, Ernest V. ;
Nye, Jonathon ;
Ward, Laura ;
Kutner, Michael H. ;
Raggi, Paolo ;
Pearce, Brad D. ;
Shah, Amit J. ;
Quyyumi, Arshed A. ;
Vaccarino, Viola .
PSYCHOSOMATIC MEDICINE, 2018, 80 (06) :515-525
[7]   Neural correlates of exposure to traumatic pictures and sound in Vietnam combat veterans with and without posttraumatic stress disorder: A positron emission tomography study [J].
Bremner, JD ;
Staib, LH ;
Kaloupek, D ;
Southwick, SM ;
Soufer, R ;
Charney, DS .
BIOLOGICAL PSYCHIATRY, 1999, 45 (07) :806-816
[8]   Insights into the pathophysiology of neuropathic pain through functional brain imaging [J].
Casey, KL ;
Lorenz, J ;
Minoshima, S .
EXPERIMENTAL NEUROLOGY, 2003, 184 :S80-S88
[9]   Emotion and the Prefrontal Cortex: An Integrative Review [J].
Dixon, Matthew L. ;
Thiruchselvam, Ravi ;
Todd, Rebecca ;
Christoff, Kalina .
PSYCHOLOGICAL BULLETIN, 2017, 143 (10) :1033-1081
[10]   Deep brain stimulation restores frontostriatal network activity in obsessive-compulsive disorder [J].
Figee, Martijn ;
Luigjes, Judy ;
Smolders, Ruud ;
Valencia-Alfonso, Carlos-Eduardo ;
van Wingen, Guido ;
de Kwaasteniet, Bart ;
Mantione, Mariska ;
Ooms, Pieter ;
de Koning, Pelle ;
Vulink, Nienke ;
Levar, Nina ;
Droge, Lukas ;
van den Munckhof, Pepijn ;
Schuurman, P. Richard ;
Nederveen, Aart ;
van den Brink, Wim ;
Mazaheri, Ali ;
Vink, Matthijs ;
Denys, Damiaan .
NATURE NEUROSCIENCE, 2013, 16 (04) :386-U195