Takotsubo syndrome is a sudden form of acute heart failure. It is also known as broken heart syndrome. The causes of this syndrome remain poorly understood, but it is usually brought on by emotional or physical stress, such as the loss of a loved one.
New research by the University of Aberdeen identified changes in areas of the brain associated with emotion in people with Takotsubo syndrome. They also discovered differences in the level of brain activity in areas known to control the beating of the heart.
Dr. Hilal Khan, Clinical Research Fellow at the University of Aberdeen, said: “For years, we’ve known that there is a link between the brain and the heart, but the role this plays in Takotsubo has been a mystery. For the first time, we’ve revealed changes in the brain regions responsible for controlling the heart and emotions. Further work will be required to determine if these changes cause Takotsubo syndrome.”
“We hope that with more research, we can determine which treatments are the most effective. We already hope to explore the impact cardiac rehabilitation and psychotherapy have on the structure and function of the brain after Takotsubo to improve the care of these patients ultimately.”
In this study, scientists looked at the brains of 25 patients who had suffered an episode of Takotsubo in the previous five days. MRI scans measured brain volume, surface area, and communication signals between different brain regions. They then compared these results with control patients matched for age, gender, and other medical conditions.
They discovered that Takotsubo patients had decreased connections in the thalamus, amygdala, insula, and basal ganglia than healthy people. These parts of the brain control higher-level activities like emotions, reasoning, language, stress responses, and heart control.
They also found that the thalamus and insula areas of the brain were enlarged. In contrast, the total brain volume, including the amygdala and the brainstem, was smaller than healthy people.
The scientists will now conduct follow-up brain MRI scans on the same patients to track Takotsubo’s natural progression in the brain. They’re also scanning the brains of heart attack victims to determine if Takotsubo syndrome causes brain alterations 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 which has only been recognized in recent years. Our understanding of the condition is still in its infancy, so we must learn more about this neglected area of cardiology.”
“This research is a significant step forward in understanding how the brain and the heart are intricately linked 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 ICU. She said: “Because Takotsubo can be triggered by an emotional event, there is a misconception that it is just in your head. Knowing that researchers saw measurable changes in my scans makes me feel we are getting closer to Takotsubo being considered a physical condition.”
“I am so pleased to have taken part in this research. It gives me hope that scientists are moving towards fully understanding and better treating this misunderstood condition.”