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

Wittbrodt, Matthew T.; Moazzami, Kasra; Lima, Bruno B; Alam, Zuhayr S.; Corry, Daniel; Hammadah, Muhammad; Campanella, Carolina; Ward, Laura; Quyyumi, Arshed A.; Shah, Amit; Vaccarino, Viola; Nye, Jonathon A.; Bremner, J. Douglas

doi:10.1016/j.jad.2019.05.018

Cited by 21 publications

(15 citation statements)

References 94 publications

(123 reference statements)

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“…We also found that CVD patients with mental stress-induced myocardial ischemia had increased anterior cingulate function with mental stress compared to CVD patients without ischemia [41], and brain activation in these regions correlated with increased stress-induced peripheral vasoconstriction [27]. Furthermore, in a series of studies, we observed that CVD patients have differing brain activation patterns to mental stress based on gender [55], obesity [56], symptoms of angina [42,57], history of early trauma [58], and co-occurring depression [59,60].…”

Section: Neurobiology Of Stress In Relation To Cvdsupporting

confidence: 50%

Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient

et al. 2021

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The influence of psychological stress on the physiology of the cardiovascular system, and on the etiology and outcomes of cardiovascular disease (CVD) has been the object of intense investigation. As a whole, current knowledge points to a "brain-heart axis" that is especially important in individuals with pre-existing CVD. The use of acute psychological stress provocation in the laboratory has been useful to clarify the effects of psychological stress on cardiovascular physiology, immune function, vascular reactivity, myocardial ischemia, neurobiology and cardiovascular outcomes. An emerging paradigm is that dynamic perturbations of physiological and molecular pathways during stress or negative emotions are important in influencing cardiovascular outcomes, and that some patient subgroups, such as women, patients with an early-onset myocardial infarction, and patients with adverse psychosocial exposures, may be at especially high risk for these effects. This review summarizes recent knowledge on mind-body connections in CVD among cardiac patients and highlights important pathways of risk which could become the object of future intervention efforts. As a whole, this research suggests that an integrated study of mind and body is necessary to fully understand the determinants and consequences of CVD.

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Section: Neurobiology Of Stress In Relation To Cvdsupporting

confidence: 50%

Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient

et al. 2021

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“…Through its connections with the parietal lobe, the inferior lobe also mediates a heightened activity in brain areas involved in perception and cognition during stress. We have recently shown that among individuals with CAD, this region is highly activated in response to acute MS [ 11 ], and the magnitude of activation correlates with both the peripheral vasoconstriction and MS-induced myocardial ischemia [ 21, 22, 27 ]. Our current findings further expand the role of inferior frontal lobe activation with respect to cardiovascular health by demonstrating that higher activation of this region adversely affects executive function, at least partly by a greater vasoconstrictor response to stress.…”

Section: Discussionmentioning

confidence: 99%

“…Analysis of HR-PET images, including realigning, normalizing, and smoothing, was completed following established protocols using statistical parametric mapping (SPM12; www.fil.ion.ucl.ac.uk/spm/ software/spm12/) [35][36][37]. First, a mean intensity image was created from the eight individual scans.…”

Section: Brain Imaging Analysesmentioning

confidence: 99%

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Neurobiological Pathways Linking Acute Mental Stress to Impairments in Executive Function in Individuals with Coronary Artery Disease

Moazzami

Wittbrodt

Lima

et al. 2021

ADR

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Background: Individuals with coronary artery disease (CAD) have worse executive function compared to the general population but the mechanisms are unknown. Objective: To investigate the role of acute mental stress (MS) on the executive function of patients with CAD. Methods: Participants with stable CAD underwent acute MS testing with simultaneous peripheral vascular function measurements and brain imaging using high resolution-positron emission tomography. Digital pulse wave amplitude was continuously measured using peripheral artery tonometry (PAT, Itamar Inc). Stress/rest PAT ratio (sPAT) of pulse wave amplitude during MS/baseline was calculated as a measure of microvascular constriction during MS. Plasma levels of catecholamine and interleukin-6 were assessed at baseline and after MS. Executive function was assessed both at baseline and at 2 years follow-up using the Trail Making Test parts A and B. Results: We studied 389 individuals with brain data available for 148 participants. Of this population follow-up cognitive assessments were performed in 226 individuals (121 with brain imaging). After multivariable adjustment for baseline demographics, risk factors, and medication use, a lower sPAT, indicating greater vasoconstriction, a higher inferior frontal lobe activation with MS, and increases in norepinephrine and IL-6 levels with MS were all independently associated with greater time to complete Trail B test.-38.4pt Conclusion: In response to acute MS, greater peripheral vasoconstriction, higher inferior frontal lobe brain activation, and increases in the levels of norepinephrine and IL-6 are associated with worse executive function.

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“…Traumatic events during childhood are a well-known risk factor for FMS that also has the potential to alter brain activation patterns [70]. Cognitive coping mechanisms including reappraisal were identified to contribute to resilience in children with a history of maltreatment.…”

Section: Discussionmentioning

confidence: 99%

Clustering fibromyalgia patients: A combination of psychosocial and somatic factors leads to resilient coping in a subgroup of fibromyalgia patients

Braun

Evdokimov

Frank

et al. 2020

Preprint

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Background: Coping strategies and their efficacy vary greatly in patients suffering from fibromyalgia syndrome (FMS). Objective: We aimed to identify somatic and psychosocial factors that might contribute to different coping strategies and resilience levels in FMS. Subjects and methods: Standardized questionnaires were used to assess coping, pain, and psychological variables in a cohort of 156 FMS patients. Quantitative real-time polymerase chain reaction (qRT-PCR) determined gene expression of selected cytokines in white blood cells of 136 FMS patients and 25 healthy controls. Data of skin innervation, functional and structural sensory profiles of peripheral nociceptive nerve fibers of a previous study were included into the statistics. An exploratory factor analysis was used to define variance explaining factors, which were then included into cluster analysis. Results: 54.9% of the variance was explained by four factors which we termed (1) affective load, (2) coping, (3) pain, and (4) pro-inflammatory cytokines (p < 0.05). Considering differences in the emerged factors, coping strategies, cytokine profiles, and disability levels, 118 FMS patients could be categorized into four clusters which we named maladaptive, adaptive, vulnerable, and resilient (p < 0.05). The adaptive cluster had low scores in disability and in all symptom categories in contrast to the vulnerable cluster, which was characterized by high scores in catastrophizing and disability (p < 0.05). The resilient vs. the maladaptive cluster was characterized by better coping and a less pro-inflammatory cytokine pattern (p < 0.05). Conclusion: Our data suggest that problem- and emotion-focused coping strategies and an anti-inflammatory cytokine pattern are associated with reduced disability and might promote resilience. Additional personal factors such as low anxiety scores, ability of acceptance, and persistence further favor a resilient phenotype. Individualized therapy should take these factors into account.

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

Cited by 21 publications

References 94 publications

Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient

Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient

Neurobiological Pathways Linking Acute Mental Stress to Impairments in Executive Function in Individuals with Coronary Artery Disease

Clustering fibromyalgia patients: A combination of psychosocial and somatic factors leads to resilient coping in a subgroup of fibromyalgia patients

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