Brain Correlates of Mental Stress-Induced Myocardial Ischemia

Abstract

These findings suggest that mental stress-induced myocardial ischemia is associated with activation in brain areas involved in the stress response and autonomic regulation of the cardiovascular system. Altered brain reactivity to stress could possibly represent a mechanism through which stress leads to increased risk of CAD-related morbidity and mortality.

Early childhood trauma alters neurological responses to mental stress in patients with coronary artery disease

“…Evidence for the effects of psychological stress on neurohormonal systems following exposure to childhood trauma has been demonstrated previously, with increased hypothalamic-pituitary-adrenal axis response to both traumatic memory stressors in women with abuse-related posttraumatic stress disorder (Elzinga et al, 2003) and public speaking stressors in women with abuse and depression (Heim et al, 2000). Previously, in CAD patients, we have shown that mental stress activates areas within the inferior frontal gyrus and parietal cortex while deactivating areas within the pre-and postcentral gyrus, cerebellum, fusiform gyrus, and lingual gyrus (Bremner et al, 2018). Thus, mental stress appears to modulate brain activity in limbic, cognitive, and autonomic brain areas responding to the dual cognitive and emotional stress elicited by the tasks.…”

“…The difficulty of mental math was increased until participants incorrectly answered three successive problems. The stressful public speaking task required participants to prepare (two minutes) and present (two minutes) a speech in response to two stressful interpersonal situations (Bremner et al, 2018). The speech was presented to a video camera and audience wearing white coats and participants were told the content and duration would be evaluated.…”

“…One method to induce acute psychological stress is via mental stress. These paradigms include mental arithmetic (performing arithmetic under time pressure with negative feedback) and public speaking (Bremner et al, 2018;Hammadah et al, 2017b;Ramadan et al, 2013;Sheps et al, 2002;Specchia et al, 1984;Sullivan et al, 2018;Vaccarino et al, 2018;Vaccarino et al, 2016). Evidence for the effects of psychological stress on neurohormonal systems following exposure to childhood trauma has been demonstrated previously, with increased hypothalamic-pituitary-adrenal axis response to both traumatic memory stressors in women with abuse-related posttraumatic stress disorder (Elzinga et al, 2003) and public speaking stressors in women with abuse and depression (Heim et al, 2000).…”

“…The purpose of this study was to examine whether a history of early childhood trauma is related to neural responses to mental stress in CAD patients. We hypothesized that early childhood trauma will increase brain activations and deactivations in brain areas previously identified to be involved in mental stress in CAD patients (Bremner et al, 2018) and implicated in the neural circuits of early trauma (Bremner, 2005;Bremner and Vaccarino, 2015): anterior cingulate, medial prefrontal cortex, insula, and the cerebellum.…”

A meta-analysis on the prevalence, associated factors and diagnostic methods of mental stress induced myocardial ischemia

“…The phenomenon implied that we should consider individual differences in the consequence caused by different types of mental stress task, which is consistent with Bremner et al's study. Bremner [41] conducted a study with the intent of revealing the association between brain and MSIMI. It was found that mental arithmetic was associated with left insula activation, while public speaking was associated with right pre/ post-central gyrus and middle temporal gyrus activation.…”