Key result
Acute takotsubo syndrome linked to smaller white and gray matter volumes and increased cortical thickness.
Why the study?
The mechanism by which emotional processing in the context of stress leads to significant cardiac injury is poorly understood, prompting an investigation into brain structure and function in takotsubo syndrome patients.
Are there structural and functional brain changes in patients with acute Takotsubo syndrome compared to controls?
Cross-Sectional (n=50)
Yes
Are there structural and functional brain changes in patients with acute Takotsubo syndrome compared to controls?
Absolute Event Rate: 411342% vs 424934%
p-value: p=<0.001
Acute Takotsubo syndrome is associated with significant structural and functional brain changes, including altered gray and white matter volumes and functional connectivity linked to emotion and autonomic control.
Should not change takotsubo management; leaves open causality and clinical relevance of brain changes.
BACKGROUND: Takotsubo syndrome mimics an acute myocardial infarction, typically in the aftermath of mental or physical stress. OBJECTIVES: The mechanism by which emotional processing in the context of stress leads to significant cardiac injury is poorly understood, so a full exploration of brain structure and function in takotsubo syndrome patients merits investigation. METHODS: Twenty-five acute (<5 days) takotsubo patients and 25 control subjects were recruited into this observational cross-sectional study. Surface-based morphometry was carried out on magnetic resonance imaging (MRI) brain scans to extract cortical morphology based on volume, thickness, and surface area with the use of Freesurfer. Cortical morphology general linear models were corrected for age, sex, photoperiod, and total brain volume. Resting-state functional MRI and diffusion tensor tractography images were preprocessed and analyzed with the use of the Functional Magnetic Resonance Imaging of the Brain Diffusion Toolbox and Functional Connectivity Toolbox. RESULTS: There was significantly smaller total white matter and subcortical gray matter volumes in takotsubo (P < 0.001), with smaller total brain surface area but increased total cortical thickness (both P < 0.001). Individual gray matter regions (hippocampus and others) were significantly smaller in takotsubo (P < 0.001); only thalamus and insula were larger (P < 0.001). There was significant hyperfunctional and hypofunctional connectivity in multiple areas, including thalamus-amygdala-insula and basal ganglia (P < 0.05). All structural tractography connections were increased in takotsubo (P < 0.05). CONCLUSIONS: The authors showed smaller gray and white matter volumes driven by smaller cortical surface area, but increased cortical thickness and structural tractography connections with bidirectional changes in functional connectivity linked to emotion, language, reasoning, perception, and autonomic control. These are interventional targets in takotsubo patients' rehabilitation.
No takes yet. Share an insight, caveat, or question.
Khan et al. (2023) conducted a cross-sectional in Acute Takotsubo Syndrome (n=50). Acute Takotsubo Syndrome vs. Matched control subjects was evaluated on Total cerebral white matter volume (mm3) (p=<0.001). Acute takotsubo syndrome was associated with significantly smaller total white matter and subcortical gray matter volumes, smaller cortical surface area, and increased cortical thickness.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: