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Amygdalar activity and cardiovascular events

Biopsychology of Stress

Interpretetion

  • resting metabolic activity within the amygdala, a key component of the brain’s salience network involved in stress, significantly predicts the development of cardiovascular disease independently of established cardiovascular risk factors.
  • that amygdalar activity is associated with increased haemopoietic activity and increased arterial inflammation.
  • the link between amygdalar activity and cardiovascular disease events was substantially mediated by arterial inflammation

Methods

Procedure

Design&

Participants

Procedure

as coronary death, myocardial infarction, coronary insufficiency, angina, cerebrovascular accidents, revascularisation, peripheral artery disease, and heart failure.

Longitudinal

  • Two cardiologists blinded to PET/CT data used clinical records to adjudicate cardiovascular disease events

F-FDG (Fluorodeoxyglucose) was given intravenously after an overnight fast -> PET/CT

Image analyses (appendix) were done by a radiologist (AI) who was blinded to the clinical data and used a dedicated workstation.

Design

Cross-sectional

2 imaging studies

  • N 13 with increased burden of chronic stress (history of PTSD) were recruited from the community

  • completedten-item Perceived Stress Scale (PSS-10) and underwent 18F-FDG PET.

  • Amygdalar activity, C-reactive protein (CRP), and arterial inflammation were measured

Hypothesis:

Perceived stress is associated with resting amygdalar metabolic activity, arterial inflammation, and inflammatory biomarkers.

Cross-sectional

psychometric measures of perceived stress, resting amygdalar metabolic activity, and atherosclerotic inflammation.

N = 13

Longitudinal

resting amygdalar metabolic activity, atherosclerotic inflammation, and subsequent cardiovascular events

N = 293

  • no cancer disease history
  • no cardiovascular disease history
  • at least three clinical encounter notes

Background

Findings

  • Chronic stress is associated with an increased risk of cardiovascular disease

  • Activation of salience network (incl. the amygdala as a key) leads to hormonal, autonomic, and behavioural changes typically associated with fear and stress.

  • no studies have yet shown whether amygdalar activation precedes and predisposes to the subsequent development of cardiovascular events.

Stress prompts activation of

1. the sympathetic nervous system

2. hypothalamic–pituitary– adrenal axis, leading to increases in circulating

catecholamines, glucocorticoids, and (eventually) inflammatory cytokines.

3. + stress can increase heart rate and blood pressure via the autonomic nervous system, all of

Anna Dudka,

Goethe University Frankfurt, WiSe 23/24, 25.01

Tawakol, A., Ishai, A., Takx, R. A., Figueroa, A. L., Ali, A., Kaiser, Y., ... & Pitman, R. K. (2017). Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study. The Lancet, 389(10071), 834-845.

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