Sex differences in brain activation patterns with mental stress in patients with coronary artery disease

• Type of Material: Article
• Authors: Nicole Kasher, Emory University; Matthew T. Wittbrodt, Emory University; Zuhayr S. Alam, Emory University; Bruno B. Lima, Emory University; Jonathon Nye, Emory University; Carolina Campanella, Emory University; Stacy Ladd, Emory University; Muhammad Hammadah, Emory University; Amit Shah, Emory University; Paolo Raggi, Emory University; Arshed Quyyumi, Emory University; Viola Vaccarino, Emory University; J. Douglas Bremner, Emory University
• Language: English
• Date: 2019-07-12
• Publisher: BMC (part of Springer Nature)
• Publication Version: Final Published Version
• Copyright Statement: © 2019 The Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s13293-019-0248-4
• Title of Journal or Parent Work: Biology of Sex Differences
• ISSN: 2042-6410
• Volume: 10
• Issue: 1
• Start Page: 35
• End Page: 35
• Grant/Funding Information: Additional support came from NIH grants R01 HL088726, K24 MH076955, T32 MH067547, R01 MH56120, K24 HL077506, R01 HL068630, R01 HL109413, K23 HL127251, R01 HL125246, and S10 RR16917.; This research was supported by NIH research grant P01 HL101398.
• Keywords: FUNCTIONAL CONNECTIVITY; PERCEIVED STRESS; MEDIAL PREFRONTAL CORTEX; WORKING-MEMORY; AMYGDALA RESPONSE; HEART-DISEASE; Life Sciences & Biomedicine; GLOBAL BURDEN; Science & Technology; Endocrinology & Metabolism; RISK-FACTORS; YOUNG-PATIENTS; Genetics & Heredity; ACUTE MYOCARDIAL-INFARCTION
• Research Categories: Biology, Neuroscience; Health Sciences, Radiology; Health Sciences, Epidemiology

Abstract

Background: Stress is an important contributor to myocardial ischemia and the progression of coronary artery disease (CAD), and women are more susceptible than men to these effects. Little is known, however, about the neural basis of these sex differences. Methods: We investigated sex differences in neural correlates of mental stress in a sample of 53 female and 112 male participants (N = 165) with CAD, with and without mental stress-induced myocardial ischemia (MSI), during exposure to mental arithmetic tasks and public speaking stress tasks using high-resolution positron emission tomography (HR-PET) and radiolabeled water imaging of the brain. Results: Women compared to men had significantly greater activation with stress in the right frontal (BA 9, 44), right parietal lobe (Area 3, 6, 40), right posterior cingulate gyrus (BA 31), bilateral cerebellum, and left temporal/fusiform gyrus (BA 37) and greater deactivation in bilateral anterior cingulate gyrus (BA 24, 32), bilateral medial frontal gyrus (BA 6, 8, 9, 10), right parahippocampal gyrus, and right middle temporal gyrus (BA 21). Women with MSI (but not those without MSI) showed significantly greater activation than men in the right posterior cingulate gyrus (BA 31) and greater deactivation in several frontal and temporal lobe areas. Conclusion: Men and women with CAD show differences in responses to stress in brain limbic areas that regulate emotion, and these functional responses differ by MSI status. Our results suggest that the cingulate gyrus may be involved in sex differences in MSI.