Evaluation the Neurobiological Correlates of Vasoconstriction during Emotional Stress 公开

Abstract

The influence of acute psychological stress on cardiovascular disease is an emerging public health concern.The brain mechanisms through which acute emotional stress leads to peripheral vasoconstriction are not clear. Understanding the relationship between brain perfusion and vasoconstriction during mental stress may ultimately help guide therapies for patients with abnormal stress reactivity. We hypothesize that patients who vasoconstrict more will have less blood flow in prefrontal cortex and cingulate cortex, as well as increased blood flow in insula during stress compared to rest. A retrospective case control study was performed. A group of 59 patients with a history of coronary artery disease (CAD) from Emory University Hospital, Grady Memorial Hospital and Atlanta VA Medical Center was selected. Microvascular vasoconstriction was measured with EndoPAT^TM device. All patients underwent 8 positron emission tomography (PET) scans of the brain, including 4 at control scans and 4 with mental stress scans.The results of our findings are that vasoconstriction during acute mental stress is associated with increased activation in several brain areas, including theleft parietal lobe, left temporal lobe, left occipital lobe, left frontal lobe and left insula. Additionally, it is associated with deactivations in the right parietal lobe,right temporal lobe, and right frontal lobe. More research should be done to understand the significance of these findings in clinical practice to decrease stress-induced microvascular dysfunction.

Table of Contents

Introduction ...............................................................................................................1 

Methods .....................................................................................................................2 

Population ..................................................................................................................2

Measurement of Vasoconstriction using Peripheral Arterial Tonometry ...........................3

Brain Imaging .............................................................................................................3

Statistical Analysis......................................................................................................4 

Results .......................................................................................................................5 

Discussion ..................................................................................................................7 

Appendices ...............................................................................................................10 

Table 1. Descriptive analysis for predictor and controlled variables ...............................10

Table 2. Multivariate Model of Predictors of Microvascular Function .............................12

Table3. Increased Blood Flow with Stress Compared to Rest in Cases vs. Controls .............................................................13

Table 4. Reduced Blood Flow with Stress compared to Rest in Cases vs. Controls ..............................................................15

Figure1. A diagram showing the pathway by which the brain area might influence the vasoconstriction ............................16

Figure 2. Stress Activations – Pointer on left temporal lobe (largest cluster) ....................................................................17

Figure 3. Stress Deactivations – Right Frontal Lobe (largest cluster, most significant) ......................................................18 

Reference ...................................................................................................................................................................19 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
关键词	brain imaing Vasoconstriction
Committee Chair / Thesis Advisor	Shah, Amit J, Emory University

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