Cerebral cortical hyperactivation in response to mental stress in patients with coronary artery disease

Abstract

The central nervous system (CNS) effects of mental stress in patients with coronary artery disease (CAD) are unexplored. The present study used positron emission tomography (PET) to measure brain correlates of mental stress induced by an arithmetic serial subtraction task in CAD and healthy subjects. Mental stress resulted in hyperactivation in CAD patients compared with healthy subjects in several brain areas including the left parietal cortex [angular gyrus͞parallel sulcus (area 39)], left anterior cingulate (area 32), right visual association cortex (area 18), left fusiform gyrus, and cerebellum. These same regions were activated within the CAD patient group during mental stress versus control conditions. In the group of healthy subjects, activation was significant only in the left inferior frontal gyrus during mental stress compared with counting control. Decreases in blood f low also were produced by mental stress in CAD versus healthy subjects in right thalamus (lateral dorsal, lateral posterior), right superior frontal gyrus (areas 32, 24, and 10), and right middle temporal gyrus (area 21) (in the region of the auditory association cortex). Of particular interest, a subgroup of CAD patients that developed painless myocardial ischemia during mental stress had hyperactivation in the left hippocampus and inferior parietal lobule (area 40), left middle (area 10) and superior frontal gyrus (area 8), temporal pole, and visual association cortex (area 18), and a concomitant decrease in activation observed in the anterior cingulate bilaterally, right middle and superior frontal gyri, and right visual association cortex (area 18) compared with CAD patients without myocardial ischemia. These findings demonstrate an exaggerated cerebral cortical response and exaggerated asymmetry to mental stress in individuals with CAD.

Bidirectional asymmetry in the neurovisceral communication for the cardiovascular control: New insights

“…It is worth, however to indicate that no clear predominant laterality on CVC or stroke prognosis in relation to insular cortex stroke has been reported in patients (Nagai et al 2010). On the other hand, under stress, heart disease correlates with an asymmetric hyperactivation of certain brain areas such as the left parietal cortex or the right visual association cortex (Soufer et al 1998). Inducing a stroke in genetically hypertensive rats with a diet containing 4% NaCl and 0.75% of K + , results in higher density of cerebrovascular sympathetic nerves in the left hemisphere than in the right (Smeda 1990).…”

Reflexion and reflection: A social cognitive neuroscience approach to attributional inference

“…Consistent with two-factor theories of emotion (James, 1894;Schacter & Singer, 1962;cf. Ellsworth, 1994), the anterior cingulate, along with the insula, is one of the major sites of autonomic feedback (Buchanan, Valentine & Powell, 1985;Critchley, Corfield, Chandler, Mathias, & Dolan, 2000;Soufer et al, 1998). Finally, awareness of one's emotional state correlates with anterior cingulate activity (Lane et al, 1998), and alexithymia (a disorder characterized by impaired identification of one's own emotional states) is associated with reduced cingulate activity in response to emotionally evocative stimuli (Berthoz et al, 2000).…”

Instant Stress: Detection of Perceived Mental Stress Through Smartphone Photoplethysmography and Thermal Imaging (Preprint)

“…From the literature on mental stress induction studies in psychology, neuroscience and affective computing (e.g., [2,20,22,38]), we chose two cognitiveload induction tasks -the Stroop Color Word test [39] and the Mathematical Serial Subtraction test [40]. These tests were selected as they have been shown in various studies to induce mental stress and also they have been used in other thermal imaging studies.…”