Key result
Acute Takotsubo syndrome is linked to attenuated limbic brain responses that normalize by three months.
Why the study?
The role of the limbic system in the acute phase and during the recovery of takotsubo syndrome needed further clarification.
Does Takotsubo syndrome alter limbic brain responses to aversive visual stimuli during the acute and recovery phases compared to healthy controls and myocardial infarction patients?
Observational (n=49)
No
Does Takotsubo syndrome alter limbic brain responses to aversive visual stimuli during the acute and recovery phases compared to healthy controls and myocardial infarction patients?
The functional neuroimaging findings extend evidence that the brain-heart axis, particularly central limbic structures responsible for emotional processing, is transiently impaired during acute Takotsubo syndrome.
Transient limbic changes in acute Takotsubo may reflect brain-heart axis involvement; extends observational evidence but remains hypothesis-generating.
The role of the limbic system in the acute phase and during the recovery of takotsubo syndrome needs further clarification. In this longitudinal study, anatomical and task-based functional magnetic resonance imaging of the brain was performed during an emotional picture paradigm in 19 postmenopausal female takotsubo syndrome patients in the acute and recovery phases in comparison to sex- and aged-matched 15 healthy controls and 15 patients presenting with myocardial infarction. Statistical analyses were performed based on the general linear model where aversive and positive picture conditions were included in order to reveal group differences during encoding of aversive versus positive pictures and longitudinal changes. In the acute phase, takotsubo syndrome patients showed a lower response in regions involved in affective and cognitive emotional processes (e.g., insula, thalamus, frontal cortex, inferior frontal gyrus) while viewing aversive versus positive pictures compared to healthy controls and patients presenting with myocardial infarction. In the recovery phase, the response in these brain regions normalized in takotsubo syndrome patients to the level of healthy controls, whereas patients 8-12 weeks after myocardial infarction showed lower responses in the limbic regions (mainly in the insula, frontal regions, thalamus, and inferior frontal gyrus) compared to healthy controls and takotsubo syndrome patients. In conclusion, compared to healthy controls and patients suffering from acute myocardial infarction, limbic responses to aversive visual stimuli are attenuated during the acute phase of takotsubo syndrome, recovering within three months. Reduced functional brain responses in the recovery phase after a myocardial infarction need further investigation.
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Steiger et al. (2022) conducted an observational in Takotsubo syndrome (n=49). Takotsubo syndrome vs. Healthy controls and patients with myocardial infarction was evaluated on Blood-Oxygen-Level-Dependent (BOLD) response in limbic brain regions during processing of aversive versus positive visual stimuli (p=<0.001). Patients with acute Takotsubo syndrome exhibited attenuated limbic brain responses to aversive visual stimuli compared to healthy controls and myocardial infarction patients, which normalized within three months.
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