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Mental Stress-Induced Brain Activation Linked to Angina

MONDAY, Aug. 10, 2020 -- Mental stress-induced inferior frontal lobe activation is associated with angina among patients with coronary artery disease, according to a study published online Aug. 10 in Circulation: Cardiovascular Imaging.

Kasra Moazzami, M.D., M.P.H., from the Rollins School of Public Health at Emory University in Atlanta, and colleagues conducted acute mental stress testing among 148 individuals with stable coronary artery disease using a series of standardized speech/arithmetic stressors in conjunction with high-resolution positron emission tomography brain imaging. The association between blood flow to the inferior frontal lobe, assessed as a ratio compared with whole brain flow, and angina frequency was examined.

The researchers found that in a model adjusted for baseline demographics, angina frequency increased 13.7 units at baseline and 11.6 units during follow-up for every doubling in the inferior frontal lobe activation. Overall, 40.0 and 13.1 percent of the total effect of inferior frontal lobe activation on angina severity was due to mental stress-induced ischemia and activation of other brain pain-processing regions (thalamus, insula, and amygdala), respectively.

"Although more research is needed, these results may potentially shift the paradigm by which angina is evaluated by refocusing clinical evaluation/management of psychological stress as adjunct to traditional cardiac evaluations," the authors write.

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