Brain correlates of stress-induced peripheral vasoconstriction in patients with cardiovascular disease

• Type of Material: Article
• Authors: Amit Shah, Emory University; Chuqing Chen, Boehringer Ingelheim Pharmaceut; Carolina Campanella, Well Living Lab; Nicole Kasher, Emory University; Sarah Evans, Emory University; Collin Reiff, Emory University; Sanskriti Mishra, Emory University; Muhammad Hammadah, Emory University; Bruno B. Lima, Emory University; Kobina Wilmot, Emory University; Ibhar Al Mheid, Emory University; Ayman Alkhoder, Emory University; Nino Isakadze, Emory University; Oleksiy Levantsevych, Emory University; Pratik M. Pimple, Emory University; Ernest V Garcia, Emory University; Matthew Wittbrodt, Emory University; Jonathon Nye, Emory University; Laura Ward, Emory University; Tene Lewis, Emory University; Michael Kutner, Emory University; Paolo Raggi, Emory University; Arshed Quyyumi, Emory University; Viola Vaccarino, Emory University; J. Douglas Bremner, Emory University
• Language: English
• Date: 2019-02-01
• Publisher: WILEY
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 Society for Psychophysiological Research
• Final Published Version (URL): http://dx.doi.org/10.1111/psyp.13291
• Title of Journal or Parent Work: PSYCHOPHYSIOLOGY
• Volume: 56
• Issue: 2
• Start Page: e13291
• End Page: e13291
• Grant/Funding Information: This study was supported by NIH research grant to AQ P01 HL101398. Additional support came from NIH grants to AJS K23 HL127251; to JDB R01 HL088726, K24 MH076955, T32 MH067547–01, R01 MH56120, S10 RR016917; and to LVV K24 HL077506, R01 HL109413, R01 HL125246, and R01 HL068630. Additionally, support was obtained from the American Heart Association 15SDG25310017.
• Keywords: MENTAL STRESS; PREFRONTAL CORTEX; Neurosciences; PET/SPECT; Psychology, Experimental; HEART-RATE-VARIABILITY; INDUCED-MYOCARDIAL-ISCHEMIA; cardiovascular; Psychology; RISK-FACTORS; Life Sciences & Biomedicine; METAANALYSIS; Social Sciences; CONDITIONED FEAR; Psychology, Biological; neuropsychology; Physiology; stress; DISORDER; EXTINCTION; Neurosciences & Neurology; Science & Technology; INSULA
• Research Categories: Psychology, Experimental; Health Sciences, Medicine and Surgery; Psychology, Psychobiology; Biology, Neuroscience

Abstract

The influence of acute psychological stress on cardiovascular disease is an emerging public health concern. Identification of brain mechanisms underlying this may aid in the discovery of possible treatments. Acute psychological stress may induce arteriolar vasoconstriction and reduce blood flow to vital organs. We hypothesized that functional changes in brain regions involved with memory and autonomic/emotional regulation are implicated in the vasoconstrictive stress response, including the medial prefrontal cortex (anterior cingulate), insula, and dorsolateral prefrontal cortex. Subjects with a history of coronary artery disease (N = 59) underwent measurement of microvascular vasomotor tone with the EndoPAT device and O–15 positron emission tomography (PET) imaging of the brain during exposure to mental stress and control conditions. The peripheral arterial tonometry (PAT) ratio was calculated as the mean peripheral vasomotor tone during stress divided by the mean tone during rest. Whole brain contrasts were performed between groups above and below the median PAT ratio, and significant contrasts were defined with cutoff p < 0.005. Stress-induced peripheral vasoconstriction (below median PAT ratio) was associated with increased stress activation in insula and parietal cortex, and decreased activation in the medial prefrontal cortex with stress tasks compared to control tasks. These findings demonstrate that stress-induced vasoreactivity is associated with changes in brain responses to stress in areas involved in emotion and autonomic regulation. These findings have important implications on possible treatments for mental stress-induced vascular toxicity.