Open AccessNeurobiological Pathways Linking Acute Mental Stress to Impairments in Executive Function in Individuals with Coronary Artery Disease
Author(s) -
Kasra Moazzami,
Matthew T. Wittbrodt,
Bruno B Lima,
Jeong Hwan Kim,
Zakaria Almuwaqqat,
Amit Shah,
Ihab Hajjar,
Felicia C. Goldstein,
Aĺlan I. Levey,
Jonathon A. Nye,
J. Douglas Bremner,
Viola Vaccarino,
Arshed A. Quyyumi
Publication year - 2021
Publication title -
journal of alzheimer's disease reports
Language(s) - English
Resource type - Journals
ISSN - 2542-4823
DOI - 10.3233/adr-200287
Subject(s) - medicine , cardiology , population , vasoconstriction , frontal lobe , coronary artery disease , peripheral , psychiatry , environmental health
Background: Individuals with coronary artery disease (CAD) have worse executive function compared to the general population but the mechanisms are unknown. Objective: To investigate the role of acute mental stress (MS) on the executive function of patients with CAD. Methods: Participants with stable CAD underwent acute MS testing with simultaneous peripheral vascular function measurements and brain imaging using high resolution-positron emission tomography. Digital pulse wave amplitude was continuously measured using peripheral artery tonometry (PAT, Itamar Inc). Stress/rest PAT ratio (sPAT) of pulse wave amplitude during MS/baseline was calculated as a measure of microvascular constriction during MS. Plasma levels of catecholamine and interleukin-6 were assessed at baseline and after MS. Executive function was assessed both at baseline and at 2 years follow-up using the Trail Making Test parts A and B. Results: We studied 389 individuals with brain data available for 148 participants. Of this population follow-up cognitive assessments were performed in 226 individuals (121 with brain imaging). After multivariable adjustment for baseline demographics, risk factors, and medication use, a lower sPAT, indicating greater vasoconstriction, a higher inferior frontal lobe activation with MS, and increases in norepinephrine and IL-6 levels with MS were all independently associated with greater time to complete Trail B test.-38.4pt Conclusion: In response to acute MS, greater peripheral vasoconstriction, higher inferior frontal lobe brain activation, and increases in the levels of norepinephrine and IL-6 are associated with worse executive function.