Summary: Takotsubo syndrome, a sudden form of acute heart failure often brought on by emotional or physical stress, is associated with changes in brain regions associated with emotion and emotional processing.
Source: University of Aberdeen
Changes in areas of the brain associated with emotions have been identified in people with Takotsubo syndrome, sometimes known as broken heart syndrome, according to a study from the University of Aberdeen.
The study, presented at the British Cardiovascular Society’s centenary conference in Manchester, also found changes in the level of brain activity in areas known to control the beating of the heart.
Takotsubo syndrome is a sudden form of acute heart failure which is estimated to affect up to 5,000 people in the UK each year and is mainly seen in postmenopausal women. It can cause the same symptoms as a heart attack, and although the arteries leading to the heart are not blocked, the risk of complications is similar to that of a real heart attack.
It is not yet fully understood what causes Takotsubo syndrome, but it is usually brought on by emotional or physical stress such as the loss of a loved one, hence the name broken heart syndrome.
Dr Hilal Khan, Clinical Research Fellow at the University of Aberdeen, said: “We have known for years that there is a connection between the brain and the heart, but the role this plays in Takotsubo is a mystery. For the first time, we have revealed changes in brain regions responsible for controlling the heart and emotions. Further work will be needed to determine if these changes cause Takotsubo syndrome.
“We hope that with more research we can determine which treatments are most effective. We already hope to explore the impact of cardiac rehabilitation and psychotherapy on brain structure and function after Takotsubo to ultimately improve the care of these patients.
In the most detailed study of its kind, scientists examined the brains of 25 patients who had experienced an episode of Takotsubo within the previous five days. They used brain MRI scans to measure brain volume, surface area, and communication signals between different areas of the brain. They then compared these results with control patients matched for age, sex and other medical conditions.
They found that there were fewer connections in the thalamus, amygdala, insula and basal ganglia of Takotsubo patients compared to healthy people. These are areas of the brain involved in the regulation of higher level functions such as emotions, thought, language, stress responses and heart control.
The researchers also found that the thalamus and insula areas of the brain were enlarged, while the total volume of the brain, including the amygdala and brainstem, was smaller than that of healthy people.
The team now plans to perform follow-up brain MRIs on the same patients to track the natural course of Takotsubo in the brain. They are also scanning the brains of heart attack patients in hopes of determining if Takotsubo syndrome causes changes in the brain or if the changes cause Takotsubo syndrome.
Professor James Leiper, Associate Medical Director at the British Heart Foundation, said: “Takotsubo syndrome is a sudden and potentially catastrophic heart condition that has only been recognized in recent years. Our understanding of the disease is still in its infancy, so it is essential that we learn more about this neglected area of cardiology.
“This research is a significant advance in our understanding of how the brain and heart are intertwined in this enigmatic condition, and how an emotional event can lead to heart failure.”
Carol Duncan, 73, from Aberdeen, is part of the study as she suffered an episode of Takotsubo after her brother fell ill and was admitted to intensive care. She said: “Because Takotsubo can be triggered by an emotional event, there’s a misconception that it’s just in your head. Knowing that researchers have seen measurable changes in my scans makes me feel like we are getting closer to the fact that Takotsubo is considered a physical condition.
“I am very happy to have participated in this research. It really gives me hope that scientists are moving towards a full understanding and better treatment for this misunderstood disease.
About this Heart Health and Emotions Research News
Original research: The results will be presented at the British Cardiovascular Society meeting
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